SUO 2019

Washington, DC (UroToday.com) Continuing the plenary session on nonmuscle invasive bladder cancer (NMIBC) at this year’s Society of Urologic Oncology Annual Meeting, Dr. Mark Soloway presented on the management of small, low grade bladder cancer recurrences.

Washington, DC (UroToday.com) The session on Non-muscle invasive bladder cancer (NMIBC) at this year’s Society of Urologic Oncology Annual Meeting continued with a presentation from Dr. Georgios Gakis on the role of en bloc resection of bladder tumors.

Washington, DC (UroToday.com) As part of the Research Scholars Update at the 20th Annual Meeting of the Society of Urologic Oncology, Dr. Karen Wheeler presented her work on immunotherapy and bladder cancer. Previous work has shown that surgery can induce an immune suppressive state. Using a mouse model, Dr. Wheeler assessed survival of mice with intravenous MB49 (lung metastasis) or intravesical MB49 (orthotopic) demonstrating that surgery can worsen survival in the metastatic model but not in an orthotopic (bladder cancer) model:

Washington, DC (UroToday.com) In the Thursday afternoon session of the Society of Urologic Oncology’s Annual Meeting Plenary, Dr. Cheryl Lee led a session examining Transurethral Resection of Bladder Tumor (TURBT) quality. She began by outlining the rationale for considering this question and laid out a number of key reasons:

Washington, DC (UroToday.com) While PSA screening has resulted in decreasing prostate cancer mortality, PSA is also known to be a poorly specific test for the detection of clinically significant cancer and can lead to unnecessary biopsies, over-detection of low risk prostate cancer or even miss aggressive disease. PSA’s lack of robustness as a screening biomarker has led to the development of new prostate cancer screening tools (urine, blood, and imaging-based) to add specificity to PSA for the detection of clinically significant prostate cancer. During the oral abstract session at the 20th Annual Meeting of the Society of Urologic Oncology, Dr. Claire De La Calle and colleagues presented results of their study evaluating and comparing three screening tools in the clinical setting: serum based 4K score and urine based studies SelectMDX and ExoDx™. Their objective was to assess these three study’s added value for the detection of clinically significant prostate cancer when combined with multiparametric parametric MRI (mpMRI).

Washington, DC (UroToday.com) The second session on renal cell carcinoma at the SUO focused on the management of advanced disease. Dr. Brugarolas was invited to present data regarding the value of a critical assessment of one’s own institution’s outcomes to drive patient outcomes. He is a professor at UT Southwestern (UTSW) Medical Center in both the Department of Hematology/Oncology and Developmental Biology, where he leads the Kidney Cancer Program and as such is uniquely posed to discuss quality outcomes in the multidisciplinary setting.

Washington, DC (UroToday.com) Non-muscle invasive bladder cancer (NMIBC) has high rates of recurrence and low risk of progression. However, the natural history of NMIBC is heterogeneous, with significant variation depending on stage and grade at diagnosis. Currently, available risk calculators provide broad estimates of any recurrence and progression to muscle-invasive disease but are not able to predict the stage and grade of the recurrence. Understanding the patterns of recurrence on a more granular level may enable risk-stratified NMIBC treatment and surveillance. At the 20th Annual Meeting of the Society of Urologic Oncology, during the Young Urologic Oncologists Podium Session, Dr. Tullika Garg presented her study titled Risk of Multiple Levels of Recurrence and Progression after Initial Diagnosis of Non-Muscle Invasive Bladder Cancer in a Multi-Site, Community-Based Cohort. The study aimed to predict the risk of multiple levels of recurrence and progression outcomes across the NMIBC stage and grade in a large cohort from two community-based health systems- Geisinger and Kaiser Permanente Northwest (KPNW).

Washington, DC (UroToday.com) There is a need for a new line of treatment for BCG unresponsive superficial high-grade non-muscle invasive bladder cancer (NMIBC). Both BCG and anti-PD1 agents have proven activity in urothelial cancer, and upcoming trials are looking at monotherapy or combination therapy with these agents to provide an alternative to radical cystectomy. At the 20th Annual Meeting of the Society of Urologic Oncology, during the Young Urologic Oncologists Podium Session, Dr. Shahee Alanee, presented the results of Phase I Trial of Intravesical BCG Combined with Intravenous Pembrolizumab in High-Grade NMIBC. Patients who had persistent or recurrent disease after failing treatment with at least two courses of intravesical therapy (one of which had to contain BCG) or BCG followed by maintenance BCG, were included in the study. The primary objective was to determine the safety of this combination, and the secondary endpoints were the response to treatment at 19 weeks (end of treatment).

Washington, DC (UroToday.com) The recipient of this year’s Huggins Medal is Dr. Laurence Klotz from the University of Toronto and Sunnybrook Medical Centre. Dr. Klotz has 470 peer reviewed manuscripts and six books. His basic science research interests are in the role of micronutrients and diet in prostate cancer prevention and translational research. His research lab has been active for 30 years, producing several patents and a biotech company. Dr. Klotz’s clinical research interests have been in the areas of active surveillance, image-guided therapy, molecular biomarkers, and androgen receptor targeted therapy; additionally, he has lead numerous randomized trials in prostate cancer. His awards include the Queen’s Jubilee Medal in 2013 for meritorious public service, and in 2014 he received the Urologic Oncology Medal in 2014. He’s also received Canada’s highest civilian award, the Order of Canada, and the Harold Warwick Prize from the Canadian Cancer Society for international contributions to cancer control.

Washington, DC (UroToday.com) Dr. Arnulf Stenzl provided the EAU guest lecture today at the 20th Annual Meeting of the Society of Urologic Oncology, discussing his innovative work on improving urologic oncology surgery with intraoperative real-time technology. Dr. Stenzl has more than 600 publications and two international patents. He is the former chair of the EAU Scientific Congress and is on the executive board of the Comprehensive Cancer Center of Southwestern Germany. His research and clinical interests include bladder and prostate cancer, as well as reconstructive surgery.

Washington, DC (UroToday.com) At the 20th Annual Meeting of the Society of Urologic Oncology, Dr. Martin Gleave reviewed findings of the genomic umbrella neoadjuvant study (GUNS) and other biomarker trials. Older neoadjuvant androgen deprivation therapy (ADT) studies showed improved pathologic surrogates (4-8% pathologic cure rate (pCR)) but no difference in PSA recurrence rates.¹ Similarly, newer neoadjuvant trials using LHRH with abiraterone or enzalutamide or both showed improved pCR rates, 8%.² A Clinical Cancer Research (CCR) study evaluated the impact of neoadjuvant docetaxel and ADT on genomics and transcriptomics in high-risk prostate cancer. The study evaluated 52 patients, of which 3 had microfocal residual cancer after treatment, and none had pCR. The investigators found alterations in TMPRSS2-ERG fusion, TP53, PTEN, FOXA1, and SPOP; furthermore, the study demonstrated that androgen receptor (AR) signaling suppression varied among treated tumors, with an upregulation of certain neuroendocrine and plasticity genes. The alterations in this high-risk localized group of patients are distinct and different from those with advanced metastatic castrate resistant prostate cancer mCRPC.