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Nomenclature Matters: What Should the Future Be for Gleason Grade Group 1?

Matt Cooperberg | November 30, 2022

The term “cancer” dates to the time of Hippocrates, when the crab (karkinos)-like cutaneous manifestations of advanced tumors heralded incurable disease, pain, decline, and death. Today the term denotes an incredibly diverse spectrum of conditions, all characterized by abnormal cell division and growth—and nearly all by the capacity for metastasis—but varying very widely in aggressiveness and kinetics of progression. In the era of microscopy and histopathology, each cancer now has its formal criteria for diagnosis, and clinicians recognize the variable meaning of each. To the public, however, the connotation of the diagnosis “You have cancer” has changed only to an extent in the modern age.

In the case of prostate cancer, prostate specific antigen (PSA)-based early detection and the years-to-decades lead time associated with screening has radically changed the clinical meaning of the diagnosis. Countless research articles and reviews on prostate cancer begin by citing the fact that it is the most common non-cutaneous cancer diagnosed among men in the US and in many other countries.

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Matthew R. Cooperberg, MD, MPH

Matthew R. Cooperberg, MD, MPH graduated from Dartmouth College, where he finished summa cum laude with a major in English. He earned his MD and MPH degrees at Yale University and completed residency in Urology and fellowship in Urologic Oncology at UCSF. At the end of his training, Dr. Cooperberg joined the faculty at UCSF, where he maintains busy clinical practices at the UCSF Helen Diller Family Comprehensive Cancer Center and the San Francisco VA Medical Center. He also holds a secondary appointment in the Department of Epidemiology & Biostatistics. He is actively engaged in research approaching the challenges of prostate cancer from many interrelated angles, from molecular analyses to health system-wide research. He has written or contributed to over 350 research articles. Early in 2013 Dr. Cooperberg co-authored a proposal for a national urology registry which served as the basis for the AUA Quality (AQUA) Registry, a project for which he now serves as Senior Physician Advisor. In 2015 he won the AUA Gold Cystoscope Award, and in 2016 was awarded his first R01 grant as Principal Investigator from the National Cancer Institute, to develop and validate novel miRNA-based biomarker signatures for refined prostate cancer prognosis. He lives in San Francisco with his wife, Jacqueline Dolev (a derm-atologist and fellow Yale Medical School alum), where they work primarily to keep up with their children, Jake and Sarah.

