The European Society for Medical Oncology (ESMO) 2025 congress spotlighted many pivotal trial results across both prostate and kidney cancers. Below, we break down some of the most important trial data presented, and what this might mean for future clinical practice.
Prof Axel S Merseburger (University Hospital Schleswig-Holstein, Lübeck, Germany)
“From radioligand breakthroughs in prostate cancer, to new combination strategies in kidney cancer, ESMO25 showcased the rapidly advancing therapeutic landscape that promises to transform patient management across disease stages”
Prostate Cancer
PSMAddition (LBA6)
In metastatic hormone-sensitive prostate cancer (mHSPC), the PSMAddition trial confirmed the utility of ¹⁷⁷Lu-PSMA-617 radioligand therapy earlier in the disease course. Adding Lu-PSMA-617 to androgen deprivation therapy (ADT) plus an AR pathway inhibitor improved radiographic progression-free survival (PFS) (HR 0.72; p=0.002) across disease burden subgroups, with manageable toxicity. Although overall survival (OS) data are immature, investigators and discussants viewed this as the entry of radioligand therapy into first-line treatment.
CAPItello-281 (23830)
The CAPItello-281 trial introduced capivasertib, an AKT inhibitor, for PTEN-deficient mHSPC, showing an rPFS of 33.2 vs 25.7 months (HR 0.81; p=0.034) when added to abiraterone. While OS is immature, this marks the first targeted strategy to demonstrate efficacy in this biomarker-defined subset.
ENZARAD (LBA86)
In the ENZARAD study, enzalutamide failed to improve metastasis-free survival when added to ADT and radiotherapy in high-risk localized prostate cancer (HR 0.88; p=0.34). Subgroup benefits in node-positive patients and those receiving pelvic RT hint that future trials may refine selection.
EMBARK (LBA87)
The EMBARK study cemented enzalutamide plus ADT as a new standard for high-risk biochemical recurrence, reducing the risk of death by 40% (OS HR 0.59). Experts described this as a major advance for patients with rapidly rising prostate-specific antigen (PSA) after definitive therapy.
Kidney Cancer
LenCabo (LBA94)
Click here to read our full interview with Dr Andrew W. Hahn on the LenCabo trial
The LenCabo trial provided the first head-to-head comparison of second-line options for metastatic clear cell renal cell carcinoma (ccRCC) after PD-1 checkpoint inhibitor therapy. In this randomized phase II study, lenvatinib plus everolimus reduced the risk of disease progression by 49% versus cabozantinib, achieving a median progression-free survival of 15.7 vs 10.2 months. With an objective response rate of 53% and manageable toxicity, the combination offers a promising strategy for patients requiring aggressive disease control following immunotherapy.
RAMPART (LBA93)
The RAMPART trial brought good news for resected renal cell carcinoma, as durvalumab plus tremelimumab significantly improved DFS (HR 0.65; p=0.009) versus active monitoring, particularly in high-risk subgroups (HR 0.52). The regimen’s manageable toxicity profile positions it as a strong contender in the adjuvant setting alongside pembrolizumab from KEYNOTE-564.
Disclosure: This short article was prepared by touchONCOLOGY in collaboration with Prof Axel Merseburger. touchONCOLOGY utilize AI as an editorial tool (ChatGPT (GPT-4o) [Large language model]. https://chat.openai.com/chat). The content was developed and edited by human editors. No fees or funding were associated with its publication.
This content has been developed independently by Touch Medical Media for touchONCOLOGY. It is not affiliated with the European Society for Medical Oncology (ESMO). Views expressed are the speaker’s own and do not necessarily reflect the views of Touch Medical Media.
Cite: ESMO25 GU round up: Breakthroughs in prostate and kidney cancer. touchONCOLOGY. November 13th, 2025
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