Javier Pérez Ardavín

Uro-oncología en H. U. i P. La Fe y andrología en Quirón Valencia, FEBU, Doctorando en último año.

[Ashish M. Kamat, MD, MBBS @UroDocAsh]

This paper by @drtanws @heerlab @emmahall71 provides supporting evidence removing TaHG NMIBC from the IR NMIBC risk category

When we properly define IR-NMIBC the way @IBCG_BladderCA recommends - LG disease only - and look at what happens to those patients across four RCTs (578 patients, contemporary treatment):
Stage progression: 2%
MIBC or metastasis: 2%
Cancer-specific mortality: <1%

[Bishal Gyawali, MD, PhD, FASCO @oncology_bg]

Story of #ASCO26 #plenary in two survival graphs. I mean the contrast between the two.

[MJosé Juan @mjuanfi81]

Can treatment be safely stopped in selected patients with mHSPC?
Phase II A-DREAM trial, 41% of responders remained treatment-free with testosterone recovery 18m after stopping ADT/ARPI. At a median FU of 21 months, 35% of patients required treatment re-initiation.
@OncoAlert

[Journal of Urology @JUrology]

Can baseline testosterone levels help predict which prostate cancer patients on active surveillance are at higher risk of progression?

In this article, researchers found that low testosterone (≤300 ng/dL) was linked to increased risk of higher-grade progression (GG3 or above), suggesting it may be a valuable prognostic marker to guide surveillance and treatment decisions.

🔗 Click to read more: https://t.co/CwjENsPNc6

[Yüksel Ürün @DrYukselUrun]

PROTEUS and STAMPEDE both support ARPI intensification in high-risk M0 prostate cancer, but across different designs and local treatments.
The real advance is not “which wins?”
It is “which patient, which path?”

#ASCO26
@DrChoueiri @TiansterZhang @CathyEngMD @montypal @tompowles1 @brian_rini @cdanicas @GlopesMd @PGrivasMDPhD @nataliagandur @yekeduz_emre @neerajaiims @ASCO @ONCOassist @OpenMedicineHQ @MedwatchKate @scserendipity1 @CParkMD @urotoday @OncLive @crisbergerot @urologysummit @SuyogCancer @Larvol @IMG_Oncologists @piet_ost @DrSpratticus @GGiannarini @declangmurphy @NehaVapiwala @Prof_Nick_James @AttardLab @Silke_Gillessen @APCCC_Lugano

[Ashish M. Kamat, MD, MBBS @UroDocAsh]

⚖️ Now put that 5% on a scale.

To move 5 more patients per 100 into the disease-free column at 2 years, you add 13 monthly IV infusions and a Grade 3/4 toxicity rate that jumps from 4% to 21%.

No OS benefit yet. Median DFS not reached in either arm.

How do we balance and offer personalized recommendations?

HR doesn’t make that decision for you. @WorldBladderCan @IBCG_BladderCA

[Ashish M. Kamat, MD, MBBS @UroDocAsh]

FDA approves durvalumab in combination with BCG for high-risk non-muscle invasive #bladdercancer

@IBCG_BladderCA @DrFelixGuerrero @joanfundi @tompowles1 @AndreaNecchi @JoshMeeks #ASCO26

[Félix Guerrero-Ramos @DrFelixGuerrero]

🚨A lot of new options for #BCGunresponsive NMIBC, but no direct comparisons
🤼We've tried to do some work on this, along with my friend @siadaneshmand and others
📖You can read it here @JUrology @AmerUrological @JUOpenPlus: https://t.co/Um9tDRn1UC
👀And much more to come!!!

[Félix Guerrero-Ramos @DrFelixGuerrero]

🤩Glad to share the final results of our #BladderGATE trial published at @OncJournal
👓Read it here: https://t.co/QqAStrsVjm
🙏Deep gratitude to all @Urologia12 MDT team: @cdanicas @g_develasco @cgdelcanizo @MarioHArroyo @MartaDueas4 @H12Octubre @SaludMadrid
@GuardConsortium @GUOaeu @ROC_Urologia @UAI_imas12 @InfoAeu @CANVES_ES @ApicesSpain @F_OncoSur @docjavip @dralvaropinto @drenriquegrande @BenjaminPradere @MRoupret @evanguelosx @spsutkaMD @UroDocAsh @A_Carrion_Puig @ADominguez_Uro @dr_flozano @DominguezEscrig @josedsh @RodriguezFaba @paolo_gontero @MariaJRibal @JGomezRivas @tompowles1 @Uro_Oncologist @mjuanfi81

[Laura Bukavina @LauraBukavinaMD]

En bloc cystectomy is proving to be a powerful approach in challenging cx> post-EV/P, bulky fibrotic disease and EV/P progressors ⬆️ R0 %, ⬇️ EBL and improved node # We keep expanding our robotic en bloc cystectomy experience with LN ctDNA measurement .. innovation in tx requires 🤖 innovation in approach . credit to @EirikKjo @CleClinicUro

[Julian Chavarriaga @chavarriagaj]