Videos
Clinical Conversations by Experts
Welcome and Background Cancer or Not Cancer "Presentation" - Scott Eggener
Rationale for Nomenclature Change Gleason Grade 1 Cancer "Presentation" - Matthew Cooperberg
Reservations About a Nomenclature Change for Gleason Grade 1 Prostate Cancer "Presentation" - Adam Kibel
When is Prostate Cancer Not Really Cancer? "Presentation" - Yuri Nikiforov
What is in a Name? Inadvertent Harm from the Designation and Label of 'Cancer' "Presentation" - Laura Esserman
Grade Group 1 Prostate Cancer: A Pathologist's Case for Cancer Classification 'Con' "Presentation" - Gladell Paner
Grade Group 1 Prostate Cancer: A Pathologist's Case for Cancer Classification 'Pro' "Presentation" - Theodorus van der Kwast
Prostate Cancer Classification Dilemma: Lessons from Breast and Colorectal Tumors "Presentation" - Jeffry Simko
Prostate Cancer Biopsy Sampling: Challenges in Grade Group 1 Classification "Discussion" - Lawrence True
Rethinking Cancer Treatment: Lessons from Breast to Prostate Cancer "Presentation" - Alastair Lamb
Where to Draw the Line? The Spatial Molecular Continuum from 'Normal' to GG1 to GG2 Prostate Cancer "Presentation" - Alastair Lamb
Active Surveillance in Prostate Cancer: Rethinking Grade Group 1 "Presentation" - Daniel Lin
Active Surveillance Challenges in Prostate Cancer Management "Presentation" - Laurence Klotz
AI-Powered Prostate Cancer Grading Predicts Active Surveillance Outcomes - Cornelia Ding
VA's Million Veterans Program Reveals Crucial Genetic Data for Prostate Cancer Treatment - Bruce Montgomery
Prostate Cancer Knowledge and Screening Barriers in Northern Tanzania: A Community-Based Study - Blandina Mmbaga & Nicholas Ngowi
MMAI Model Risk Stratification for NCCN Guidelines for Low, Intermediate, and High-Risk Prostate Cancer - Neal Shore, Daniel Spratt, & Alicia Morgans
Automated Identification of Key Steps in Robotic-Assisted Radical Prostatectomy Using Artificial Intelligence - Abhinav Khanna
Testosterone Recovery After ADT: Timing, Predictive Factors, and Clinical Implications - Pierre Blanchard
Staging High-Risk Prostate Cancer with PSMA PET: Strengths and Pitfalls - Irene Burger
Novel 18-Gene Urine Test Improves Detection of Clinically Significant Prostate Cancer - Jeffrey Tosoian
A US Real-World Study of Treatment Patterns and Outcomes in Localized or Locally Advanced Prostate Cancer Patients - Beyond the Abstract
CEASAR Study Reveals Long-Term Quality of Life Outcomes for Localized Prostate Cancer Treatments - Daniel Barocas & Bashir Al Hussein Al Awamlh
The Use of Imaging in Staging Localized Prostate Cancer: A Case Study on High-Risk Localized Prostate Cancer - Zachary Klaassen
PSMA PET & The Impact of the PRIMARY Trial "Presentation" - Louise Emmett
Radiation Outcomes Improve with Age in Localized Prostate Cancer - Mack Roach
How Mental Health Disorders Impact Treatment Decisions in Localized Prostate Cancer - Yaw Nyame & Joshua Cabral
Deciphering Prostate Cancer: How Genomic Biomarkers are Shaping Treatment Decisions - Paul Nguyen
Parsing the Evidence from the EMBARK Trial on a Promising New Drug Regimen in High-Risk Non-Metastatic Hormone-Sensitive Prostate Cancer - Matthew Cooperberg
Correlation and Validation of Gene Expression Classifiers in Prostate Cancer: A Large-Scale Study - Daniel Spratt
Decipher Scores and PSMA PET Imaging: A Correlative Study in High-Risk Prostate Cancer - Amar Kishan
PACE B Study Analysis: Acute and Late Toxicities in Prostate Cancer Radiotherapy - Ragu Ratnakumaran
Exploring Regional Variation in Genomic Testing and Imaging in Prostate Cancer - Michael S. Leapman
Journal of Urology Open Plus - Revolutionizing Access and Innovation in Urology Research - John W. Davis
Improving Primary Prostate Cancer Diagnosis Through Risk Stratified Screening: a European Perspective - Sigrid Carlsson
Advancements in Prostate Cancer Screening: Inclusion of At-Risk Groups, Imaging & Biomarkers - An AUA Guidelines Update - Daniel Lin
Risk Assessment in Localized Prostate Cancer - Insights from Real-World Data and SEER Registry - Jim Hu
ProtecT Trial Reveals New Insights for Prostate Cancer Treatment: Implications for Low-Risk vs. High-Risk Patients - David Penson
Harm-to-Benefit of Three Decades of Prostate Cancer Screening in Black Men - Jonathan Shoag
The Molecular Biology of Prostate Cancer - Christopher Barbieri
MRI and Active Surveillance for Prostate Cancer - Robert Reiter
A Probing Conversation on Prostate Cancer Diagnosis and the Potential of Liquid Biopsies and Polygenic Risk Scores - Sanoj Punnen
The ENACT Trial: Ezalutamide Monotherapy plus Active Surveillance vs Active Surveillance Alone in Patients with Low-Risk or Intermediate-Risk Prostate Cancer - Neal Shore
Who Needs Early Salvage Radiotherapy and Who Needs Adjuvant Radiotherapy in 2022? - Kosj Yamoah
Incorporating Genomic Testing for Prostate Cancer into Your Practice - Daniel Lin
Genomic Risk Classification in Localized Prostate Cancer - Matthew Cooperberg
