💧 GU Oncology — 2026-W35

What this page is. Every paper the week's monitor reviewed — including the ones that did not go into the digest. Material marked “Not selected” was reviewed and deliberately left out. It has not been fact-checked to digest standard and is not endorsed. For the curated read, see the digest itself.

Long-term (8-year) follow-up of the phase 3 ENZAMET trial in metastatic hormone-sensitive prostate cancer, published in Annals of Oncology. Confirms durable overall survival and progression-free survival benefit of adding enzalutamide to testosterone suppression over a first-generation anti-androgen, reinforcing its role as standard first-line therapy.

Pan-cancer genomic analysis (Clin Cancer Res, elite/Q1) characterizing SMARCA4 alteration classes across tumor types, showing that patients with monoallelic class 2 SMARCA4 alterations and preserved BRG1 benefited from a BRM-degrader phase 1 trial. Suggests a biomarker-defined strategy for selecting patients for BRM-degrader therapy across SMARCA4-altered cancers.

Translational biomarker analysis of the phase 3 CHAARTED trial in metastatic castration-sensitive prostate cancer, published in JCO Precision Oncology. Identifies an androgen-metabolism gene panel (APUC-6) combined with AR expression that predicts which patients benefit from adding docetaxel to ADT, potentially informing treatment selection.

Translational study profiling expression of 62 antibody-targetable proteins across metastatic castration-resistant prostate cancer biopsies, published in European Journal of Cancer, linking target expression to transcriptomic subtypes and validating findings in an independent cohort. Findings could help guide selection of patients for emerging antibody-based therapies (e.g., PSMA, STEAP1-directed agents) based on molecular subtype.

Narrative review outlining practical strategies for PSMA-targeted radioligand therapy in advanced prostate cancer, published in Eur Urol Focus. Offers guidance on patient selection, adaptive dosing, and monitoring that could refine how oncologists sequence and personalize this therapy.

Retrospective claims-database analysis in Prostate Cancer and Prostatic Diseases characterizing first-line prescribing trends among second-generation androgen receptor pathway inhibitors in the US. Descriptive utilization data showing a shift toward darolutamide, informing prescribing landscape but not clinical outcomes.

Secondary biomarker subgroup analysis of the phase 3 PROpel trial in first-line metastatic castration-resistant prostate cancer, published in European Urology Oncology. Examines outcomes with olaparib plus abiraterone by specific single homologous recombination repair gene mutations, providing more granular data to guide use of this combination in molecularly stratified patients.

Retrospective cohort study using a large national health-record database examining new-onset metabolic syndrome in men starting androgen receptor pathway inhibitors for prostate cancer, published in JAMA Oncology. Findings could inform proactive metabolic monitoring in patients on ADT-ARPI combinations.

Translational study in Clinical Cancer Research combining preclinical models with a large clinico-genomic cohort and rapid autopsy tissue microarray to show SPEN inactivation drives resistance to androgen receptor pathway inhibitors in metastatic prostate cancer. Identifies SPEN loss as a biomarker associated with shorter time to next treatment on ARPIs, informing resistance mechanisms and potential treatment selection.

Preclinical laboratory study using cell line models of advanced prostate cancer, published in Cancers (Basel), characterizing transcriptomic and mechanistic changes underlying PARP inhibitor response. Identifies ATM inhibition and targeting of EMT/fatty acid metabolism as potential co-targeting strategies, but findings are mechanistic without patient-derived clinical outcome data.

Translational biomarker study combining patient-derived xenograft and plasma cohort data, published in Eur J Cancer, developing a circulating miRNA risk score that improves prognostic stratification in non-muscle-invasive and muscle-invasive bladder cancer, though it is prognostic rather than predictive of a specific therapy.

Retrospective cohort study (with validation cohort) in Eur Urol Oncol examining germline cancer-predisposition variants in urinary tract cancer patients and their association with treatment outcomes. Suggests germline testing may identify small subsets with DDR mutations or Lynch syndrome who respond well to platinum or immunotherapy, but supporting outcome data are from very small subgroups.

Prospective multicenter validation study in JNCI evaluating a urine-based multiplex assay (Oncuria-Detect) for detecting urothelial cancer in patients presenting with gross hematuria, compared with cytology and another point-of-care test. Suggests improved sensitivity for non-invasive detection of bladder cancer, potentially informing diagnostic work-up, but does not address treatment selection.

Retrospective global real-world cohort study in Int J Cancer of olaparib in HRR-altered metastatic castration-resistant prostate cancer after AR-pathway inhibitor progression. Highlights that primary refractoriness and specific BRCA gene/mutation features predict differential survival and treatment duration, offering nuance for patient selection but not changing standard practice.

Nonrandomized clinical trial in nonmetastatic castration-resistant prostate cancer, published in JAMA Network Open, evaluating safety/efficacy of darolutamide combined with lipid-modifying agents, informing management of concomitant cardiovascular risk during treatment.

Multi-institutional retrospective study in metastatic castration-resistant prostate cancer patients receiving Lu-PSMA-617, published in The Oncologist, quantifying the healthcare-contact burden ('time toxicity') of this therapy to help inform patient counseling and treatment planning.

Exploratory cross-trial analysis calculating number-needed-to-harm for adverse events of different androgen receptor inhibitors in nmCRPC and mHSPC, published in European Journal of Cancer. Provides comparative safety context to help individualize AR inhibitor selection, though cross-trial comparisons are inherently limited.

Retrospective cohort study of enfortumab vedotin with/without pembrolizumab in ultra-elderly (≥80) patients with advanced urothelial carcinoma, published in JCO Oncology Practice. Provides real-world toxicity and dosing data to help guide treatment decisions in this underrepresented, frail population.

Retrospective cohort study from Vietnam comparing abiraterone versus docetaxel with ADT in metastatic hormone-sensitive prostate cancer, published in Cancer Control. Offers real-world comparative outcome data but is a small, single-country series without randomization, providing a supportive rather than practice-changing nuance.

Cancer Cell commentary highlighting a preclinical study identifying macrophage-tumor niches that drive chemoresistance in bladder cancer, with PARP14 inhibition able to reverse this protective effect. Mechanistic and preclinical only, without patient outcome data, but points to a potential future strategy to overcome cisplatin resistance.

Retrospective study evaluating the prognostic nutritional index at baseline and follow-up in metastatic prostate cancer patients on androgen receptor pathway inhibitors, published in Discov Oncol. Proposes a nutrition-based prognostic model for survival stratification, but it is prognostic rather than predictive of therapy response.