HERMES trial supports shortened SBRT schedule without added toxicity for patients with prostate cancer

CANCERtreatment with this regimen significantly improved event-free survival and overall survival in comparison with cystectomy alone.6 Furthermore, data presented at the 2026 American Society of Clinical Oncology (ASCO) Genitourinary Cancers Symposium highlighted the benefits of pembrolizumab plus EV over gemcitabine plus cisplatin in cisplatin-eligible patients with MIBC.7 "The treatment paradigm has evolved rapidly," Dr Chen says.In his practice, he orders ctDNA testing at the baseline before initiating these neoadjuvant treatments and monitors ctDNA every 3 months."ctDNA monitoring gives us molecular information and allows for early detection of cancer recurrence."Retrospective data presented at the 2026 ASCO Annual Meeting showed that early ctDNA measures could provide physicians with a measure of response to EV plus pembrolizumab.Specifically, ctDNA clearance allowed for identification of patients with a deep and durable benefit, whereas ctDNA positivity showed early resistance.8 However, Dr Chen notes that prospective data will be needed before ctDNA-directed treatment decisions can become standard of care with EV plus pembrolizumab.