AUA Guidelines on Localized Prostate Cancer - Stephen Boorjian & James Eastham
Barriers and Opportunities in Active Surveillance, HIFU, and Focal Therapy in Latin American Countries - Laurence Klotz
Novel Approaches in the Management of High-Risk Prostate Cancer - Ray Manneh Kopp
Racial and Ethnic Disparity in the Use of Prostate MRI - a UroToday Journal Club - Christopher Wallis & Zachary Klaassen
Treatment Delay Experiences Among Black and White Men with Prostate Cancer - Bhav Jain & Christopher Dee
Risk Stratification for Localized Prostate Cancer - Matthew Cooperberg
Associations of Adverse Pathology With 20 Year Risk of Distant Metastasis and Prostate Cancer Specific Mortality - Michael Brooks
Validating the Association of Adverse Pathology with Distant Metastasis and Prostate Cancer Mortality 20-Years After Radical Prostatectomy - Eric Klein
AI-Derived Digital Pathology-Based Biomarker To Predict the Benefit of ADT in Localized Prostate Cancer – Dan Spratt
Validation of Performance of the Decipher Biopsy Genomic Classifier in Intermediate-Risk Prostate Cancer: The Phase III Randomized Trial NRG Oncology/RTOG 0126 – Jeff Michalski
Association of Inherited Mutations in DNA Repair Genes with Localized Prostate Cancer – Kara Maxwell
NCCN Guidelines 2022 - Prostate Cancer on Comparison of Treatment Options for Localized Disease + Local Therapies + Disease Monitoring - Zachary Klaassen and Chris Wallis
Treatment-Related Regret Among Men With Localized Prostate Cancer Journal Club - Christopher Wallis & Zachary Klaassen
High Risk Prostate Cancer and Genomics - Paul Nguyen & Alan Pollack
NCCN Prostate Cancer Clinical Practice Guidelines on Risk Stratification for Clinically Localized Prostate Cancer – Christopher Wallis & Zachary Klaassen
Improving the Quality of Care for Men in Michigan With Prostate Cancer, the MUSIC Collaborative, a Focus on the G-MINOR and G-MAJOR Trials – Todd Morgan
Personalized Hormone Therapy with Post-Operative Radiation Therapy and Validation of the Decipher Genomic Classifier in SAKK 09/10 Trial - Dan Spratt and Alan Dal Pra
When to Add ADT to Early or Late Salvage Radiation - Dan Spratt
Clinical Case Discussions - "Rising PSA 18 Months Post RP and Timing of Radiotherapy" - Ashley Ross, Alan Dal Pra, and Dan Spratt
Prostate Cancer Screening and Shared Decision Making in the Veterans Health Administration - Stacy Loeb
Validating the Genomic Classifier to Identify Patients With a High Risk of Metastasis Among African American Men With Early Localized Prostate Cancer, VANDAAM Study – Kosj Yamoah
PCORI-Funded Initiative Evidence Gaps To Guide Future Research on the Use of Active Surveillance for Prostate Cancer – M. Minhaj Siddiqu
Prostate Cancer Modeling: The CISNET Prostate Group - Ruth Etzioni
Relugolix vs. Traditional ADT: A Comparative Analysis in the Setting of Definitive Therapy for Localized Disease - Ashley Ross
The Decipher® Genomic Classifier for Recurrent Prostate Cancer in the NRG/RTOG 9601 Randomized Clinical Trial, Journal Club - Christopher Wallis & Zachary Klaassen
Genomics Guide Treatment Decisions in Post Prostatectomy Patients - Ashley Ross
A Systematic Review of the Decipher® Genomic Classifier in Prostate Cancer - Ashley Ross & Daniel Spratt
Timing of Radiotherapy After Radical Prostatectomy (RADICALS-RT) Journal Club - Zachary Klaassen and Christopher Wallis
The Accidental Journey of Shepherding PSMA PET Imaging in Prostate Cancer to the Clinic in the United States - Thomas Hope
Clinical Implications of the Study Findings from the Radiotherapy Adjuvant Versus Early Salvage ((TROG 08.03/ANZUP RAVES) Trial - Andrew Kneebone and Declan Murphy
(TROG 08.03/ANZUP RAVES) Phase 3 Trial on Adjuvant Radiotherapy Versus Early Salvage Radiotherapy Following Radical Prostatectomy Journal Club - Christopher Wallis & Zachary Klaassen
Prostate Active Surveillance Study (PASS) - Daniel Lin
How Can We Accelerate Clinical Trial Accrual in Localized Prostate Cancer? - Brian F. Chapin
An Expert Discussion on Gleason 6 (Grade Group 1) Prostate Cancer - Scott Eggener 
MRI Versus Ultrasound for Prostate Cancer - Samir Taneja
Active Surveillance for Low-Risk Prostate Cancer - Laurence Klotz and Peter Carroll
Data from the RTOG 9601 Study: Treating Prostate Cancer Patients with Low-Volume Disease - Daniel Spratt
Study of Baseline PSA Screening of Men (45 years old) - Peter Albers
Epidemiologic Outcomes of Prostate Cancer Patients Undergoing Active Surveillance - Sigrid Carlsson
Increasing Rates of Active Surveillance as the Standard of Care in Men with Low Risk Prostate Cancer- Matthew Cooperberg
Practice Patterns of Active Surveillance in Prostate Cancer - Matt Cooperberg
Active Surveillance: Recent Findings and Case Studies - Laurence Klotz
Long-Term Outcomes of Active Surveillance for Prostate Cancer - Interview with Sigrid Carlsson
The Men’s Eating and Living (MEAL) Study, Diet Intervention in Men on Active Surveillance for Prostate Cancer - Interview with J. Kellogg Parsons
Active Surveillance: Who is the Right Patient? - Matt Cooperberg

