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GU Cancers 2026 | TulmiSTAR-02: tulmimetostat plus darolutamide or abiraterone in mHSPC

Neal Shore, MD, FACS, Carolina Urologic Research Center, Myrtle Beach, SC, discusses the Phase I/II TulmiSTAR-02 trial (NCT07190300) of tulmimetostat with darolutamide or abiraterone in metastatic hormone-sensitive prostate cancer (mHSPC). This dose escalation and expansion study assesses safety, tolerability, and preliminary efficacy of the EZH2/EZH1 inhibitor tulmimetostat with androgen receptor pathway inhibitors. The trial includes dose optimization followed by randomized comparison to evaluate biochemical response rates and survival outcomes in this patient population. This interview took place at the 2026 ASCO GU Cancers Symposium in San Francisco, CA.

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Transcript

So the TulmiSTAR-02 is looking at adding in the mCSPC population what’s known as an EZH2 inhibitor. And essentially this protein essentially can, by blocking EZH2, that conversion, one can enhance the delay in ultimately developing resistance to the androgen receptor pathway. It has to do with affecting chromatin regulation. There’s also what’s known as the PRC2 complex, which there can be, in addition to delaying resistance, there is actually a plausible immunogenic effect...

So the TulmiSTAR-02 is looking at adding in the mCSPC population what’s known as an EZH2 inhibitor. And essentially this protein essentially can, by blocking EZH2, that conversion, one can enhance the delay in ultimately developing resistance to the androgen receptor pathway. It has to do with affecting chromatin regulation. There’s also what’s known as the PRC2 complex, which there can be, in addition to delaying resistance, there is actually a plausible immunogenic effect. The bottom line is that we know that ARPIs, regardless of the one that you choose, has really become a mainstay in prostate cancer care, whether it’s in sensitive or resistant biology. So there are now multiple studies, including the TulmiSTAR-02. Looking at Tumimetastat, there are other EZH2 inhibitors. And I think it’s really important for the field that we’re going to see multiple phase three trials read out over the next several years, trying to enhance the long-term benefit of an ARPI, even potentially adding an EZH2 after an ARPI is no longer effective. So these are oral medications. The Tumimetastat impacts both EZH2 and EZH1. So there may be some receptor enhancement there as well.

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