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The 2026 European Association of Urology (EAU) Annual Meeting
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| Impact of 89Zr-girentuximab PET Versus Conventional Imaging on Clinical Decision-making in Patients with Indeterminate Renal Masses (ZIRCON-X)
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| David Liu, MD
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| 89Zr‑girentuximab PET/CT, a CAIX‑targeted imaging modality for clear cell RCC, would have changed multidisciplinary management plans in about half of patients with indeterminate renal masses in this post‑hoc ZIRCON analysis. Nearly 40% would have had major shifts, and team confidence increased in roughly one‑third of cases, suggesting this PET approach can both escalate and de‑escalate care more appropriately while reducing unnecessary invasive procedures.
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| [89Zr]Zr-girentuximab PET/CT in the Non-invasive Characterization of Indeterminate Renal Lesions: Initial Real-World Clinical Experience
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| Irene Huebner-Resch, MD
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| [89Zr]Zr-girentuximab PET/CT, a CAIX‑targeted tracer highly specific for clear cell RCC, showed excellent real‑world performance for characterizing indeterminate renal masses, correctly identifying all ccRCC and all benign/non‑cc lesions in the small pathology‑confirmed subset. In this early series, scan results changed management in over half of patients—often enabling active surveillance instead of invasive procedures—supporting its role as a valuable noninvasive tool to guide treatment decisions in ambiguous renal lesions.
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| Impact of Girentuximab Based Radionuclide Imaging in Patients with RCC on Virtual Tumor Board Decision Making: An Interim Analysis
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| T.J. van der Werff, MD
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| Girentuximab-based CAIX imaging meaningfully altered multidisciplinary decisions for suspected RCC, changing the recommended management in about two-thirds of reviewed cases. It often allowed clinicians to omit biopsy and sometimes to switch between active local treatment, surveillance, and systemic therapy, indicating substantial added value for clear cell RCC–focused decision-making.
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| Development of a Novel 68Ga-Labeled Radiotracer Targeting Carbonic Anhydrase IX for Diagnosis of Clear Cell Renal Cell Carcinoma
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| Tonghu Liu
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| 68Ga‑C1 is a novel PET radiotracer that targets CA IX, a molecule highly overexpressed in clear cell RCC, and showed high affinity, specific uptake, and favorable pharmacokinetics in preclinical models. In an initial human series, it demonstrated strong uptake in nearly all clear cell RCC cases (and no uptake in a non–clear cell RCC), suggesting high specificity and potential value for noninvasive diagnosis and restaging of clear cell RCC.
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| First-in-Human Phase I Evaluation of [⁶⁸Ga]Ga-OncoCAIX PET/CT in Clear Cell Renal Cell Carcinoma: Preliminary Diagnostic Performance, Safety and Biodistribution
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| Fabrizia Gelardi, MD, PhD
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| [⁶⁸Ga]Ga-OncoCAIX is a new CAIX‑targeted PET tracer that appears safe, with favorable biodistribution and strong, increasing uptake in suspected tumors while sparing normal renal parenchyma. Early first‑in‑human data suggest it can help distinguish clear cell RCC from benign or non–clear cell lesions, supporting its promise as a noninvasive molecular imaging biomarker for ccRCC.
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| Efficacy and Safety of Padeliporfin VTP in the ENLIGHTED Phase 3 Study for Low-Grade UTUC
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| Asaf Shvero, MD
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| Padeliporfin vascular‑targeted photodynamic therapy (VTP) in the ENLIGHTED phase 3 trial for low‑grade UTUC is showing high local efficacy, with an interim complete response rate around 70% and overall response near 87% after induction, while preserving the kidney. Toxicity has been mostly grade 1–2, with rare, short‑lived grade 3 events such as renal colic or flank pain, supporting padeliporfin VTP as a promising organ‑sparing option pending final phase 3 results and potential regulatory approval.
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| Efficacy and Safety of Disitamab Vedotin Combined with Tislelizumab as Adjuvant Therapy After Radical Surgery for Patients with HER2-Expression UTUC: A Prospective, Controlled, Phase II Study
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| Gu Liangyou, MD
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| This phase II trial found that adjuvant disitamab vedotin plus tislelizumab after nephroureterectomy markedly improved 12‑month disease‑free survival versus platinum‑based chemotherapy in HER2‑expressing UTUC, with mostly grade 1–2 toxicities. Chemotherapy produced far more grade 3–4 hematologic events, suggesting the ADC–IO regimen may offer both superior early efficacy and a more favorable tolerability profile, pending confirmation in a phase III trial.
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| Preliminary Results of a Phase II Study to Evaluate the Efficacy and Safety of Disitamab Vedotin (RC48-ADC) in Combination with Radiotherapy for Adjuvant Therapy in Upper Tract Urothelial Carcinoma
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| Zihao Tao, MD
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| This phase II study suggests that adjuvant disitamab vedotin plus radiotherapy in HER2‑overexpressing, cisplatin‑intolerant UTUC yields a higher 1‑year disease‑free survival than surveillance with manageable toxicity dominated by neuropathy and mild lab changes. Grade ≥3 treatment‑related events were infrequent and included gastrointestinal hemorrhage and peripheral neuropathy, supporting this antibody–drug conjugate–RT combination as a feasible organ‑preserving adjuvant strategy that merits confirmation with longer follow‑up and full enrollment.
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| Circulating and Urine Tumor DNA Dynamics Predict Minimal Residual Disease and Recurrence Risk in Locally Advanced UTUC: CURATE-UTUC – A Multicenter Prospective Longitudinal Cohort Study
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| Jiwei Huang, MD, PhD
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| CURATE‑UTUC shows that tumor‑informed ctDNA and utDNA can flag molecular residual disease and site‑specific recurrence risk months before imaging in locally advanced UTUC. Early postoperative ctDNA positivity and especially on‑treatment positivity (T2) strongly enrich for extravesical relapse, while T2 utDNA positivity tracks intravesical recurrence, enabling much sharper risk stratification than clinicopathologic factors alone.
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| Society of Urologic Oncology (SUO) Lecture: Rare Renal Tumors: What Should the General Urologist Know?
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| Brian Shuch, MD
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| Rare renal tumors now span more than 20 WHO‑recognized subtypes, so urologists must use detailed histology and molecular profiling to decide between surveillance, partial or radical nephrectomy, and systemic therapy rather than treating all “RCC” alike. Many small “guppy/goldfish” lesions are benign or indolent, whereas “piranha/shark” tumors are aggressive and often hereditary, making prompt genetic evaluation and cascade testing crucial for both patient management and family screening.
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| Ongoing Trials in Rare Genitourinary Cancers
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| Fernando Maluf, MD, PhD
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| Fernando Maluf highlighted that rare GU cancers, especially advanced penile squamous cell carcinoma, have huge unmet needs but now have more dedicated trials, led by the HERCULES study where pembrolizumab plus platinum chemotherapy achieved about a 40% response and earned guideline listing as a first-line option. He emphasized that a growing pipeline of neoadjuvant, maintenance, second-line, and basket trials using IO, ADCs, and targeted agents makes trial enrollment—particularly in high‑prevalence regions and expert centers—crucial to improving outcomes.
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