A Journal Club for Patients with Prostate Cancer

Physician-Scientist Review Articles
State of the Evidence Review Articles
Written by Rashid Sayyid, MD MSc, & Zachary Klaassen, MD MSc
March 21, 2023
While external beam radiotherapy is a standard treatment option as first-line therapy for men with localized prostate cancer, it is also an important component of care for patients following radical prostatectomy. For approximately two-thirds of patients undergoing radical prostatectomy for prostate cancer, surgery is curative, and patients remain disease-free (without biochemical or radiographic evidence of recurrence).1 However, patients with adverse pathologic findings (defined as seminal vesicle invasion, extraprostatic extension, and positive surgical margins (residual tumor at the surgical site) experience up to a 60% risk of recurrence at 10 years.2
Written by Rashid K. Sayyid, MD MSc and Zachary Klaassen, MD,MSc
March 27, 2023

Introduction

The last decade has seen an increased uptake of the robotic-assisted laparoscopic approach for radical prostatectomies. Despite the negative results of the only published phase III randomized clinical trial comparing robotic-assisted laparoscopic to open radical prostatectomy, which demonstrated no significant differences in short- and medium-term functional outcomes between the two approaches,1 it is currently estimated that more than 70% of radical prostatectomy surgeries performed since 2012 in the United States have been with robotic assistance.2 In 2018, it was estimated that 92.6% of all radical prostatectomies in England were performed using this minimally invasive technique.3
Written by Zachary Klaassen, MD MSc & Rashid K. Sayyid, MD MSc
March 29, 2023

Across all aspects of daily life, artificial intelligence more than ever is harnessing the power of machine learning to automate and improve the efficiency of tasks. This is also true in medicine and, in particular, in the field of prostate cancer. The concept of artificial intelligence began in the 1950s with the prime objective of emulating the cognitive capabilities of human beings in machines. More specifically, artificial intelligence is the ability of a machine to independently replicate intellectual processes typical of human cognition. Machine learning comprises algorithms that parse data, learn from that data, and then apply what they have learned to make informed decisions. Deep learning is a form of machine learning that is inspired by the structure of the human brain and is particularly effective in feature detection:1

Written by Zachary Klaassen, MD, MSc & Sherita A. King, MD
January 9, 2023
Despite prostate cancer being the second most common cause of cancer mortality among American men,1 there are over 3 million men in the United States living with prostate cancer. As such, there are many “prostate cancer survivors” that are either on active surveillance/watchful waiting or have undergone treatment for localized (ie. radiation therapy, radical prostatectomy, focal therapy, etc) or advanced disease (ie. androgen deprivation therapy, chemotherapy, novel hormonal therapy, immunotherapy, etc).
Written by Rashid Sayyid, MD MSc, & Zachary Klaassen, MD MSc
January 6, 2023

External beam radiotherapy, along with radical prostatectomy, has been a mainstay treatment option for prostate cancer for decades and is currently recommended by numerous guidelines for the treatment of intermediate- and high-risk disease.1-3 Unlike surgery which is often, at least initially, planned as a monotherapy, many patients who opt for external beam radiotherapy will receive concurrent therapy. This center of excellence article will review the evidence for concurrent systemic therapy with radiotherapy in men with localized and locally advanced disease.

Written by Rashid Sayyid, MD MSc, & Zachary Klaassen, MD MSc
December 13, 2022

External beam radiotherapy, along with radical prostatectomy, has been a mainstay treatment option for prostate cancer and is currently recommended by numerous guidelines for the treatment of intermediate- and high-risk disease.1-3 While external beam radiotherapy has been foundational in prostate cancer treatment for decades, there have been significant changes in the delivery of radiotherapy, corresponding to technical advances.

Written by Christopher J.D. Wallis, MD, PhD & Zachary Klaassen, MD, MSc
December 8, 2021

Active Surveillance Background


Prostate cancer represents a public health dilemma: while prostate cancer is the second leading cause of death among men in the US1 and third in Canada,2 it is widely over-diagnosed and over-treated, leading to significant patient anxiety and morbidity.3 Much of the over-diagnosis of prostate cancer relates to the use of serum prostate-specific antigen (PSA) testing for prostate cancer screening, beginning in 1987.4
Written by David Crawford, MD
December 8, 2021

Over the nearly two years of navigating the COVID pandemic, urology practices were forced to increase their efficiency by focusing on streamlining patient visits without sacrificing care quality. However, postponed checkups were unavoidable as the public was encouraged to stay home. According to the Centers for Disease Control and Prevention (CDC), 40% of Americans in 2020 delayed or avoided medical care due to pandemic-related concerns. Although necessary, we are now facing the severe consequences of delayed diagnosis and prostate cancer seems to be leading the way.

