ASCO GU 2026: Experts Highlight Key Updates in Prostate Cancer
Key Points
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Prostate-specific membrane antigen (PSMA) PET imaging is demonstrating valuable utility across prostate cancer populations.
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Upfront molecular testing should be performed in all patients with prostate cancer to open up targeted therapy options.
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Additional androgen deprivation therapy may not be necessary in patients undergoing salvage radiotherapy after radical prostatectomy.
Prostate Cancer Advancements at ASCO GU 2026
Second-year medical oncology fellow, Brooke Kania, DO, of National Cancer Institute, met with medical oncologist, Sindhuja Kadambi, MD, MS, of University of Rochester Medical Center, to discuss advancements in prostate cancer treatment presented at the 2026 American Society of Clinical Oncology Genitourinary Cancers Symposium (ASCO GU 2026), including PSMA PET, molecular testing, and potentially practice-changing trials.
Dr. Kania noted that the use of PSMA PET is expanding in the prostate cancer space and asked Dr. Kadambi for her perspective on its clinical utility. PSMA PET is valuable across staging, treatment decision-making, and surveillance, primarily in the localized disease and unfavorable risk patient populations, said Dr. Kadambi. Although it’s also helpful for ruling out metastatic disease in high-risk patients and for locating disease sites in patients with biochemical recurrence, she added.
Molecular testing is also gaining importance in prostate cancer treatment. Dr. Kadambi suggested upfront molecular testing should be the standard of care for all patients as more targeted therapies move into earlier lines of treatment, such as the recent FDA approval of niraparib and abiraterone plus prednisone for metastatic hormone–sensitive prostate cancer with BRCA2 mutations.
Dr. Kania asked Dr. Kadambi which findings presented at ASCO GU 2026 may lead to practice updates in metastatic prostate cancer. One major update was the overall survival benefit reported with the addition of radium-233 to enzalutamide in metastatic castration–resistant prostate cancer in the EORTC-1333-GUCG/PEACE-3 trial. Dr. Kadambi also highlighted the POSEIDON meta-analysis, which suggested hormone therapy could be avoided in select patients undergoing early salvage radiotherapy without compromising survival outcomes.