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HIGHLIGHTS FROM THE 2024 EUROPEAN ASSOCIATION OF UROLOGY ANNUAL MEETING |
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Navigating Urothelial Carcinoma: From Innovative Diagnostics to Therapeutic Strategies
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| Non-Thermal Atmospheric Plasma Ablation for Intermediate Risk Non-Muscle Invasive Bladder Cancer: A First in Human Trial |
| Husney Mahmud, MD |
| Husney Mahmud presented findings from a first-in-human trial of non-thermal atmospheric plasma ablation for intermediate-risk non-muscle invasive bladder cancer at the EAU 2024 meeting. The procedure demonstrated a high safety profile and potential as an outpatient alternative to transurethral resection for low-volume, low-to-intermediate risk tumors, with a treatment complete response rate of 85% at the initial 3-month follow-up. |
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| Is There a Role for BCG in Very High-Risk Non-Muscle Invasive Bladder Carcinoma? Multicenter Analysis of Oncological Outcomes and Risk Dynamics
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| Jose Subiela, MD
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| Jose Subiela presented findings from a multicenter retrospective study at the EAU 2024 meeting, assessing the role of BCG therapy in very high-risk non-muscle invasive bladder carcinoma (NMIBC). The study, involving 640 patients, demonstrated that longer BCG maintenance durations (>1-2 years and >2 years) were associated with superior oncological outcomes compared to <1-year maintenance.
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| A Phase II Clinical Trial of Neoadjuvant Sasanlimab and Stereotactic Body Radiation Therapy as an in Situ Vaccine for Cisplatin Ineligible Muscle Invasive Bladder Cancer |
| Raj Satkunasivam, MD, MS |
| Raj Satkunasivam presented a phase II clinical trial at the EAU 2024 congress, investigating neoadjuvant sasanlimab combined with stereotactic body radiation therapy (SBRT) as an in-situ vaccine for cisplatin-ineligible MIBC patients prior to radical cystectomy. The trial aims to assess the safety, feasibility, and efficacy of this combination therapy, with primary objectives including evaluating the rate of pathologic complete response and the safety and feasibility of the treatment regimen. |
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| Pembrolizumab in BCG Refractory Non-Muscle Invasive Bladder Cancer is Associated with High Rates of Adverse Events and Discontinuation of Treatment |
| Borivoj Golijanin, MD |
| Borivoj Golijanin presented findings on pembrolizumab use in BCG refractory non-muscle invasive bladder cancer at EAU 2024. Among 18 patients treated, 72.2% discontinued treatment due to adverse events, with only one achieving complete response. