Genitourinary Oncology Highlights from the European Society for Medical Oncology Annual Meeting 2025: Advances in Renal Cell Carcinoma and Muscle-invasive Bladder Cancer

Several practice-relevant advances in genitourinary oncology were reported across renal cell carcinoma (RCC) and muscle-invasive bladder cancer (MIBC) at ESMO 2025. In localized RCC, the NESCIO study showed that short-course neoadjuvant checkpoint inhibition can induce pathologic responses, while RAMPART supported the use of adjuvant dual checkpoint blockade in high-risk disease. In cisplatin-ineligible MIBC, the KEYNOTE-905/EV-303 trial demonstrated significant survival benefit with perioperative enfortumab vedotin plus pembrolizumab. In advanced RCC, KEYMAKER-U03 demonstrated improved progression-free survival with HIF-2α-based triplet therapy, the LenCabo study supported lenvatinib plus everolimus in later lines and the CALYPSO trial highlighted limited benefit of empiric combinations without biomarker selection. Emerging approaches including transcriptomic stratification (OPTIC RCC) and circulating biomarkers (KIM-1, ctDNA) support a shift toward biologically guided treatment selection.