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The 2025 Genitourinary (GU) Cancers Symposium, held in San Francisco, California, concluded on February 15 after three days of groundbreaking presentations on advancing research in urothelial cancer, prostate cancer, and renal cell carcinoma (RCC). Experts shared their top insights, highlighting new therapies and practices in the field.
Top Experts Share Their Takeaways
Key speakers at the symposium included:
- Tanya B. Dorff, MD, from City of Hope
- Rohan Garje, MD, from Baptist Health Miami Cancer Institute
- Robert Jones, MBChB, PhD, from the University of Glasgow School of Medicine
- Bradley McGregor, MD, from Dana-Farber Cancer Institute
- Funda Meric-Bernstam, MD, from The University of Texas MD Anderson Cancer Center
- Guru P. Sonpavde, MD, from AdventHealth Cancer Institute
For those unable to attend, their key findings offer valuable perspectives on the latest advancements in GU cancer treatments.
Talazoparib Plus Enzalutamide Shows Promise in Metastatic Castration-Resistant Prostate Cancer
Updates from the phase 3 TALAPRO-2 trial suggested a significant survival benefit of combining talazoparib and enzalutamide in unselected metastatic castration-resistant prostate cancer (mCRPC) patients. Rohan Garje, MD explained that while the major benefit was observed in the homologous recombination-deficient (HRD) population, there was also a notable OS benefit in the all-comers cohort.
Robert Jones, MBChB, PhD echoed this sentiment, emphasizing the trial’s evaluation of talazoparib and enzalutamide in patients who had not previously received receptor pathway drugs for metastatic hormone-sensitive prostate cancer. Jones highlighted the statistically significant OS advantage in the all-comers population, independent of HRR mutation status.
According to Bradley McGregor, MD, while the OS signal in the all-comers population was primarily driven by HRD patients, the findings raise questions about the role of talazoparib with enzalutamide in HRR-proficient patients. McGregor noted that incorporating these data into clinical practice is likely to be controversial.
Durvalumab May Offer Benefits in Muscle-Invasive Bladder Cancer Regardless of pCR
Follow-up on the NIAGARA study indicates that durvalumab as an adjuvant treatment in muscle-invasive bladder cancer (MIBC) could provide benefits even for patients who do not achieve a pathological complete response (pCR). While the regimen is currently not approved, the results show a potential benefit across all patients. Further research is needed to identify predictive biomarkers and improve patient selection for durvalumab.
New Targeted Therapies and Strategies in Urothelial Cancer
Updated data on enfortumab vedotin-efjv (Padcev) for metastatic urothelial cancer continue to highlight its significant benefits and durable complete response rates. This enhances confidence in the drug as a first-line treatment option.
Exciting developments in targeted therapies targeting HER2, TROP2, and FGFR3 offer new avenues for urothelial cancer treatment. The perioperative use of chemoimmunotherapy and HER2-based therapies holds promise, particularly for cisplatin-ineligible patients or those selected by biomarkers.
Garje also discussed bladder preservation strategies, such as the phase 3 CheckMate 274 trial showing interim data suggesting an OS benefit with adjuvant nivolumab (Opdivo) compared to placebo in high-risk MIBC patients. Funda Meric-Bernstam, MD, noted the rapid evolution of treatment paradigms and the many unanswered questions regarding treatment sequencing and the role of immunotherapy.
Mevrometostat Shows Potential in Abiraterone-Resistant mCRPC
Early results from the phase 3 MEVPRO-1 study of mevrometostat in combination with enzalutamide in abiraterone-acetate–pretreated mCRPC patients indicate promising data. Mevrometostat is part of a novel class of drugs aimed at finding new approaches to attack prostate cancer.
COSMIC-313 Trial Reveals No Overall Survival Advantage for Cabozantinib/Nivolumab/Ipilimumab in Advanced RCC
The final analysis of the phase 3 COSMIC-313 trial on cabozantinib and nivolumab in advanced clear cell RCC showed no OS benefit when adding cabozantinib to nivolumab and ipilimumab. While not practice-changing, these results provide valuable insights and contribute to the overall understanding of treatment options.
To delve deeper into OncLive‘s coverage of the 2025 GU Cancers Symposium, visit OncLive.
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