Editor’s Note: In recent years, the incidence of urological malignancies in China has risen steadily. Prostate, bladder, and kidney cancers now rank among the most common malignancies in the country, posing a serious threat to public health. The Department of Urology at the National Cancer Center / Cancer Hospital, Chinese Academy of Medical Sciences (CICAMS), has long been dedicated to the diagnosis and treatment of urological tumors. With extensive experience in laparoscopic and minimally invasive surgery as well as multidisciplinary cancer management, it stands as a leading force in China’s field of urologic oncology. 

During the NCCU 2025 conference, Oncology Frontier – Urology Frontier invited Professor Ye Xiongjun from the National Cancer Center / CICAMS to share key highlights from the event, discuss stratified treatment strategies for kidney cancer, address the issue of positive surgical margins, and explore the future of liquid biopsy and emerging innovations in renal cancer care.

01

Oncology Frontier – Urology Frontier: As one of the chairs of this year’s conference, how do you view its role in advancing the field of urologic oncology in China? Which aspects of the program stood out most to you?

Professor Ye Xiongjun: This conference holds significant value for the advancement of urological oncology in China, primarily in two ways.

First, it provides clear strategic direction for the field. Academician He Jie, Director of the National Cancer Center, emphasized the critical importance of urologic cancers — whose incidence continues to rise — within the broader national cancer control strategy. Citing the latest data from the National Cancer Center, he stressed that improving the survival rates of the top ten malignancies (including prostate and other urologic cancers) is essential to achieving the national five-year overall survival target outlined in China’s long-term development plan.

He Jie expressed his hope that this high-level, deeply integrated, and international academic platform would focus on pressing clinical challenges in urologic oncology — particularly early detection and treatment, and survival improvement — ultimately contributing to the goals of “Healthy China.”

Second, the conference underscored the importance of practical implementation. Conference Chair Professor Xing Nianzeng, Vice President of CICAMS, has actively promoted initiatives such as the “Urologists’ Nationwide Tour” organized by the Chinese Medical Doctor Association. These efforts have helped elevate the technical standards of grassroots medical institutions and facilitated the dissemination and clinical application of updated national treatment guidelines for the three major urologic cancers. Such initiatives are instrumental in accelerating the translation of cutting-edge research into clinical practice, benefiting more patients across the country.

Notable highlights of the academic sessions included:

• Live Surgery Demonstrations: Leading medical centers across China — including the PLA General Hospital, Peking University First Hospital, Beijing Shijitan Hospital (Capital Medical University), Tsinghua Changgung Hospital, and CICAMS — collectively conducted 27 high-quality live surgeries. These sessions attracted a large online audience and offered an invaluable opportunity for surgical education and technical exchange.

• Innovative Therapeutic Approaches: Several promising treatment advancements were presented. For example, under Professor Xing’s leadership, a small-scale clinical trial investigating CAR-NK cell therapy for advanced metastatic prostate cancer showed encouraging preliminary results. Meanwhile, Professor Huang Jiaoti from Duke University introduced a potential novel target, GCP3, and discussed its relevance to developing new drugs for castration-resistant prostate cancer.

• Clinical Practice Focus: Every presentation was closely tied to real-world clinical experiences. Particularly insightful was the lecture by Professor Peter Hammerer, former President of the European Association of Urology (EAU) Oncology Section, who explored whether cytoreductive surgery should be performed in oligometastatic prostate cancer. Given the prevalence of such cases in China’s rural regions, this topic holds both academic and practical urgency.

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Oncology Frontier – Urology Frontier: Treatment for advanced kidney cancer has entered the era of immunotherapy combinations. With various “immunotherapy + targeted therapy” and “dual-immunotherapy” regimens now available, how should clinicians tailor treatment based on patients’ risk stratification and pathological subtypes? Are there any predictive biomarkers worth noting?

Professor Ye Xiongjun: For patients with advanced or metastatic renal cell carcinoma (RCC), we formulate personalized treatment plans based on risk stratification, most commonly using the IMDC (International Metastatic RCC Database Consortium) and MSKCC (Memorial Sloan Kettering Cancer Center) criteria. These frameworks are vital in estimating prognosis and guiding therapeutic decisions.