#AUA26 First indirect comparison of two FDA-approved bladder-sparing strategies for BCG-unresponsive NMIBC: NAI + BCG vs TAR-200.
After MAIC adjustment:
🎯 12-mo CR:
• NAI+BCG: 49.2%
• TAR-200: 45.9%
⚠️ TRAEs:
• 61.7% with NAI+BCG
• 83.5% with TAR-200
→ ~68% lower odds of treatment-related toxicity with NAI+BCG (OR 0.32)
🚨No head-to-head trial yet, but an important attempt to compare emerging bladder-preserving options in BCG-unresponsive NMIBC. @UroToday @AmericanUrological

[DR CARVAJAL @RomanCarvajal]

At #AUA2026, the message was clear:
📌 ePLND provides staging information, but its therapeutic benefit remains uncertain.
📌 RCTs have not shown consistent improvements in BCR outcomes.
📌 PSMA PET/CT has a high NPV (~96%) and may safely avoid unnecessary PLND in intermediate-risk patients with negative scans.
📌 Morbidity is not negligible: lymphedema, DVT/PE, and potential overtreatment.
📌 Up to 47% of nodal metastases may even lie outside the standard ePLND template.
The question is no longer “PLND yes or no?”
👉 It’s about smarter selection using PSMA PET, nomograms, and individualized risk assessment.
#ProstateCancer #PSMAPET

[UroToday.com @urotoday]

Comparison of #EMBARK and EAU criteria to identify high-risk patients with biochemical recurrence after radical prostatectomy. Presentation by Nadine Friedrich, MD @CedarsSinai. #AUA26 written coverage by @chavarriagaj &gt; https://t.co/yyHo8ko8vo @AmerUrological

[Zach Klaassen @zklaassen_md]

Does ePLND improve outcomes at RP in PSMA PET -ve HR PCa? @urotoday

Randomized DISSECTION 2.0 Ph 3 trial (#EAU26): RP + ePLND vs RP alone (n=400, 15 🇨🇭 centers)

Prim EPs:
• PSA persistence ≥0.1 ng/mL @ 3 mos
• BCR-FS

Results expected 2027

[NEJM @NEJM]

New in our partnership with @DGlaucomflecken: the KEYNOTE-905 trial evaluated enfortumab vedotin plus pembrolizumab as perioperative therapy in patients with muscle-invasive bladder cancer who were ineligible to receive cisplatin. Read the full study for free: https://t.co/A1RikB7ZIo

[MJosé Juan @mjuanfi81]

PROpel trial:

☄️ Biomarker evaluability increased to 98% when tissue + ctDNA
☄️ High concordance :HRRm: 85%,BRCA: 94%
☄️ ctDNA informative tissue samples
☄️ Large rearrangements and homozygous deletions: limitations of plasma testing

https://t.co/RbCFLEyp4A

@OncoAlert

[Sabine D. Brookman-May @brookmans76]

As the Clinical Lead at J&J at that time writing the #PROTEUS protocol and defining the specific PET-based MFS endpoint, I am curious to see the final official results at ASCO as well.
A few considerations:
🔵 As #PSMA PET imaging was not integrated in the study from the beginning, this endpoint will only be available for a subset of patients
🔵 PET based #MFS is defined in a specific way for PROTEUS as aligned with the FDA - not every positive PET scan counted
🔵 Subsequent therapy is important to consider which is often initiated prior to reaching conventional MFS
🔵 QoL is one key aspect to consider. Concerning erectile function, I’d expect that in cases with nerve sparing surgery and perioperative function (limited subset in a HR setting) recovery will be good
➡️ We will need to consider PROTEUS results together with results from other trials in this early setting including the #BCR setting
➡️ Finally, it will be most important to develop treatment strategies for patients resulting in as much as possible Freedom From Clinical Deterioration (FFCD) with as limited as possible subsequent treatment needed - new endpoints are needed! @ChrisSweens1 @oncodaily @AttardLab @DrPaulNguyen #RadicalProstatectomy #ProstateCancer @TylerSbrt

[Daniel Castellano @cdanicas]

🎯 @APCCC_Lugano mHSPC
Prof Dana Rathkopf talk about
👉 Considerations for selection of ARPIs in older patients with mHSPC
- Aggregate meta-analysis showed no clear benefit with triplet therapy in older men > 70 y
- probably a baseline geriatric score is Key to avoid >> toxicity
@OncoAlert @myESMO @ASCOPres @urotoday @GuardConsortium @Uromigos @UroTarget @UroTeragLATAM

[Chiara Re @ChiaraRe]

A busy April wraps up with an outstanding prospective multi-institutional study on AS for small renal masses:
🔹Median FU 88 mo
🔹8-yr OS 88%
🔹Treatment-free survival 83%
🔹Only 17% required intervention
Tumour doubling time &amp; location guide deferred active treatment plan.

[Tyler Seibert MD PhD @TylerSbrt]

Nice observation that RT to the primary may be preferable to intensifying systemic therapy in older patients w #ProstateCancer

@APCCC_Lugano #APCCC