Dr. Park shares the three largest takeaways, in his opinion, to have come out of the ASCO GU Symposium; © Cavan – inventory.adobe.com
Following the 2025 Annual ASCO Genitourinary (GU) Cancers Symposium, Dr. Chandler Park, a medical oncologist of Genitourinary Medical Oncology on the Norton Healthcare Institute in Louisville, Kentucky, sat down for an interview with CURE®, by which he shared his biggest takeaways from the assembly.
“The ASCO GU Symposium is the Tremendous Bowl for prostate, kidney and bladder most cancers [treatment]. All of the totally different most cancers docs, scientists and researchers get collectively to advance the sector for our sufferers. Relating to essentially the most vital advances by way of kidney, bladder and prostate most cancers, I might say there’s one [specific update that shines] in every specialty,” Park emphasised.
Within the interview, Park broke down the three largest research, in his opinion, to have come out of the ASCO GU Symposium, highlighting research throughout kidney, bladder and prostate cancers. To learn extra of our dialog with Park, click on right here.
What was the largest takeaway from the assembly by way of kidney most cancers therapy?
Lots of our sufferers which are [being] handled for colon most cancers or ovarian most cancers have a blood take a look at that is been recognized to be predictive of how unhealthy the most cancers is or if the therapy goes to work. In colon most cancers, now we have a blood take a look at known as carcinoembryonic antigen [CEA]; in ovarian most cancers, it’s known as CA 125, which is prognostic and predictive. Now, in kidney most cancers, we did not have something till we had some new knowledge introduced right here at ASCO GU. The examine that was introduced was shared by Dana-Farber Most cancers Institute, [in Boston, Massachusetts,] and it has to do with the KIM-1 kidney marker.
This examine checked out sufferers that obtained immune remedy for stage 4 renal cell most cancers, and [investigators] checked the blood for KIM-1 — known as the kidney damage molecule one — and so they adopted sufferers initially earlier than therapy, after which they adopted this blood take a look at after three cycles of therapy. What they discovered is that this appears to be a really dependable blood marker that oncologists can comply with. This fashion [we] can know if this therapy is working or not.
I believe one of many hardest issues, for me, is whenever you begin anyone on therapy, after which having to attend for the scan for 2 or three months to see if the therapy is working. That is one thing that I believe could be very vital, and I can see it changing into one thing that is a part of the clinic, the place sufferers and households may examine this to ask, ‘How’s the therapy working?’ and ‘Is that this therapy going to proceed to be efficient?’
What was the largest takeaway from the assembly by way of bladder most cancers therapy?
Now, the second examine that that appears to be very fascinating is for our sufferers with bladder most cancers. Bladder most cancers has 5 levels, [beginning with] stage 0 when the most cancers is contained in the bladder, and it is simply on the floor of [the first] layer, and that is known as non-muscle invasive bladder most cancers. The most cancers is like when you put a seed on the bottom, rising and forming roots, it varieties a stalk. Bladder most cancers slowly will get larger, and the roots go into the muscle. If the most cancers is within the muscle, that is known as muscle-invasive bladder most cancers, and that is known as stage 2 bladder most cancers.
One of many research that [was shared] at ASCO GU — which I believe could be very promising — is named the RETAIN-2 medical trial. What query does the RETAIN-2 medical trial reply? At any time when I see a affected person in clinic, there’s three issues they take take into consideration each time we give them a prognosis of bladder most cancers that is within the muscle: one, ‘Is that this therapy that we’ll present curable?’ and the reply is [hopefully] sure. Not everyone will get cured, however the aim is to treatment. The second query now we have is, ‘Do I’ve to take the bladder out?’ and sadly, numerous our sufferers do should take the bladder out. We will treatment individuals with radiation, however there are numerous sufferers that don’t need to have radiation, nor do they need to have a cystectomy.
