Abstract / Summary
Abstract Background The Uromigos is a global genitourinary (GU) oncology initiative that developed the Uromigos Score, a 0–3 scale quantifying clinical expert support for treatment options across advanced GU cancer disease states. The perspectives of Asian clinicians have not been systematically analyzed as a distinct cohort. We characterized the Uromigos Score among Asian GU oncology experts and compared it with global expert opinion. Methods GU oncology experts from across Asia, predominantly Japan, scored treatment options across seven disease states in urothelial and prostate cancer using the same four-point scale as the global panel (3 = undisputed standard of care [SOC]; 2 = potentially inferior but reasonable; 1 = limited role; 0 = should be avoided). Mean scores were computed and compared descriptively with the global cohort. Results Broad consensus was observed across most disease states. Enfortumab vedotin plus pembrolizumab received the maximum score (3.0) from both cohorts in first-line advanced urothelial cancer, and androgen deprivation therapy (ADT) plus an androgen receptor pathway inhibitor was near-undisputed SOC for metastatic hormone-sensitive prostate cancer. Notable regional differences included higher scoring by Asian experts of ADT monotherapy (0.9–1.6 vs 0.1–0.9) and lutetium-177–PSMA therapy (2.4–2.8 vs 1.8–2.4), higher scoring of BCG plus durvalumab in papillary high-risk NMIBC without CIS (2.3 vs 1.5), and lower scoring of disitamab vedotin plus toripalimab (1.9 vs 2.5). Conclusion Asian and global expert opinion align across most GU cancer disease states. Several regional differences likely reflect differential drug availability, regulatory timelines, and practice patterns, and identify areas warranting Asia-specific evidence generation.