💧 GU Oncology — 2026-W41

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.

Narrative review in Lancet Oncology synthesizing evidence linking the gut microbiome to outcomes with immune checkpoint inhibitors in melanoma, NSCLC, and renal cell carcinoma, and surveying emerging microbiome-directed interventions. Highlights how antibiotic/PPI use and microbial diversity may influence ICI efficacy, informing clinicians on an evolving but still investigational modifiable factor in immunotherapy outcomes.

Translational biomarker study of urine cell-free RNA profiling in bladder cancer, published in Nature Medicine. Detects disease and minimal residual disease and predicts response to BCG versus chemotherapy, suggesting a potential tool for treatment selection pending prospective validation.

Large real-world comparative effectiveness study in metastatic hormone-sensitive prostate cancer, published in JCO Oncol Pract. Supports ARPI doublets over docetaxel doublets for progression outcomes, with no clear differences among ARPIs.

Retrospective SEER-Medicare cohort study in JAMA Network Open comparing palliative care, systemic therapy, and hospice utilization between Medicare Advantage and Traditional Medicare patients with advanced breast, colorectal, lung, pancreatic, or prostate cancer. Highlights insurance-network-related disparities in supportive care access that could inform practice organization, though it does not change treatment selection directly.

Translational study using multiplex immunofluorescence and mouse models to define CXCL13-associated tertiary lymphoid structure-like niches in bladder cancer, published in Clinical Cancer Research. These niches were associated with survival and favorable response in a PD-L1 blockade-treated subset, suggesting a potential biomarker to guide immunotherapy selection pending further validation.

Narrative case-based review in CA: A Cancer Journal for Clinicians covering the multidisciplinary management spectrum of recurrent prostate cancer after prostatectomy, from biochemical recurrence through metastatic disease. Offers a state-of-the-art overview to inform sequencing of therapy and multidisciplinary coordination in advanced prostate cancer.

Translational study in JCO Precision Oncology deriving an ERCC2-mutation-associated mutational signature from targeted panel sequencing to identify nucleotide excision repair deficiency in bladder cancer. Tumors with this signature showed better response and survival with neoadjuvant platinum therapy, suggesting a clinically actionable biomarker for platinum-based treatment selection.

Randomized phase 2 trial of PSMA-PET-guided radiotherapy intensification versus standard radiotherapy across salvage, high-risk and oligometastatic prostate cancer, published in Eur Urol. The primary failure-free survival endpoint was not clearly improved, so it informs but does not establish PSMA-guided intensification.

Retrospective dual-tracer PET imaging analysis in metastatic castration-resistant prostate cancer patients with suspected treatment-emergent neuroendocrine differentiation, published in Clinical Genitourinary Cancer. Finds PSMA expression often persists despite suspected neuroendocrine transformation, informing decisions about continuing PSMA-targeted imaging/therapy in this setting.

Prospective multicenter diagnostic validation study (JAMA Network Open) of a urine DNA methylation assay for detecting and surveilling urothelial carcinoma. Could improve noninvasive detection and follow-up but is a diagnostic rather than treatment-selection tool.

Final long-term results and exploratory biomarker analysis of the single-arm phase II KEYNOTE-427 trial of first-line pembrolizumab monotherapy in advanced clear-cell and non-clear-cell RCC, published in Ann Oncol. Confirms durable activity and shows gene-expression profile/PD-L1 associations with response, refining understanding of biomarker-response relationships but not changing standard first-line combination approaches.

Retrospective longitudinal analysis in advanced prostate cancer using an AI algorithm on serial PET-CTs, published in JNCI. Shows progressive muscle quality loss across successive systemic therapies, supporting automated identification of patients at risk for muscle wasting, though it does not change treatment selection.