Within the RETAIN-2 medical examine, sufferers obtained chemotherapy and immunotherapy — that is known as neoadjuvant therapy — and as soon as they obtained a therapy, the urologist went again into the bladder to go searching, so if they didn’t see any most cancers, that is named a pathological full response. Now, the usual of care in that state of affairs right now is to nonetheless do surgical procedure. Nonetheless, on this examine, they determined to sort of see, do they actually need [surgery]? The sufferers bought randomized after they obtained chemotherapy, after which they did analysis cystoscopy, and in the event that they did not discover any most cancers, sufferers randomized to an arm the place they may do surveillance, [meaning to] simply look within the bladder, each three or six months. To be in that group, they checked out genetic markers to see if they’ve sure excessive threat genetic markers.
Within the RETAIN-2 examine, which is a really small examine, so that is one thing they should proceed, 82% of sufferers that obtained chemotherapy, and went [on to] statement stay most cancers free. I see one thing like this taking off as a bigger examine and changing into — hopefully —a mainstream method.
What was the largest takeaway from the assembly by way of prostate most cancers therapy?
The third examine that’s within the prostate most cancers discipline is the TALAPRO-2 examine. The [trial looked at] sufferers with prostate most cancers, once they’re recognized. There are two forms of prostate most cancers: one is named metastatic-hormone delicate prostate most cancers, and that signifies that these sufferers are nonetheless delicate to testosterone, so we give them testosterone blockers — sort of like estrogen blockers for sufferers with breast most cancers; however the extra aggressive sort is named castrate-resistant prostate most cancers. This [diagnosis] could be very robust and we need to discover new therapies for this.
In TALAPRO-2, sufferers bought randomized to Xtandi [enzalutamide], which is taken into account an amazing customary of care therapy for metastatic castration-resistant prostate most cancers, and the opposite arm obtained Xtandi plus Talzenna [talazoparib], which is taken into account a PARP inhibitor. Now, PARP inhibitors are one thing that we’d all hear about once we deal with for sufferers in ovarian most cancers, breast most cancers and pancreatic most cancers, and the hot button is they want these genetic markers known as BRCA1 and BRCA2. It was very related within the prostate most cancers world, the place sufferers needed to have both the BRCA1 or BRCA2 mutations; these mutations may very well be both within the germline or the somatic.
Germline is each time a buccal swab or blood examine [is done] to see if [patients] inherited BRCA1/BRCA2 genes. Now, what’s somatic mutation? Think about if I’ve a black mark on my hand, and that mark is melanoma. In the event that they take a biopsy of this black a part of my hand, and so they take a biopsy of my regular hand, the DNA of that most cancers is totally totally different from the pores and skin, and that’s known as somatic mutation. If there is a BRCA1/BRCA2 mutation contained in the most cancers, then you would qualify for a PARP inhibitor. Now, with all that stated, that’s thought of a choose affected person inhabitants; we should see if the sufferers qualify for a PARP inhibitor on this examine.
What makes this examine, as we thought of it, a spotlight at ASCO GU, is that they did not have a look at that by way of randomizing sufferers to the examine, they took all comers. It was near 800 sufferers, a big part 3 trial, by which sufferers bought randomized to Xtandi versus Xtandi plus Talzenna, and there was a 20% lower by way of the most cancers.
Loads relies upon the molecular subgroups, however it’s encouraging that if a affected person reveals up with metastatic castration-resistant prostate most cancers [we could refer to this]. Though I like to recommend everyone [complete testing], not everyone practices within the large metropolis. Some individuals observe in rural America, and they won’t have entry [to germline and somatic testing]. So if they do not have entry, and these oncologists see sufferers… [they should focus on family history of cancer], as there could be some sort of genetic concern for most cancers. In these conditions, I might take into account this primarily based upon the ASCO GU examine. Now, it’s not FDA permitted but, however I anticipate it is going to be, so we’ll cross our fingers.
These are the three impactful research that I see for affected person care [following the ASCO GU Symposium].
Transcript has been edited for readability and conciseness.
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