Genitourinary Oncology Research Updates

In a phase Ib/II open‑label trial of 36 BCG‑naïve high‑risk non‑muscle invasive bladder cancer patients (median age 70), intravenous atezolizumab combined with intravesical BCG was tolerable with no dose‑limiting toxicities and low incidence of serious drug‑related adverse events. Median recurrence‑free survival was not reached, with RFS rates of 83% at 1 year and 73% at 2 years, no observed impairment in health‑related quality of life, and results reported as consistent with the ALBAN study which did not show a clear benefit over BCG alone.

In a Phase Ib trial of 12 patients with advanced melanoma or renal cell carcinoma, intramuscular personalized neoantigen synthetic long peptide vaccines with poly-ICLC were well tolerated (only grade 1–2 local pain or fever, no immune-mediated toxicities) and induced de novo CD8+ and CD4+ T‑cell responses detectable as early as one week. On average roughly half of vaccine peptides per patient were immunogenic, responses included IFN-γ–dominant CD8+ and TNF-α–dominant CD4+ phenotypes with increased effector memory differentiation, and tumor biopsies showed enhanced CD8+ infiltration with evidence of epitope spreading in some cases.

A retrospective review of 2,767 oncology patients eligible for germline testing (breast, prostate, pancreatic, ovarian, colorectal cancers) evaluated a Rapid Access Cancer Genetic Testing program using pretest video education, genetic testing coordinators for navigation, and targeted genetic counselor/physician follow-up for pathogenic/likely pathogenic (P/LP) results. Uptake was high with 89.1% consenting and 87.9% completing testing; 13.2% of those tested had P/LP variants (most frequently BRCA1/2 and CHEK2), but disparities were observed with lower testing completion among patients aged ≥50, Black/African American patients, and those with pancreatic cancer, and lower follow-up rates for pancreatic and prostate cancer and recessive findings. The program integrated testing into oncology workflows and increased access, while the authors note persistent disparities in testing and follow-up.