Dr. Chandler Park

Dr. Chandler Park sat down for an interview with CURE® to discuss the biggest takeaway from the 2025 ASCO GU Symposium in terms of prostate cancer therapy.

Xtandi and Talzenna Therapy Shows Promise in Advanced Prostate Cancer

Dr. Chandler Park, a medical oncologist of Genitourinary Medical Oncology, at the Norton Healthcare Institute, in Louisville, Kentucky, sat down for an interview with CURE® to discuss the biggest takeaway from the 

2025 Annual ASCO Genitourinary (GU) Cancers Symposium

The TALAPRO-2 study, a large phase 3 trial presented at the meeting, evaluated the combination of Xtandi (enzalutamide) and Talzenna (talazoparib) in metastatic castration-resistant prostate cancer, he explained. The investigative agent demonstrated a 20% reduction in cancer progression regardless of BRCA1/BRCA2 mutation status, with potential future FDA approval, according to the expert.

Read more from our interview with Park on additional 

takeaways from the meeting encompassing bladder and kidney cancer

, as well as our conversation with him on 

the importance of precision medicine in oncology

[An important] study that is in the prostate cancer field is the TALAPRO-2 study. The [trial looked at] patients with prostate cancer when they're diagnosed. There are two types of prostate cancer: one is called metastatic-hormone sensitive prostate cancer, and that means that these patients are still sensitive to testosterone, so we give them testosterone blockers — kind of like estrogen blockers for patients with breast cancer; but the more aggressive type is called castrate-resistant prostate cancer. This [diagnosis] is very tough and we want to find new treatments for this.

In TALAPRO-2, patients got randomized to Xtandi, which is considered a great standard of care treatment for metastatic castration-resistant prostate cancer, and the other arm received Xtandi plus Talzenna, which is considered a PARP inhibitor. Now, PARP inhibitors are something that we might all hear about when we treat for patients in ovarian cancer, breast cancer and pancreatic cancer, and the key is they need these genetic markers called BRCA1 and BRCA2. It was very similar in the prostate cancer world, where patients had to have either the BRCA1 or BRCA2 mutations; these mutations could be either in the germline or the somatic.

Germline is whenever a buccal swab or blood check [is done] to see if [patients] inherited BRCA1/BRCA2 genes. Now, what's somatic mutation? Imagine if I have a black mark on my hand, and that mark is melanoma. If they take a biopsy of this black part of my hand, and they take a biopsy of my normal hand, the DNA of that cancer is completely different from the skin, and that is called somatic mutation. If there's a BRCA1/BRCA2 mutation inside the cancer, then you could qualify for a PARP inhibitor. Now, with all that said, that is considered a select patient population; we must see if the patients qualify for a PARP inhibitor in this study.

What makes this study, as we considered it, a highlight at ASCO GU, is they didn't look at that in terms of randomizing patients to the study, they took all comers. It was close to 800 patients, a large phase 3 trial, in which patients got randomized to Xtandi versus Xtandi plus Talzenna, and there was a 20% decrease in terms of the cancer.

A lot is based upon the molecular subgroups, but it is encouraging that if a patient shows up with metastatic castration-resistant prostate cancer [we could refer to this]. Although I recommend everybody [complete testing], not everybody practices in the big city. Some people practice in rural America, and they might not have access [to germline and somatic testing]. So if they don't have access, and these oncologists see patients… [they should focus on family history of cancer], as there might be some kind of genetic concern for cancer. In these situations, I would consider this based upon the ASCO GU study. Now, it is not FDA approved yet, but I anticipate it will be, so we'll cross our fingers.

Those are the three impactful studies that I see for patient care [following the ASCO GU Symposium].

Transcript has been edited for clarity and conciseness.

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Videos

Xtandi and Talzenna Therapy Shows Responses in Advanced Prostate Cancer

Dr. Park sat down for an interview with CURE® to discuss the key takeaways from the 2025 Annual ASCO Genitourinary Cancers Symposium.

An Expert Highlights His Key Takeaways From The 2025 ASCO GU Symposium 

2025 Annual ASCO Genitourinary Cancers Symposium

, Dr. Chandler Park sat down for an interview with 

® to discuss the key takeaways from the meeting. One of the key messages that he highlighted was the importance of genetic testing.

In the interview he stated: “I would highly encourage that whenever you see an oncologist… ask for genetic testing — not just germline testing, but somatic.”

