🚨⭐ #ESMO26 | GU ONCOLOGY — DAY 2 HIGHLIGHTS
@urologysummit
A major day for both #BladderCancer and #ProstateCancer — with one message coming through clearly:
intensification only matters when it delivers durable, clinically meaningful benefit.
🟠 VOLGA | LBA2 — MIBC
Perioperative durvalumab + neoadjuvant EV in cisplatin-ineligible/refusing MIBC:
✅ 2-year EFS: 64% vs 45% | HR 0.51
✅ 2-year OS: 78% vs 69% | HR 0.58
Important survival signal — but not a head-to-head comparison with EV + pembrolizumab.
🔵 DASL-HiCaP | LBA4
Darolutamide + ADT + RT in very-high-risk prostate cancer:
✅ 4-year MFS: 95% vs 88% | HR 0.42
OS remains immature; still investigational.
🔵 PEACE-1 | 2215O
After 7.7 years of follow-up in de novo mCSPC:
✅ Median OS: 6.2 vs 4.4 years
✅ 8-year OS: 40.3% vs 27.1%
This is what durable treatment intensification looks like.
🔵 PROTEUS substudy | LBA53
Perioperative apalutamide + ADT around prostatectomy:
✅ EFS HR 0.38
Promising — but longer follow-up and setting-specific interpretation are essential.
🧬 STAMPEDE / Decipher | 2045O
Genomic risk may help identify who derives greater benefit from abiraterone for distant-metastasis prevention.
Interesting biomarker signal — not yet a basis for de-escalation.
🟠 NIAGARA molecular analysis | 4741RO
Exploratory EFS signals across molecular subtypes, including basal-squamous disease.
Still no validated biomarker to withhold perioperative durvalumab.
🟠 EV-103 | 4740RO
Long-term EV + pembrolizumab follow-up:
✅ Estimated 5-year OS: 33%
Durability matters — and so does late toxicity.
🟠 GDFATHER-NEO | 4757RO
Visugromab + nivolumab:
✅ pCR: 33.3% vs 7.7%
Intriguing, but exploratory in a small dataset.
⭐ MY CLINICAL PEARL
Not every form of intensification is equal.
What matters is proven survival or metastasis prevention, weighed against toxicity, patient selection, quality of life, and long-term treatment burden.
Precision + durable benefit — not just higher response rates.
@gbanna74 @ravikanesvaran @neerajaiims @PGrivasMDPhD @Sebastiano_Buti @dmukherji @alison_tree @DrYukselUrun @yekeduz_emre @AgrawalTrush
#GUOncology #MIBC #mCSPC #PrecisionOncology #OncoAlert
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Perioperative durvalumab with or without tremelimumab plus neoadjuvant enfortumab vedotin in muscle-invasive bladder cancer: Results from the phase 3 VOLGA trial
https://esmocongress.esmo.orgVOLGA
https://esmocongress.esmo.org🚨⭐ #ESMO26 | GU ONCOLOGY — DAY 2 HIGHLIGHTS A major day for bladder and prostate cancer: practice-relevant phase III data, longer survival follow-up and new molecular clues. 🟠 VOLGA | LBA2 — A pivotal MIBC result In cisplatin-ineligible/refusing MIBC, perioperative durvalumab + neoadjuvant enfortumab vedotin vs radical cystectomy ± approved adjuvant therapy: ✅ 2-year EFS: 64% vs 45% | HR 0.51 ✅ 2-year OS: 78% vs 69% | HR 0.58 A meaningful survival signal, but not a head-to-head comparison with EV + pembrolizumab. 🔵 DASL-HiCaP | LBA4 — Intensification with radiotherapy Darolutamide + ADT + RT improved 4-year metastasis-free survival to 95% vs 88% (HR 0.42) in very-high-risk prostate cancer. OS remains immature; this use is investigational. 🔵 PEACE-1 | 2215O — Durability matters After 7.7 years' follow-up in de novo mCSPC, ADT + docetaxel + abiraterone delivered median OS of 6.2 vs 4.4 years (HR 0.68). Eight-year OS: 40.3% vs 27.1%. 🔵 PROTEUS substudy | LBA53 Perioperative apalutamide + ADT around prostatectomy vs surgery alone in high-risk localised disease: ✅ EFS HR 0.38 (n=408). Promising but setting-specific evidence; longer follow-up matters. 🧬 STAMPEDE / Decipher | 2045O Genomic risk may help identify patients deriving greater benefit from abiraterone for distant-metastasis prevention. Retrospective biomarker evidence—not yet a mandate to de-escalate. 🟠 NIAGARA molecular analysis | 4741RO Exploratory EFS signals across several molecular subtypes, including basal-squamous disease. No validated biomarker yet to withhold perioperative durvalumab. 🟠 EV-103 | 4740RO Long-term EV + pembrolizumab follow-up in advanced urothelial cancer: ✅ Estimated 5-year OS: 33% in pooled cohorts. Durability and late toxicity both matter. 🟠 GDFATHER-NEO | 4757RO Visugromab + nivolumab: ✅ pCR 33.3% vs 7.7% with nivolumab + placebo. Exciting but exploratory (n=28 evaluable). ⭐ MY CLINICAL PEARL Not every form of intensification is equal. What matters is proven survival or metastasis prevention, alongside toxicity, patient selection and quality of life. Precision AND durable benefit—not just higher response rates. @gbanna74 @ravikanesvaran @nataliagandur @neerajaiims @Sebastiano_Buti @CinziaConted @dralishadamani @amg120395 @PGrivasMDPhD @koshkin85 @MicheleMaffezz @ParamMariappan @dmukherji @VanitaNoronha @montypa @DanieleRaggi83 @PasRescigno @jteoh_hk @alison_tree @DrYukselUrun @yekeduz_emre @AgrawalTrush @AndrewKevinAlo1 #ESMO26 #GUOncology #BladderCancer #ProstateCancer #MIBC #mCSPC #PrecisionOncology在 X 查看被引用的帖子
Source: Dra. María Natalia Gandur Quiroga · x.com