November 8, 2021
In prostate pre- and post-biopsy decision making, more precision is urgently needed. Whereas expert imaging and biomarker-based risk scores already enable the clinician in this respect, the dilemma remains for those patients that are diagnosed with apparent indolent cancer. Additional diagnostic tools that (de)select patients for active surveillance (AS) would provide a great benefit for the patient.
Written by Neal D. Shore, MD, FACS, and Michael S. Cookson, MD, MMHC
October 12, 2020
The COVID-19 pandemic has resulted in numerous physical and psychological adjustments for clinicians, patients, and their families—wearing personal protective equipment, adopting telemedicine, adjusting clinic workflow, etc. The ensuing uncertainty and attendant anxiety from the fluidity of information and healthcare policy debate has augmented the need for enhanced communication
Written by Neal D. Shore, MD, FACS, and Michael S. Cookson, MD, MMHC
June 24, 2020
Despite the recent disruptions in health care delivery due to the COVID-19 pandemic, patients at risk for developing prostate cancer as well as those diagnosed with prostate cancer still deserve timely and optimal decision making.
Written by Zachary Klaassen, MD, MSc
April 20, 2020
Currently, there is a global pandemic surrounding the spread of betacoronavirus SARS-CoV-2 leading to Coronavirus Disease 2019 (COVID-19). The rapid spread to all corners of the globe has had tremendous health and economic implications, including the appropriate allocation of healthcare resources.
Written by Zachary Klaassen, MD, MSc
April 17, 2020
The rapid spread of Coronavirus Disease 2019 (COVID-19) throughout the world, caused by the betacoronavirus SARS-CoV-2, has had dramatic effects on health care systems with impacts far beyond the patients actually infected with COVID-19. Patients who manifest severe forms of COVID-19 requiring respiratory support typically require this for prolonged durations, with a mean of 13 days of respiratory support reported by the China Medical Treatment Expert Group for Covid-19.1
Written by Zachary Klaassen, MD, MSc
March 19, 2020
Radiographic imaging has played a key role in the diagnosis and staging of patients with prostate cancer for decades. Today, transrectal ultrasound and multiparametric magnetic resonance imaging are important in diagnosis and local staging of the primary tumor while axial imaging and molecularly targeted positron emission tomography
Written by Zachary Klaassen, MD, MSc
April 16, 2019
Secondary to the introduction of prostate specific antigen (PSA) screening in the 1980’s/1990’s, symptomatic presentation of prostate cancer has become less frequent. Symptoms of locally advanced prostate cancer may include obstructive urinary symptoms, gross hematuria, and/or upper tract urinary obstruction leading to renal failure.
Written by Zachary Klaassen, MD, MSc
April 16, 2019
Over the last decade, imaging for prostate cancer has improved immensely. Specifically, prostate multiparametric MRI (mpMRI) has improved primarily as a result of an increase in magnet strength from 1 to 3-tesla. mpMRI consists of anatomic and functional imaging techniques:
Physician-Scientist Commentaries
Peer-reviewed Abstract Supplemental Commentaries
Written by Anwar R. Padhani, MBBS, FRCP, FRCR Consultant & Ivo G. Schoots, MD
Prostate cancer is a leading cause of male cancer-related deaths worldwide, with over one million new cases diagnosed each year. Most deaths occurring in the first decade after detection are due to late diagnoses of high-risk states. Early detection is crucial for improving outcomes, and MRI has emerged as a promising tool for detecting prostate cancer at an early stage.
Written by Leonardo K. Bittencourt, Anwar R. Padhani, Clare M. Tempany, & Ivo G. Schoots
The wide adoption of MRI and MRI-directed biopsies in the diagnostic workup of suspected prostate cancer (PCa) has ignited discussions about the appropriate balance between the benefits and harms of the biopsy decisions.
Written by Udit Singhal, MD, and Randy A. Vince Jr., MD, MS
Genomic classifiers are used for prognostication and risk stratification in prostate cancer. Despite the emerging data, a commonly cited limitation is the retrospective datasets used for analysis. While there has been a litany of data using retrospective datasets to extrapolate the value of commercially available platforms in the pretreatment setting, the evaluation of these assays using prospectively collected data is still needed.
Written by Bishoy M. Faltas, MD
Englander Institute for Precision Medicine, Weill Cornell Medicine
Germline DNA damage repair (gDDR) alterations are common in men with prostate cancer (PCa). Men with PCa and gDDR alterations showed poor clinical outcomes. It is unclear if men with high-risk PCa and gDDR alterations would respond differently to neoadjuvant androgen
Conference Coverage
Conference Highlights Written by Physician-Scientist
Presented by Yaw Nyame, MD, MS, MBA
The 2024 American Urological Association (AUA) annual meeting featured a plenary session, and a State-of-the-Art lecture by Dr. Yaw Nyame discussing prostate cancer screening in high risk groups. Dr. Nyame started his presentation by highlighting that prostate cancer will be the #1 malignancy diagnosed in males in the United States in 2024 (299,010 cases, 29%),
Presented by Rana R. McKay, MD
