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Highlights from the 2026 ASCO Genitourinary Cancers Symposium
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| Reimaging Cancer Research and Care in the Age of Artificial Intelligence
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| Eliezer Van Allen, MD
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| Eliezer Van Allen’s ASCO GU 2026 keynote outlined how artificial intelligence can transform cancer research and care across three questions: understanding cancer biology (“why”), tailoring care for individual patients (“for whom”), and implementing these tools ethically and at scale (“how”). He highlighted biologically informed models that open the “black box” between tumor genomes and lethal disease, patient-similarity AI to enable real-time learning health systems, and AI-ready cancer centers and policy frameworks as essential infrastructure.
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| Final Overall Survival Results from the EORTC 1333/PEACE-3 Trial: Enzalutamide with or Without Radium-223 in Metastatic Castration-Resistant Prostate Cancer
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| Enrique Gallardo, MD
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| In the phase 3 EORTC 1333/PEACE-3 trial, adding six cycles of radium-223 to enzalutamide for men with mCRPC and bone metastases produced a statistically significant overall survival gain and confirmed a radiographic PFS benefit compared with enzalutamide alone, with a modest increase in grade 3–5 adverse events but no new major safety signals. The OS advantage was generally consistent across subgroups, and longer follow-up continues to show separated curves despite early crossing, supporting enzalutamide plus radium-223 as an effective—though slightly more toxic—option for appropriately selected men with bone-predominant mCRPC.
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| BRCAAway: Overall Survival from the Phase 2 Trial of Abiraterone, Olaparib, or Abiraterone + Olaparib in First-Line mCRPC with DNA Repair Defects
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| Maha Hussain, MD
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| Maha Hussain presented the BRCAAway trial which showed that in men with mCRPC harboring BRCA1/2 or ATM alterations, first-line abiraterone + prednisone + olaparib produced higher response rates, longer progression-free survival, and the best overall survival compared with abiraterone alone, olaparib alone, or crossover sequencing.
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| POSEIDON: Hormone Therapy Use and Duration with Post-Operative Radiotherapy for Recurrent Prostate Cancer – an Individual Patient Data Meta-Analysis
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| Amar Kishan, MD
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| POSEIDON pooled individual patient data from six phase 3 trials and found that adding hormone therapy to post‑operative radiotherapy for recurrent prostate cancer did not yield a clear overall survival benefit overall, though metastasis-free survival improved. The analysis suggests that androgen suppression may only meaningfully help men with higher pre‑RT PSAs, and that for most patients, short‑term rather than prolonged hormone therapy is likely sufficient when used with salvage radiotherapy.
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| 15-Year Survival Analysis from the ASCENDE-RT Randomized Trial of External Beam Boost Versus Brachytherapy Boost in Localized Prostate Cancer
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| Scott Tyldesley, MD, MPA, ABR, FRCPC
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| ASCENDE-RT’s 15-year update shows that while a brachytherapy boost markedly improves long-term biochemical control, it does not translate into a clear overall survival advantage over external beam boost in this older, comorbid localized prostate cancer population. Prostate cancer–specific deaths were numerically lower with brachytherapy, but attribution and power limitations mean any survival benefit is likely modest even with large gains in freedom from biochemical failure.
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| Making Sense of Many Options: Metastatic Hormone Sensitive Prostate Cancer Treatment Selection
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| Christopher Sweeney, MBBS
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| Christopher Sweeney’s ASCO GU 2026 talk emphasizes that in metastatic hormone‑sensitive prostate cancer, virtually all fit patients should get ADT plus an ARPI, with docetaxel and other agents added selectively rather than universally. He advocates moving toward biomarker‑ and PSA‑response–guided intensification and de‑escalation strategies to match treatment intensity to individual risk while limiting long‑term toxicity.
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| Evaluation and Definition of Response and Progression From Trials to Clinical Practice
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| Andrew Armstrong, MD, MSc
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| Andrew Armstrong’s ASCO GU 2026 talk outlines how updated PCWG4 recommendations are reshaping how we define response and progression in advanced prostate cancer, moving beyond PSA alone to integrate imaging (including PSMA PET), clinical endpoints, and blood-based biomarkers.
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| New Treatment Options for Patients With Castrate-Resistant Prostate Cancer OR Androgen Pathway Modulator Resistant Cancer
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| Dana Rathkopf, MD
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| Dana Rathkopf presents the mCRPC “ABC” framework, with AR pathway inhibitors as the backbone, biomarker‑ and bone‑targeted therapies layered on top, and chemotherapy when needed—while adding a new wave of “D” options like radioligand platforms, ADCs, T‑cell engagers, AR degraders, and epigenetic/AKT/DNA repair agents. As choices multiply, she argues that treatment must be increasingly personalized using molecular profiling, advanced imaging, and an understanding of resistance and lineage plasticity, with rational combinations and sequencing to maximize benefit while preserving quality of life.
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