🚨⭐ #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