The 2024 GU ASCO annual meeting included a prostate cancer session featuring trials in progress and a presentation by Dr. Rana McKay discussing the trial design of NePtune, a phase 2 study of neoadjuvant PARP inhibition followed by radical prostatectomy in patients with unfavorable intermediate-risk or high-risk prostate cancer with BRCA1/2 gene alterations.
Presented by Michael Leapman, MD, MHS
(UroToday.com) The 2023 AUA annual meeting included a session on markers in prostate cancer, featuring a presentation by Dr. Michael Leapman discussing the development of a longitudinal prostate cancer transcriptomic and real-world clinical data linkage. Genomic classifiers have been shown to be prognostic
Presented by Michael Leapman, MD, MHS
(UroToday.com) The 2023 AUA annual meeting included a session on markers in prostate cancer, featuring a presentation by Dr. Michael Leapman discussing the association between the Decipher genomic classifier and prostate cancer outcomes in a large-scale, real-world dataset.
Presented by Freddie Hamdy, MD, FRCS(Urol), FMedSci
The 2023 European Association of Urology (EAU) annual congress was host to a plenary session addressing the “right management” of prostate cancer patients in the early detection and active surveillance settings. Dr. Freddie Hamdy presented the updated 15-year oncologic outcomes of the PROstate TEsting for Cancer and Treatment (ProtecT) trial.
Presented by Jenny L Donovan, Liverpool, PhD, FMedSci, FFPH, NIHR SI, AcSS, OBE
The 2023 European Association of Urology (EAU) annual congress was host to a plenary session addressing the “right management” of prostate cancer patients in the early detection and active surveillance settings. Professor Jenny Donovan presented the updated 15-year quality of life (QoL) outcomes of the Prostate Testing for Cancer and Treatment (ProtecT) trial.
Presented by Daniel Keizman, MD
The 2023 ASCO GU cancers symposium held in San Francisco, CA between February 16th and 18th was host to a prostate cancer poster session where Dr. Daniel Keizman presented his group’s study evaluating the geographic variation of Decipher® genomic classifier in patients with early prostate cancer.
Presented by Ashley E. Ross, MD, PhD
The 23rd Annual Meeting of the SUO was host to a prostate cancer session. Dr. Ashley Ross, MD, PhD presented the results of an external validation of a digital pathology-based artificial intelligence (AI) model predicting metastasis and death in high and very high risk men from the NRG/RTOG 9902 phase III trial.
Presented by Alan Dal Pra, MD
The 2022 ASTRO Annual Meeting was host to a session evaluating new insights into post-prostatectomy radiotherapy. Dr. Dal Pra presented his group’s work evaluating the prognostic and predictive performance of a 24-gene post-operative radiation therapy outcomes score (PORTOS) 
Presented by Zaeem Lone, MD
The 2022 ASTRO annual meeting featured an improving prostate cancer survival session, including a presentation by Zaeem Lone discussing transcriptomic features of cribriform and intraductal carcinoma of the prostate. Prostate cancer risk stratification has largely relied upon Gleason grade and PSA level. However, recent recommendations from the International Society of Urologic Pathologists has suggested modifying the Gleason grade system to include reporting of cribriform and intraductal carcinoma.  
Presented by Skyler B. Johnson, MD
The 2022 ASTRO annual meeting featured an improving prostate cancer survival session, including a presentation by Dr. Skyler Johnson discussing the impact of tertiary Gleason pattern 5 and high Genomic Classifier Score on predicting lymph node invasion at the time of radical prostatectomy in patients with intermediate-risk disease.  
Presented by Alicia K. Morgans, MD, MPH
The 2022 ASCO annual meeting featured a session on prostate cancer, including a trial in progress presentation by Dr. Alicia Morgans discussing ERADICATE, a phase III double blinded study of early intervention after radical prostatectomy with ADT with darolutamide versus placebo in men at highest risk of prostate cancer metastasis by genomic stratification.
Presented by James Eastham, MD
The 2022 Annual Meeting of the American Urological Association was host to an AUA Guidelines sessions focused on localized prostate cancer, presented by Dr. James Eastham. The guidelines were divided into multiple sections:
In this plenary session, Dr. Jeffrey Cadeddu, Dr. Jihad Kaouk, and Dr. Li-Ming Su elaborated on the specific advantages and disadvantages of the multiport (MP) and single port (SP) robotic platforms in performing prostatectomies in hopes of delineating one’s superiority over the other. Of note, Dr. Cadeddu and Dr. Kaouk, who were both arguing counterpoints, have experience with both robotic platforms.
Presented by Kostantinos Morris, Judd Moul, MD, Srinath Kotamarti, MD,
The 2022 American Urological Association (AUA) Annual Meeting featured work from Mr. Kostantinos Morris and colleagues from Duke University School of Medicine (Durham, North Carolina) assessing the usage of prostate health index (PHI) in pre-biopsy work-up of African-American men.
Presented by Brandon Mahal, MD
The 2022 Advanced Prostate Cancer Consensus Conference (APCCC) Hybrid Meeting included a session on biochemical recurrence and a presentation by Dr. Brandon Mahal discussing who needs systemic treatment with salvage radiotherapy. Dr. Mahal started his presentation by highlighting the RTOG 9601 trial,1 
Presented by Felix Feng, MD

