Top advances of the year: Genitourinary cancer

Abstract

AbstractThere have been significant advances in the treatment of urology cancers, with a number of practice‐changing treatments. There is now greater clarity on the role of the use of immunotherapies in renal cell carcinoma. The use of triplet combinations with immune checkpoint inhibition with anti‐vascular endothelial growth factor tyrosine kinase inhibitors in the front‐line setting for metastatic disease (COSMIC313) has been explored. The use of adjuvant therapy has been complicated by a series of negative immune therapy trials. Promising results with the HIF‐2α transcription factor inhibitor, belzutifan, alone or in combination with other agents, have been reported. Antibody drug conjugates, including enfortumab vedotin and sacituzumab govitecan, have continued to show activity in urothelial cancer with promising clinical outcomes. This has led to further exploration of the combination of these novel agents with immunotherapy and accelerated Food and Drug Administration approvals. Data are also discussed regarding intensification for front‐line therapy of metastatic castrate sensitive prostate cancer. The combination of androgen‐signaling inhibitors, docetaxel, and androgen deprivation therapy (PEACE‐1, ARASENS), as well as the use of abiraterone acetate for adjuvant therapy in high‐risk disease (STAMPEDE), is included. There is also growing evidence for the use of the radioligand therapy 177Lu‐PSMA‐617 in metastatic castrate resistant disease, with an established overall survival benefit in this patient population (VISION, TheraP).Plain Language Summary There have been many advancements in the treatment of cancers of the kidney, bladder, and prostate in the past year. Several studies using new therapies or new combinations of therapies have improved the chances of patients living longer with these cancers, especially those with advanced disease. Here, we discuss a selection of the most compelling recently published data that have changed the way these cancers are treated, as well as those that are expected to change treatment in the near future.