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Highlights from the 2026 American Urologic Association (AUA) Annual Meeting
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| Evaluating the Surrogacy of Intermediate Clinical Endpoints for Overall Survival after Perioperative Treatment in MIBC Patients Undergoing Radical Cystectomy
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| Pietro Scilipoti, MD
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| Pietro Scilipoti's AUA 2026 meta-analysis of 23 perioperative MIBC trials found that event-free survival met formal surrogacy criteria for overall survival in neoadjuvant settings and in sensitivity analyses excluding high-bias trials, supporting its use as a primary or co-primary endpoint in future trials.
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| Real World Outcomes of Enfortumab Vedotin in Patients with Advanced Urothelial Carcinoma Ineligible for Clinical Trials
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| Naoto Wakita, MD
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| Naoto Wakita's AUA 2026 real-world study of 180 advanced urothelial carcinoma patients found that trial-ineligible patients had significantly shorter median PFS and OS compared to trial-eligible patients, with lower objective response rates. However, safety profiles were comparable between groups, and poor performance status and anemia—but not renal impairment—were associated with worse survival, suggesting enfortumab vedotin remains a feasible treatment option even in trial-ineligible patients.
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| Adding Upfront, Perioperative Durvalumab vs Adopting Risk-Adapted Adjuvant Nivolumab? Cost-Effectiveness Analysis of Competing Treatment Strategies for Cisplatin-Eligible MIBC in the Era of Immune Checkpoint Inhibitors
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| Zhuo Su, MD
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| Zhuo Su's cost-effectiveness analysis showed that perioperative durvalumab (neoadjuvant durvalumab + gemcitabine + cisplatin plus adjuvant durvalumab) was both more effective and less expensive than neoadjuvant chemotherapy followed by risk-adapted adjuvant nivolumab in cisplatin-eligible MIBC, with greater QALYs and lower total costs, supporting it as a cost-effective new standard of care.
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| Perioperative and Oncologic Outcomes of Consolidative Surgery for Advanced Urothelial Carcinoma Following Induction Enfortumab Vedotin and Pembrolizumab: A Multicenter Experience
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| Daniel Roberson, MD
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| Daniel Roberson's AUA 2026 multicenter study of 53 patients who underwent consolidative surgery after induction enfortumab vedotin + pembrolizumab for advanced urothelial carcinoma found high rates of pathologic downstaging, including 37.7% pathologic complete response, with acceptable perioperative morbidity. With median 6-month follow-up, 12-month recurrence-free survival was 82.8%, suggesting consolidative surgery after EV+P is safe, feasible, and associated with promising early oncologic outcomes in carefully selected patients with advanced urothelial carcinoma.
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| Differences in Patient-Reported and Objective Functional Recovery Trajectories Following Radical Cystectomy: Findings from the UW Prospective Bounceback Cohort Study
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| Matthew Kirschenbaum,
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| Matthew Kirschenbaum's prospective study of 69 patients aged ≥60 undergoing radical cystectomy found that patient-reported instrumental activities of daily living declined sharply at 2 weeks and recovered by 3 months, while objective Short Physical Performance Battery scores showed minimal change. Baseline frailty was associated with worse patient-reported functional recovery trajectories but not with objective performance measures, suggesting that standard performance testing may systematically misclassify patient-reported function and that the two measures capture distinct aspects of postoperative recovery.
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| Evaluating Effect of Prior Checkpoint Inhibitor Exposure on Disease Control with Enfortumab Vedotin + Pembrolizumab in First-Line Metastatic Bladder Cancer
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| Michael Jalfon, MD
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| Michael Jalfon's retrospective study of 86 patients with metastatic urothelial carcinoma treated with first-line EV+P found that prior checkpoint inhibitor exposure significantly reduced early response rates and shortened treatment failure-free survival among responders. These findings demonstrate that prior adjuvant immunotherapy, such as nivolumab after radical cystectomy, may attenuate the efficacy of subsequent pembrolizumab-containing regimens in the metastatic setting.
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| Patient-Reported Recovery Trajectories Following Radical Cystectomy: Findings from the UW Prospective Bounceback Cohort Study
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| Matthew Kirschenbaum
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| Matthew Kirschenbaum's AUA 2026 Bounceback study of 69 patients aged ≥60 found that baseline frailty strongly predicted multidomain recovery trajectories after radical cystectomy: the least frail experienced sharp early declines but returned to ~95% of baseline by 3 months, while the frailest started lowest yet were the only group to improve beyond baseline across all domains, with longer hospital stays and greater need for mobility aids, underscoring the importance of frailty-informed perioperative planning.
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| How to Assess Response After Perioperative Enfortumab Vedotin and Pembrolizumab in MIBC
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| Elaine Lam, MD
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| Elaine Lam's AUA 2026 presentation reviewed the transformative impact of perioperative enfortumab vedotin plus pembrolizumab in muscle-invasive bladder cancer, highlighting pathologic complete response rates of 57.1% in cisplatin-ineligible patients and 55.8% in cisplatin-eligible patients—among the highest ever reported and substantially exceeding historical chemotherapy benchmarks.
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