Introduction and Context
The Advanced Urologic Cancer Consensus Conference (AUC3) 2025 convened 51 multidisciplinary experts to produce a timely, practice‑focused consensus on management of renal cell carcinoma (RCC) and urinary tract cancers (UTCs). Rapid approvals and shifting indications over recent years—adjuvant immune checkpoint inhibitors (ICIs) in RCC, perioperative chemo‑immunotherapy in bladder cancer, and enfortumab vedotin plus pembrolizumab (EV+pembro) as a new frontline standard in metastatic urothelial carcinoma (UC)—have created complex sequencing questions that randomized trials have not fully answered. AUC3 used a modified Delphi process with pre‑ and post‑meeting voting to identify areas of strong agreement, nuanced recommendations and important gaps in evidence (McKay et al., AUC3 2025).1
Why AUC3 matters now
– New agents and expanded indications have created regionally variable access and significant decision complexity.
– Clinicians face daily questions about perioperative use of ICI, how to sequence ICI/TKI/antibody‑drug conjugates, and how to treat histologic variants and vulnerable populations.
– AUC3 aims to translate evolving trial data into pragmatic guidance while highlighting uncertainties that require prospective study.