August 2025 brought exciting advancements in urologic oncology, especially in bladder and kidney cancers. The month also marked the debut of a new podcast series by Urology Times®, hosted by Dr. Taylor Goodstein, focusing on cutting-edge improvements in the field.

Here are the top 5 headlines that could change the game in urologic oncology:

1. Revolutionary Combination Therapy Improves Survival in MIBC

A landmark finding from the phase 3 EV-303 (KEYNOTE-905) trial revealed that the combination of enfortumab vedotin (Padcev) and pembrolizumab (Keytruda) significantly enhances event-free survival and overall survival in patients with muscle-invasive bladder cancer (MIBC) who cannot receive cisplatin. This groundbreaking combination has outperformed surgery alone, marking a pivotal shift in treatment strategies for this high-risk group.

2. ctDNA Test Predicts Immunotherapy Success in Bladder Cancer

The phase 3 IMvigor011 trial showcased the effectiveness of the Signatera ctDNA-based assay in identifying MIBC patients who would benefit from adjuvant treatment with atezolizumab (Tecentriq) post-cystectomy. MRD-positive patients saw considerable improvements in survival rates, while MRD-negative patients achieved favorable outcomes without additional therapy. Natera is set to seek FDA approval for Signatera as a companion diagnostic tool to optimize treatment plans.

3. Pembrolizumab with Axitinib Outshines Sunitinib in Kidney Cancer

Exciting long-term results from the KEYNOTE-426 trial published in Nature Medicine confirmed pembrolizumab combined with axitinib (Inlyta) as the gold standard for untreated advanced clear cell renal cell carcinoma (ccRCC). With overall survival soaring to 47.2 months compared to 40.8 for sunitinib, this combo also demonstrated superior progression-free survival and objective response rates. The findings stress the importance of further research into biomarker-guided therapies.

4. Mitomycin Solution Proves Long-lasting Efficacy for NMIBC

The updated phase 3 ENVISION trial data spotlighted the enduring benefits of mitomycin intravesical solution (Zusduri) for recurrent low-grade, intermediate-risk non-muscle invasive bladder cancer (NMIBC). A remarkable 72.2% of patients achieved an event-free status at 24 months, solidifying mitomycin's role as a lasting chemoablative option following FDA approval.

5. Unlocking the History of Advanced Kidney Cancer Treatment