(UroToday.com) The 2022 Advanced Prostate Cancer Consensus Conference (APCCC) Hybrid Meeting included a session on biochemical recurrence, and a presentation by Dr. Felix Feng discussing how treatment can be individualized by using genomic classifiers. Dr. Feng started by highlighting that genomic biomarkers are included in certain treatment 

Presented by Christopher Koller, MD
The 2022 Southeastern Section of the AUA’s annual meeting included a prostate cancer session and Dr. Christopher Koller discussing a prospective observational prostate cancer study assessing the potential for upgrading on active surveillance among African American men.
Presented by Christopher Koller, MD
The 2022 Southeastern Section of the AUA’s annual meeting included a prostate cancer session and Dr. Christopher Koller discussing the impact of COVID-19 on adhering patients to an active surveillance protocol for prostate cancer.
Presented by J Kellogg Parsons, MD, MHS,
Dr. Parsons presented a poster describing the results of the IPASS study examining the role of PROSTVAC immunotherapy in patients eligible for active surveillance. A significant proportion of men who begin active surveillance will have disease progression.
Presented by Daniel Spratt, MD
Dr. Dan Spratt presented a poster outlining validation of the Decipher biopsy genomic classifier in intermediate-risk prostate cancer. The 22-gene Decipher genomic classifier (GC) is a prognostic biomarker that has been validated in phase III trials in high-risk localized,
Presented by Alan Dal Pra, MD

The 2021 ASTRO Meeting included a session on biomarkers and salvage radiotherapy and discussion by Dr. Alan Dal Pra regarding the performance of a genomic classifier within a phase 3 randomized trial of dose escalated salvage radiotherapy after radical prostatectomy.

Presented by Paul Nguyen, MD

The 2021 ASTRO Meeting included a session on biomarkers and salvage radiotherapy and discussion by Dr. Paul Nguyen regarding the validation of a 22-gene genomic classifier in the NRG Oncology/RTOG 9202, 9413, and 9902 phase III randomized trials.

Presented by Brian Baumann, MD

The 2021 ASTRO Meeting’s included a session on biomarkers and salvage radiotherapy and a discussant presentation of five presentations in this session by Dr. Brian Baumann. With regards to organizing these five presentations into clinical context, Dr. Baumann highlighted the SAKK 09/10 trial, a phase I trial of neoadjuvant stereotactic body radiotherapy, biomarker studies

