🚨⭐ #ESMO26 | GU ONCOLOGY — DAY 1 HIGHLIGHTS @OncoAlert 🟠🔵 From perioperative immunotherapy to molecular precision and next-generation treatments. A remarkable opening day in GU oncology, with important lessons for both #BladderCancer and #ProstateCancer. Here are our key scientific takeaways 👇 🟠 1️⃣ KEYNOTE-866 Abstract 4735O ❌ Perioperative pembrolizumab + gemcitabine/cisplatin failed to significantly improve EFS in cisplatin-eligible MIBC. 📊 EFS HR 0.88 (95% CI 0.71–1.10) p=0.1366 pCR: 44.4% vs 35.8% 💡 Higher pathological response did not translate into a statistically significant EFS benefit. 🟠 2️⃣ ENERGIZE Abstract 4736O ❌ Perioperative nivolumab + chemotherapy also failed to meet its co-primary endpoints. 📊 EFS HR 0.94; p=0.6697 pCR: 39.1% vs 29.6% 🔬 These findings reinforce the need to interpret response endpoints alongside durable clinical outcomes. 🟠 3️⃣ KEYNOTE-905 & KEYNOTE-B15 | 4733O / 4734O ✅ The exploratory three-arm KEYNOTE-905 analysis favored EV + pembrolizumab over surgery alone. 📊 OS HR 0.48 pCR: 58.8% vs 25.3% with pembrolizumab alone and 10.3% with surgery alone. 🧬 KEYNOTE-B15: ctDNA clearance with EV + pembrolizumab vs gemcitabine/cisplatin: ✅ 82.1% vs 66.7% ctDNA positivity was associated with poorer EFS. 📌 Molecular monitoring offers exciting opportunities for risk stratification, but ctDNA-guided treatment decisions still require prospective validation. 🟠 4️⃣ TROPHY-U-01 COHORT 7 4742O 💊 SG + EV + zimberelimab in untreated metastatic urothelial cancer. ✅ ORR: 81% ✅ Median PFS: 19.3 months ✅ Median DoR: 16.7 months ⚠️ Phase Ib, only 21 patients, with substantial toxicity. Promising—but not yet practice-changing. 🔵 5️⃣ CAPItello-281 LBA56 Updated overall survival in PTEN-deficient de novo mHSPC. 📊 Capivasertib + abiraterone vs placebo + abiraterone: ✅ Median OS: 57.4 vs 46.5 months HR 0.82 (95% CI 0.68–0.99) ⚠️ The prespecified statistical significance threshold was not met. An encouraging survival signal, but not a formally established OS benefit. 🔵 6️⃣ THE NEXT FRONTIER IN PROSTATE CANCER Today's educational sessions highlighted major advances in: ☢️ PSMA-targeted radioligand therapy 🧬 AR degraders and RIPTACs 💊 Next-generation ADCs 🔬 T-cell engagers and precision immunotherapy The key challenge is moving from promising biological activity toward durable clinical benefit, acceptable toxicity and better patient selection. ⭐ POINT OF VIEW More treatment does not always mean better outcomes. And an impressive response rate does not automatically establish a new standard of care. Today's data reinforce three essential principles: ✅ Robust survival endpoints matter. ✅ Biomarkers must move from prognostic value to validated therapeutic guidance. ✅ Novel combinations require careful assessment of efficacy, toxicity and clinical applicability. 💡 The future of GU oncology is not simply treatment intensification—it is smarter, biologically informed treatment selection. 🎯 The right strategy. The right patient. The right time. Outstanding scientific discussions throughout Day 1! @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 @ONCOassist @VuMedi @ProstateUK @OncologyNT @OncJournal #GUOncology #BladderCancer #ProstateCancer #mCRPC #MIBC #PrecisionOncology