ESMO China Focus – Uro-Oncology Session Concludes Successfully
Editor’s Note : During the 2025 ESMO Congress, the first and only ESMO-authorized “ESMO China Focus” Uro-Oncology Session was successfully held on October 19 in Berlin. The forum highlighted major advances in urothelial carcinoma and prostate cancer, bringing together Chinese and international experts for in-depth academic discussions and intellectual exchange. Experts agreed that data from landmark studies such as EV-302 and EV-103 firmly establish enfortumab vedotin (EV)–based combination therapy as the new first-line standard of care for locally advanced or metastatic urothelial carcinoma (La/mUC). In addition, androgen-receptor pathway inhibitors (ARPI), represented by enzalutamide—which remains the only ARPI with 8-year overall-survival follow-up—continue to redefine long-term survival expectations for patients with prostate cancer, marking a new era for uro-oncology.Opening Remarks
The session began with welcome addresses from the two co-chairs, Professor Qiang Wei of West China Hospital, Sichuan University, Vice-Chair of the Chinese Urological Association, and Professor Morgan Roupret from Pitié-Salpêtrière Hospital, Sorbonne University, who serves on the EAU Guidelines Panel for Urothelial Cancer and chairs the EAU Section of Oncological Urology. Professor Wei emphasized that the 2025 ESMO China Focus forum provides an invaluable platform for academic exchange between Chinese and international specialists. He expressed the hope that shared expertise and insights would eventually translate into improved outcomes for patients.
Keynote: ADCs in Urothelial Cancer
Professor Morgan Roupret then delivered a keynote presentation titled “The Role and Unmet Potential of Antibody–Drug Conjugates (ADCs) in Urothelial Cancer.” He reviewed the mechanisms and developmental trajectory of ADCs and noted that therapies represented by enfortumab vedotin are profoundly reshaping the survival landscape for patients with urothelial carcinoma. He reiterated that EV-based combination therapy has now been unequivocally established as the first-line standard treatment for La/mUC in contemporary clinical practice.
EV-302 Exploratory Analyses in Older Adults and Patients with Comorbidities
Professor Nataliya Mar of the UC Irvine Chao Family Comprehensive Cancer Center presented exploratory analyses from the EV-302 study focusing on patients aged 75 and above, as well as those with comorbidities such as diabetes and renal impairment.
In the older-adult subgroup, EV combination therapy significantly outperformed chemotherapy across progression-free survival, overall survival, and objective response rate. Among patients aged 75 or older, median progression-free survival was 12.3 versus 6.0 months, corresponding to a 57% reduction in the risk of disease progression. Median overall survival reached 24.4 versus 11.6 months, representing a 49% reduction in the risk of death.
In patients with diabetes at baseline, the results were even more striking. Median progression-free survival reached 26.3 versus 6.2 months, a more than four-fold improvement and a 64% reduction in progression risk. Median overall survival reached 36.1 versus 14.5 months, a 2.5-fold improvement and a 66% reduction in mortality risk. Objective response rates also doubled.
In the subgroup with renal impairment, EV combination therapy again delivered nearly double the benefit observed with chemotherapy. Median progression-free survival was 10.5 versus 6.2 months, and median overall survival was 25.6 versus 13.3 months, with mortality risk reduced by 47%. Objective response rates rose from 38.2% with chemotherapy to 66.3% with EV combination therapy.
EV-103 Cohort K: 3.5-Year Long-Term Follow-Up
Professor Terence W. Friedlander of the UCSF Helen Diller Family Comprehensive Cancer Center presented updated 3.5-year results from EV-103 Cohort K, emphasizing the durability of clinical benefit associated with EV-based therapy. Median overall survival reached 30.7 months for the combination therapy group and 22.8 months for the monotherapy group. The five-year overall survival rate for the combination arm reached 41.5 percent, and progression-free survival maintained a stable plateau around 38 percent between years three and five, underscoring sustained long-term disease control.
The median duration of response for the combination regimen was 38.7 months. At 36 months, more than half of responders in the combination arm (58.8 percent) maintained their response. Even in the monotherapy arm, one-third of responders maintained long-term remission. Professor Friedlander noted that such extended disease control in cisplatin-ineligible patients—typically a population with very poor prognosis—is exceptionally rare and suggests the possibility of “functional cure” for a subset of patients. Long-term safety remained consistent and manageable throughout the follow-up period.
A Chinese Clinical Perspective on Urothelial Cancer Management
Professor Yuwei Yang of Peking University First Hospital delivered a comprehensive presentation titled “How I Treat Urothelial Cancer—A Perspective from Chinese GU Oncologists.” Drawing on Chinese epidemiological trends and clinical realities, she outlined the evolution of treatment strategies for advanced urothelial carcinoma in China. She emphasized that EV-based ADC-immunotherapy combinations have redefined national treatment standards, reflecting not only advances in oncology but also substantial improvements in patients’ survival and quality of life.
Expert Discussion: Establishing a Platinum-Free Era
A panel discussion chaired by Professor Bin Hu of Liaoning Cancer Hospital brought together Professor Roupret, Professor Mar, Professor Friedlander, and numerous leading urologic oncologists from across China. The experts agreed that EV combination therapy has inaugurated a new platinum-free treatment era and should now be considered the gold-standard first-line regimen for La/mUC. They also emphasized that maximizing clinical benefit requires robust patient follow-up, comprehensive management, and effective communication to ensure adherence.
ESMO Perspective on Prostate Cance
Professor Arnulf Stenzl, Secretary-General of the European Association of Urology and Professor at Diakonie-Klinikum Stuttgart, delivered a lecture titled “ESMO Perspective for Prostate Cancer: From Clinical Evidence to Improved Patient Outcomes.” He highlighted key findings from influential studies. The ENZAMET trial demonstrated a strong association between bone-metastatic burden, alkaline phosphatase levels, and patient prognosis. For patients with metastatic hormone-sensitive prostate cancer, especially those with extensive bone involvement, early docetaxel therapy did not provide a clear survival advantage in certain subgroups. In contrast, enzalutamide continues to show clear superiority over traditional non-steroidal antiandrogens such as bicalutamide. Professor Stenzl also noted that the annually updated EAU guidelines maintain a cautious stance toward triplet therapy, currently issuing only a weak recommendation.
Panel Discussion: Long-Term Survival in Prostate Cancer
The ensuing discussion, moderated by Professor Bo Dai of Fudan University Shanghai Cancer Center, included expert participation from both international and Chinese faculty. The panel unanimously recognized the significance of the ENZAMET study, which demonstrated a median overall survival of approximately eight years, underscoring the substantial and durable survival benefits achievable with enzalutamide in patients with metastatic hormone-sensitive prostate cancer. The discussion then shifted toward future directions, including the potential integration of ARPIs such as enzalutamide with next-generation ADCs and radiopharmaceuticals in the treatment of metastatic castration-resistant prostate cancer.
Closing Remarks
In their closing statements, Professors Qiang Wei and Morgan Roupret reiterated the shared commitment of the international medical community to advancing the diagnosis and treatment of prostate cancer and urothelial carcinoma. They expressed hope for continued cross-regional and cross-cultural collaboration, with the overarching goal of improving outcomes and quality of life for patients worldwide.