Presented by Chris H. Bangma, MD, PhD
In this presentation, Dr. Chris Bagma, Professor of Urology at Erasmus MC, focused on anxiety and quality-of-life for men on active surveillance for prostate cancer. First, he started by reviewing active surveillance. Active surveillance (AS) is a treatment option for low-risk prostate cancer per the EAU and AUA guidelines. 
Presented by David Monty Berman, MD
In plenary abstract presentation at the 2021 ASCO GU, Dr. Berman and colleagues present their work which sought to create objective molecular biomarkers that would be resistant to sampling error and should be useful when applied to biopsy tissue, on the basis of radical prostatectomy grade.
In a plenary abstract presentation in the Poster Highlights Session: Prostate Cancer - Localized Disease session at the 2021 ASCO GU meeting, Dr. Fairmichael and colleagues presented results of the Stereotactic Prostate Radiotherapy (SPORT) trial, examining the feasibility of performing a randomized trial of SABR ± PNI.
Presented by Jim Hu, MD, MPH
In the session on prostate cancer, Jim Hu, MD, MPH, discussed the Study of Prostate Ablation Related Energy Devices (SPARED) Collaboration.
Presented by Ivo Schoots, MD, PhD
San Francisco, CA  (UroToday.com)  Dr. Ivo Schoots from the Netherlands discussed the optimal use of multiparametric MRI in the management of localized prostate cancer.
Presented by Laurence H. Klotz, MD, FRCSC
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
Presented by Matthew R Cooperberg, MD, MPH, FACS
Washington, DC (UroToday.com) In the first prostate cancer session at the 2019 Society for Urologic Oncology meeting in Washington, DC, Dr. Matthew Cooperberg highlighted the similarities
Presented by Ganesh S. Palpattu, MD, FACS
Athens, Greece (Urotoday.com) In today’s medical environment of the growing number of patients, increasing complexity of patient problems, an ever-growing body of literature
Presented by Derya Tilki, MD
Athens, Greece (Urotoday.com) In this talk, Dr. Tilki reviewed several prognostic biomarkers in the setting of localized prostate cancer management.  According to the EAU guidelines, the results of prospective multicenter studies are awaited before a recommendation can be made regarding the routine application of currently available prognostic biomarkers. This means more evidence is required before these biomarkers can be used in a standardized manner. 

 

Presented by Andre Abreu, MD
Athens, Greece (UroToday.com) Cryoablation involves freezing of the targeted prostate tissue in two cycles, reaching minus 40 degrees Celsius, with the following histological changes:
Presented by Professor Christopher Parker
Barcelona, Spain (UroToday.com) Men who undergo surgery as definitive therapy for their localized prostate cancer generally only receive subsequent radiation therapy
Presented by Claire Vale, PhD
Barcelona, Spain (UroToday.com) There are three randomized trials, RADICALS,1 GETUG-AFU 17 and RAVES; recently presented at ASTRO 2019, that have compared adjuvant radiotherapy with a policy of salvage radiotherapy
Presented by Zachary Kornberg, Staff Research Associate
Chicago, IL (UroToday.com) Dr. Kornberg presented his talk on- A 17-gene Genomic Prostate Score as a Predictor of Adverse Pathology for Men on Active Surveillance. The Oncotype DX® Genomic Prostate Score (GPS) test is an RNA expression assay that can be performed on needle-core biopsies from men with prostate cancer (PCa).
Presented by Zachary Klaassen, MD, MSc
Barcelona, Spain (UroToday.com) At the Active Surveillance vs Focal Therapy in Prostate Cancer session at EAU 2019, Dr. Francesco Giganti and colleagues from the United Kingdom presented results of their use of the PRECISE recommendations and outcome of men on active surveillance for prostate cancer. 
Presented by Roderick van den Bergh, MD
Barcelona, Spain (UroToday.com) Dr. van den Bergh presented on the current and future role of active surveillance in prostate cancer. Approximately 350 studies on active surveillance have been published per year in the last 5 years. This therapeutic strategy has been incorporated into all major urological guidelines
Presented by Guan Hee Tan, Clinical Fellow
Barcelona, Spain (UroToday.com) Active Surveillance (AS) for prostate cancer (PCa) is the standard of care of men with low-risk PCa. However, approximately 30-40% of men on AS will eventually progress to treatment – either due to choice or due to progression. Progression can either be due to grade or volume progression
Presented by Monique J. Roobol, PhD., MSc
Prague, Czech Republic (UroToday.com) As part of the ESOU 2019 prostate cancer session there was a discussion regarding the appropriate treatment of Gleason 3+4 disease. Dr. Monique Roobol discussed the possible utilization of active surveillance for these patients.
Presented by Nicolas Mottet, MD, Ph.D
Prague, Czech Republic (UroToday.com) It is good news for both patients and physicians that there has been wider adoption of appropriate utilization of active surveillance (AS) among patients with prostate cancer. Dr. Nicolas Mottet presented risk stratification for active surveillance.
Presented by Laurence Klotz, MD, FRCSC
Toronto, Ontario (UroToday.com) Dr. Laurence Klotz presented on the current status of active surveillance for prostate cancer. Through the years there has been greater recognition of the overtreatment problem of prostate cancer patients, and the concept of active surveillance has been more accepted.