Key Updates in Bladder, Kidney and Prostate Cancer from Experts

At the 2026 ASCO GU meeting, experts gathered to share the latest advancements in bladder, kidney and prostate cancer care. Dr. Joshua Sabari, thoracic medical oncologist at NYU Langone Health and editor-in-chief of CURE, sat down with Dr. Chandler Park, advisory dean and GU clinical trials lead at Norton Cancer Institute, to break down the most exciting updates for patients and caregivers.

From new early-stage therapies in bladder cancer to targeted treatments in kidney cancer and innovative radioligand therapy in prostate cancer, Sabari and Park explain what these advances mean for survival, quality of life and ongoing monitoring. Their insights provide a patient-focused look at emerging treatment options and the safety considerations families should be aware of.

Watch the full discussion on CURE’s YouTube channel for patient-focused insights.

Sabari: I'm Dr. Joshua Sabari, the editor-in-chief of CURE magazine. I’m really excited to be joined by my colleague and friend, Dr. Chandler Park. Dr. Park, please introduce yourself.

Park: Josh, thanks for having me. It’s always great to be here, especially at this forum, because we're all doing this for our patients. My name is Dr. Chandler Park.

Sabari: I'm really excited to hear some of the updates from you. Chandler, break it down for our patients and caregivers. Regarding ASCO GU, let's start with bladder cancer. What are the updates? What are the exciting opportunities, treatments and trials in the bladder cancer space?

Park: Great question, Josh. One of the things we think about with bladder cancer is that the five-year relative survival is close to 80%, with about 84,000 patients across America diagnosed annually. We want to do everything we can before the disease reaches stage 4 because once it is metastatic, it is very tough to treat. The field is moving more and more toward neoadjuvant treatment with antibody-drug conjugates and immunotherapy.

At our ASCO GU meeting, we saw data on the antibody-drug conjugate known as Padcev (enfortumab vedotin-ejfv) with Keytruda (pembrolizumab) versus the traditional treatment, which is cisplatin and gemcitabine. For neoadjuvant chemo, patients received four cycles on each arm. The study’s top-line event-free survival (EFS) showed a hazard ratio of 0.53 for Padcev with Keytruda versus the standard of care. At two years, the EFS was 79.4% versus 66.4%. In terms of the subgroups, everything favored the new combination, and the overall survival data is maturing well.

The bottom line for our patients is that not only can we give the right treatment to increase our cure rate, something we look for, like a pathological complete response, but Padcev with Keytruda is much easier for our patients than the chemotherapy of cisplatin and gemcitabine. There is a lot of exciting stuff for our patients in terms of quality of life and toxicity management.

Sabari: It's really exciting to hear these new therapies moving into the earlier-stage setting, hopefully increasing the rate of cure. Tell me a little bit about the toxicities. We know a lot about gemcitabine and cisplatin, but what should patients expect in this new setting? How does Padcev and Keytruda compare to historical chemotherapy?

Park: That's a great question. Padcev and Keytruda do have some toxicities. The way I explain it to patients is by looking at what side effects might appear in the first, second and third months. In the first month, it's all about the rash. You have to notice any kind of itchiness or rash. If it's grade one, meaning it's on one extremity, a moisturizing cream can often take care of it, but you must tell your oncologist so they can decide whether to hold the next treatment.

The second month is when you might start noticing a little tingling in the fingers and toes, as well as balance problems. This is not always a painful neuropathy like diabetes, but I always ask family members if they’ve noticed the patient getting close to falling. Quick dose reduction or holding the treatment is key.

In terms of historical controls, this medication showed a close to 77% response rate in the original EV-301 study for third-line metastatic treatment, so it has moved up the line. It has much less cardiac toxicity than cisplatin and much less bone marrow toxicity than gemcitabine and cisplatin. Regarding efficacy, we are seeing close to a 56% to 57% pathological complete response. That is when the pathologist looks under the microscope and cannot find any cancer at all.

Now, we are starting to think about whether we can use this medication for bladder preservation, where ctDNA and urine tumor DNA will really help us determine if patients can keep their bladder.

Sabari: That is so exciting, Chandler: a 56% complete response. I wish we were seeing numbers like that in lung cancer! We're learning from our colleagues in the GU space, so keep up the phenomenal work. We also saw some updates in kidney cancer. Tell me about those and how they change practice for patients diagnosed now.