In the interview, he went on to highlight the importance of precision medicine, as well as discuss key trials in genitourinary cancers to come out of the ASCO GU Symposium. Read here for more of our interview with Park, a medical oncologist of Genitourinary Medical Oncology, at the Norton Healthcare Institute, in Louisville, Kentucky.

One key [takeaway from the ASCO GU Symposium] is for patients that have prostate cancer [or those with] family and loved ones [with prostate cancer]. It is important to [speak with] your oncologist. I help out at the medical schools, and I can sense that certain people go into oncology because they love people, and [these people] are open to feedback. Therefore, I would highly encourage that whenever you see an oncologist, if you have a history of prostate cancer in the family, ask for genetic testing — not just germline testing, but somatic.

[Speaking to] bladder cancer, there was another study that was updated, and this is something that all patients and their family members should know about, and that's called the phase 3 NIAGARA study. This is something that's applicable today. So, what's the NIAGRA study? The NIAGRA study evaluated patients in which we want to get a high cure rate. Previously, for patients that had cystectomy, the standard of care was chemotherapy, surgery and then afterwards was to watch followed by consideration of immunotherapy, but there was no overall survival.

However, based on the ASCO GU update, if a patient received chemotherapy with an immunotherapy called Imfinzi (durvalumab), they had a much higher chance, that after surgery, they would remain cured. Everybody today that has stage 2 bladder cancer and received treatment before the surgery should ask their medical oncologist for chemotherapy and an immunotherapy. Then, after surgery, maybe even consider immunotherapy afterwards. That's something I would encourage.

For more news on cancer updates, research and education,

don’t forget to subscribe to CURE®’s newsletters here.

An Expert Highlights His Key Takeaways From The 2025 ASCO GU Symposium

Dr. Chandler Park discusses the importance of genetic testing and personalized care in patients with genitourinary cancers.

Personalized Medicine Makes Strides Across the GU Oncology Treatment Space

Patients with genitourinary cancers such as kidney, bladder or prostate cancer should ask their doctor about precision medicine, which tailors treatment based on genetic testing, according to Dr. Chandler Park.

For example, some patients with kidney cancer with specific gene mutations may benefit from targeted therapy, while those with stage 4 bladder cancer should check for FGFR3 or HER2 mutations to see if they qualify for more effective treatments. In prostate cancer, genetic testing for BRCA and other mutations can help guide treatment choices. In an interview with CURE®, Park discusses the importance of genetic testing and personalized medicine, as this approach ensures patients receive the most effective and personalized care.

Park is a medical oncologist of Genitourinary Medical Oncology, at the Norton Healthcare Institute, in Louisville, Kentucky.

One of the things about genitourinary cancers is every patient — whether you have kidney cancer, bladder cancer or prostate cancer — needs to be evaluated for precision medicine. This is something I would share with my patients and their family members: ask for precision medicine. For example, let's say a patient has kidney cancer and they have specific gene mutations, such as von Hippel Lindell (VHL) germline mutations. If they do, I would consider them for evaluation by a genetic counselor to see if they have a condition called von Hippel Lindell disease, and in the future, I would consider them for treatment with a medication called Welireg [belzutifan]; that's a precision medicine now.

In bladder cancer… there has been an explosion of precision medicine. There are three highlights that I would talk about with somebody with bladder cancer to chat with their oncologist about. First — specifically in stage 4 disease — do I have a gene mutation? Do I have a gene mutation called FGFR3, because if you do, you can receive a medication called Balversa [erdafitinib]. [This agent] has a strong 40% to 45% response rate and is better than chemotherapy. The second thing that's emerged in the last six months is asking your oncologist, if you have a gene mutation called HER2. HER2 is something that oncologists know in terms of the breast cancer world, but if a patient has stage 4 bladder cancer and they have a HER2 gene mutation, there's a 60% to 65% chance that if they receive a medication called Enhertu [fam-trastuzumab deruxtecan-nxki], that it would work. I would ask if they have a HER2 gene mutation.

In terms of prostate cancer and precision medicine, we have to check for BRCA1, BRCA2, PALB2, CDK12, [and others]. I would ask, in terms of, when you see the oncologist, whether you have prostate, kidney or bladder cancer, ask that oncologist about the role of precision medicine and the role of next-generation sequencing. This way, you are or your family member is receiving, precision medicine, which is the best treatment for their specific cancer.

Dr. Chandler Park

Xtandi and Talzenna Therapy Shows Responses in Advanced Prostate Cancer

An Expert Highlights His Key Takeaways From The 2025 ASCO GU Symposium

Personalized Medicine Makes Strides Across the GU Oncology Treatment Space

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