Advances in Prostate Cancer: Insights from ASCO GU 2025

Recent therapeutic advances have significantly improved outcomes for patients with advanced prostate cancer and have transformed the management of the disease. This review highlights some interesting developments in prostate cancer treatment presented at the 2025 American Society of Clinical Oncology (ASCO) Genitourinary (GU) Cancers Symposium. The optimal integration of radiotherapy (RT) was one major topic: Comparative data in high-risk localized disease suggest that RT in combination with androgen deprivation therapy (ADT) may be a more effective alternative to radical prostatectomy. In the oligometastatic setting, adding RT to standard of care (SoC) might significantly delay disease progression. Another important topic is the integration of personalized treatments in addition to the SoC of androgen deprivation plus androgen receptor pathway inhibitors (ARPI) in the metastatic setting. The ENZA-p study investigated the addition of radioligand therapy with LuPSMA, whereas the TALAPRO-2 trial evaluated the combination of ADT/ARPI plus poly (ADP-ribose) polymerase (PARP) inhibitor talazoparib in patients with metastatic castration-resistant prostate cancer (mCRPC). While the results are encouraging their impact is limited since the population included in both trials does not any more reflect the patient population in first-line mCRPC in Switzerland. However, they form a basis for further investigations of these treatment principles in earlier disease stages. Finally, the STOPCAP meta-analysis evaluated differences in treatment outcomes with various ARPI agents across subgroups of patients with metastatic hormone-sensitive prostate cancer (mHSPC). PEER REVIEWED ARTICLE Peer reviewers: Prof. Dr Arnoud Templeton, Medical Oncology, St. Claraspital, Basel, Switzerland PD Dr Petros Tsantoulis, Medical Oncology and Hematology, Geneva University Hospital, Geneva, Switzerland This article was received on May 26, 2025; accepted after peer review on June 11, 2025; published online on June 12, 2025.