At the 2026 American Society of Clinical Oncology Genitourinary Cancers Symposium (ASCO GU), breakthroughs in the treatment of relapsed and refractory germ cell tumors emerged as a major focus in the field of genitourinary oncology. Oncology Frontier – UroStream invited Prof. Jennifer King from Indiana University School of Medicine for an in-depth interview, discussing her team’s key research findings, evolving trends in genitourinary cancers, and future directions in clinical development. 

Oncology Frontier: Thank you very much, Dr. King, for taking the time to speak with us. To begin, could you briefly introduce the core research presented by you and your team at this ASCO GU congress, as well as its key advances and clinical value for patients with relapsed/refractory germ cell tumors?

Dr. Jennifer King:

Our team conducted a single-arm phase II clinical trial to evaluate the efficacy and safety of cabozantinib, a multi-target tyrosine kinase inhibitor (TKI), in patients with relapsed or refractory germ cell tumors (GCTs).

Germ cell tumors are malignancies that predominantly affect young and middle-aged individuals. While first-line platinum-based chemotherapy can cure the majority of patients, approximately 20% will experience disease relapse. Among these relapsed cases, nearly half will continue to progress despite salvage chemotherapy, surgery, and other available treatments. For this heavily pretreated population, therapeutic options are extremely limited, representing a major unmet clinical need.

From a biological standpoint, VEGF-mediated angiogenesis and aberrant activation of the c-MET signaling pathway play key roles in tumor development, progression, metastasis, and treatment resistance. Cabozantinib targets multiple critical pathways, including VEGFR and c-MET, providing the scientific rationale for its evaluation in this setting.

This phase II study enrolled 44 patients with relapsed/refractory GCTs who had failed standard therapies. Patients received cabozantinib at a dose of 60 mg orally once daily, continued until disease progression or unacceptable toxicity. The primary endpoint was clinical benefit rate (CBR), defined as the proportion of patients achieving complete response (CR), partial response (PR), or stable disease (SD) lasting at least three months.

The final results showed a clinical benefit rate of 43.2%. This finding is highly significant, as it represents the first non-cytotoxic therapy to demonstrate clear anti-tumor activity in this heavily pretreated population. It breaks the long-standing reliance on cytotoxic chemotherapy and offers a new treatment option with more manageable toxicity.

Oncology Frontier: Thank you for your insightful explanation. This year’s ASCO GU meeting covered cutting-edge research across the full spectrum of genitourinary oncology. In your view, what are the key clinical research trends emerging from this congress that will shape the future of the field?

Dr. Jennifer King:

I strongly believe that a patient-centered, full-cycle model of diagnosis, treatment, and management will define the future of genitourinary oncology.

This trend can be understood from two main perspectives. First, clinical trials should be designed around endpoints that truly matter to patients, particularly long-term survival and quality of life, ensuring that research addresses real clinical needs. Second, while improving anti-tumor efficacy remains essential, we must place equal emphasis on managing treatment-related toxicities and minimizing their impact on patients’ daily functioning and overall well-being.

Oncology Frontier: Several landmark studies presented at this congress are expected to reshape clinical practice. In your opinion, what are the main opportunities and challenges in translating these cutting-edge treatments into real-world clinical settings so that more patients can benefit?

Dr. Jennifer King:

The opportunities and challenges of translating new treatments into clinical practice are deeply rooted in real-world healthcare settings.

Currently, there are two major challenges. First, access to care remains a critical issue. Ensuring that all patients who need treatment can access advanced therapies is a global challenge. Second, clinicians often face significant time constraints. Adequate time is essential for meaningful doctor–patient communication, comprehensive review of medical history, and clear explanation of treatment risks and benefits, all of which are necessary for shared decision-making.

At the same time, the substantial unmet clinical needs represent a powerful driving force. They motivate continued collaboration among stakeholders to accelerate the implementation and standardization of innovative therapies in clinical practice.

Oncology Frontier: Finally, looking ahead, which research breakthroughs or directions do you believe are most likely to transform clinical practice in oncology, particularly in genitourinary cancers, over the next few years?

Dr. Jennifer King:

With current therapies, many patients with genitourinary cancers are living longer and entering a phase of long-term survival. Therefore, the next major breakthroughs will likely focus on two key areas.

The first is reducing treatment-related toxicity, ensuring that patients maintain a good quality of life while receiving effective therapy. The second is strengthening long-term survivorship care. This includes rehabilitation, management of chronic side effects, psychological support, and restoration of social functioning.

Ultimately, the goal of cancer treatment is not only to help patients live longer, but also to help them live better.

Prof. Jennifer King