• For low-risk patients, Chinese guidelines generally recommend monotherapy with targeted agents, while European (EAU) and U.S. (NCCN) guidelines also consider immunotherapy–targeted therapy combinations as viable first-line options.

• For intermediate- and high-risk patients, given their higher tumor burden, the global consensus favors combination regimens — either targeted therapy plus immunotherapy or dual-immunotherapy approaches.

Pathological subtype also influences treatment selection. For the most common clear cell RCC, the above regimens typically yield favorable outcomes. However, for non-clear cell subtypes, current evidence suggests the need for novel strategies. Our center is conducting clinical trials exploring bispecific antibody therapies for these cases, and preliminary findings are promising.

As for predictive biomarkers, no universally reliable indicators currently exist for all advanced RCC patients. Therefore, researchers are integrating multi-omics data — encompassing clinical, histopathological, and imaging features — to build AI-driven predictive models that may enhance the accuracy of treatment-response forecasting. We hope such tools will help clinicians better tailor therapies to each individual patient.

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Oncology Frontier – Urology Frontier: You discussed the issue of positive surgical margins (PSMs) in robot-assisted partial nephrectomy. Beyond tumor complexity, which technical factors can help minimize the risk of PSMs?

Professor Ye Xiongjun: During this conference, we placed special emphasis on the importance of margin status in partial nephrectomy — a topic often underappreciated compared to its well-established role in prostate cancer surgery outcomes.

Our analysis suggests that capsular invasion may be a key biological factor contributing to positive margins after partial nephrectomy, warranting heightened attention.

Several technical measures can reduce PSM risk:

1. Careful patient selection. For patients with lobulated or irregularly shaped tumors, partial nephrectomy carries a higher risk of intraoperative tumor violation. Thus, the decision to pursue a nephron-sparing approach should be made after weighing the patient’s anatomy, tumor characteristics, and the surgeon’s experience.

1. Preoperative 3D imaging and planning. Utilizing 3D reconstruction of CT or MRI data allows surgeons to visualize the tumor’s relationship to surrounding structures and plan a precise surgical route. This not only minimizes unnecessary tissue trauma but also helps reduce the likelihood of residual tumor tissue.

1. Intraoperative guidance technologies. Real-time intraoperative ultrasound can help delineate tumor boundaries, while fluorescence imaging (e.g., ICG) is being explored for enhanced margin visualization. Although these techniques still have limitations, they represent promising directions for future development.

Moreover, Chinese researchers have recently introduced metabolomic-based rapid margin assessment techniques, which hold significant potential for improving intraoperative decision-making.

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Oncology Frontier – Urology Frontier: Looking ahead, from systemic therapy for advanced kidney cancer to minimally invasive surgery for early-stage disease, which emerging technologies or concepts do you believe will most profoundly impact patient outcomes and quality of life?

Professor Ye Xiongjun: For early-stage kidney cancer, we are actively exploring the use of liquid biopsy technologies to achieve two key goals:

1. Early detection of disease in at-risk populations.

1. Postoperative surveillance through monitoring circulating biomarkers that may indicate recurrence.

This approach could significantly improve early diagnostic rates and enable more precise follow-up management. Numerous research groups worldwide are pursuing this direction, aiming to identify robust biomarkers that help clinicians detect relapse early and intervene effectively.

For advanced kidney cancer, the past two decades have seen a major evolution — from targeted therapies to immunotherapy-based combinations — resulting in dramatically improved survival outcomes. Yet, when these regimens fail, identifying effective subsequent treatments remains a major challenge.

Thus, current priorities include developing next-generation therapeutic strategies and optimizing existing regimens to prolong survival even in refractory or resistant cases. We anticipate that continued innovation in systemic therapy, coupled with precision medicine and molecular profiling, will ultimately deliver tangible benefits to patients and further improve both survival and quality of life.

Professor Ye Xiongjun National Cancer Center / Cancer Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College