Betty Wang, MD, recaps 3 key urologic cancer studies from EAU 2025

The 40th Annual European Association of Urology Congress in Madrid, Spain, featured an extensive scientific program. In a recent video for Urology Times^®, Betty Wang, MD, provided insight on 3 presentations that she believes “may be game changing” in urology.

The first study Wang highlighted was “Micro-ultrasound-guided versus MRI-guided biopsy for prostate cancer diagnosis: The OPTIMUM randomized clinical trial.”¹

“OPTIMUM was an international randomized study that compared micro-ultrasound guided vs MRI-guided biopsy for prostate cancer diagnosis,” explained Wang, a Society of Urologic Oncology fellow at Cleveland Clinic in Cleveland, Ohio.

“The authors noted that OPTIMUM demonstrated [that] micro ultrasound is non inferior to MRI fusion biopsy for detecting clinically significant prostate cancer and established itself as an appealing alternative to MRI for image guided biopsy. This would mean having a single procedure for both imaging and biopsy, and that could potentially be less expensive without using IV contrast, which is currently needed for multi-parametric MRIs,” Wang said.

The second study she highlighted was “Surgical outcomes and neoadjuvant safety with perioperative durvalumab for muscle-invasive bladder cancer (NIAGARA).”² Previously reported data from the NIAGARA trial showed that perioperative durvalumab (Imfinzi) plus neoadjuvant chemotherapy extended event-free survival and overall survival vs neoadjuvant chemotherapy alone in muscle-invasive bladder cancer (MIBC).³ The FDA recently approved this treatment regimen for adult patients with MIBC.⁴

At EAU, Wang said, investigators presented data on “the perioperative safety of durvalumab.”

“One of the main takeaways from this presentation was that durvalumab had no significant impact on the patient's ability to undergo surgery. In fact, if you look at the divide between the 2 arms, the addition of durvalumab actually increased the percentage of patients who underwent radical cystectomy from 83% (the chemo arm), compared to 88% (the chemo plus durvalumab arm). So if anything, it did not reduce the number of patients that could get their surgery in terms of cystectomy timing,” Wang said.

The final study Wang discussed was “AURORAX-0087A: Urine Glycosaminoglycan Scores for Surveillance of Recurrence in Intermediate and High-risk Non-metastatic Clear Cell Renal Cell Carcinoma - An Observational Prospective Multicenter Diagnostic Test Cohort Study.”⁵

“This study demonstrates that urine GAGome scores can be a promising biomarker for clear cell RCC [renal cell carcinoma] recurrence. It has a 97% negative predictive value, meaning a negative test can almost definitely rule out a recurrence. In terms of clinical impact, this could potentially reduce unnecessary imaging costs and radiation exposure to the patient,” Wang said.

REFERENCES

1. Kinnaird A, Luger F, Cash H, et al. Micro-ultrasound-guided versus MRI-guided biopsy for prostate cancer diagnosis: The OPTIMUM randomized clinical trial. Presented at: 40th Annual European Association of Urology Congress. March 21-24, 2025. Madrid, Spain

2. Catto JWF, Al-Ahmadie H, van der Heijden MS, et al. Surgical outcomes and neoadjuvant safety with perioperative durvalumab for muscle-invasive bladder cancer (NIAGARA) Presented at: 40th Annual European Association of Urology Congress. March 21-24, 2025. Madrid, Spain

3. Powles T, Catto JWF, Galsky MD. Perioperative durvalumab with neoadjuvant chemotherapy in operable bladder cancer. N Engl J Med. 2024;391:1773-1786. doi:10.1056/NEJMoa2408154

4. FDA approves durvalumab for muscle invasive bladder cancer. News release. US Food & Drug Administration. Published online and accessed March 28, 2025. https://www.fda.gov/drugs/resources-information-approved-drugs/fda-approves-durvalumab-muscle-invasive-bladder-cancer

5. Dabestani S. AURORAX-0087A: Urine Glycosaminoglycan Scores for Surveillance of Recurrence in Intermediate and High-risk Non-metastatic Clear Cell Renal Cell Carcinoma - An Observational Prospective Multicenter Diagnostic Test Cohort Study. Presented at: 40th Annual European Association of Urology Congress. March 21-24, 2025. Madrid, Spain