Park: This meeting featured major headlines for renal cell cancer, specifically regarding a medication called Welireg (belzutifan). Welireg has a very interesting story; around 2019, researchers at Dana-Farber found that the Von Hippel-Lindau (VHL) mutation causes HIF-2 alpha to function improperly. Patients with VHL disease or renal cell cancer often have very high levels of HIF-2 alpha. Scientists developed Welireg as an HIF-2 alpha inhibitor.

One of the fruits of this labor is the Lightspark-022 study. For patients with stage 2 or 3 kidney cancer at high risk of recurrence, we want to do everything we can to lower the chances of the cancer coming back. In this randomized phase 3 study, half the patients received Keytruda (the current standard for one year of adjuvant treatment) and the other half received Keytruda with Welireg. The top-line data showed that the disease-free survival at one year was 91.9% versus 85.2%, and at two years it was 80.7% versus 73.7%. This represents a 28% reduction in the chance of the cancer returning.

However, we have to keep a close eye on Welireg. I recommend that patients monitor for breathing problems because it can cause hypoxia (low oxygen). Any shortness of breath must be evaluated right away so the medication can be held. We also have to check for anemia.

Sabari: So, we have a second study where we add another medicine to an immune checkpoint inhibitor and see improvements in risk reduction. It’s an exciting story scientifically and for patients. We know Keytruda has unique immune-mediated adverse events, and Welireg has its own profile. Are there overlapping side effects that family members or caregivers should look out for?

Park: Absolutely. We don't want to miss pneumonitis (lung inflammation) with Keytruda, which causes shortness of breath, and Welireg can also cause hypoxia. In my practice, if I notice shortness of breath within the first month of starting the combination, it is often due to the Welireg. My advice is to hold the medication, talk to the oncologist, and get evaluated immediately.

I would also be very cautious about considering Welireg for patients with underlying COPD or lung disease.

Sabari: We have to be careful; these medicines are powerful and active, but monitoring side effects is our job as oncologists. We also saw exciting data in prostate cancer, which is the most common cancer we see in the U.S. There is a lot of work in the radioligand space. Tell us about the updates with Pluvicto (lutetium Lu 177 vipivotide tetraxetan). What are radioligands, how do they work and how are they changing the face of prostate cancer?

A: I have a 16-year-old taking chemistry, and I was looking at the periodic table at the different elements we use for prostate cancer. One of those is lutetium. I think of a radioligand as being similar to an antibody-drug conjugate.

In an antibody-drug conjugate, you have an antibody that attaches to something. With Pluvicto, you have a ligand that attaches to PSMA. PSMA is a protein on the membrane of prostate cancer cells, similar to the PSA we see in the blood.

Pluvicto attaches to the PSMA on the cancer cell and releases a "smart bomb" of lutetium to kill the cell. It was originally approved for third-line treatment based on the VISION study, but it is moving up. The PSMAaddition study looked at adding it to standard hormone therapy (like apalutamide or enzalutamide) for newly diagnosed metastatic hormone-sensitive prostate cancer. This "triplet" therapy showed a 28% reduction in the risk of progression.

What about side effects? We give up to six treatments, but if a patient has a rapid response, perhaps fewer are needed to avoid upfront toxicity. The main things to watch for are dry mouth, dry eyes, nausea, and bone marrow suppression.

Sabari: You mentioned PSMA on the membrane and how we are using PSMA PET imaging more often. Is PSMA PET now the standard? Are we using it to assess response to Pluvicto? What should patients and families know?

Park: The original FDA approval for PSMA PET scans was for patients with biochemical recurrence, when a patient has a rising PSA after surgery or radiation. It helps us see if the cancer is somewhere we can treat with targeted radiation. Now, it’s so accessible that many people get a PSMA PET scan right away.

However, the technology sometimes moves faster than the clinical trials. For example, if a scan shows three or four small lesions after surgery, but historical studies didn't use PET scans to define "low volume" disease, it puts us in a difficult spot regarding how to treat it. I would tell patients to ask their oncologist: "What is the purpose of this scan, and how will the results change my management?"

Sabari: Excellent discussion, Chandler. It’s always a pleasure. Thank you for bringing the updates from ASCO GU to our listeners and readers. To those listening, the CURE team, patients, families and caregivers, thank you for joining us and for your attention.

Transcript has been edited for clarity and conciseness.

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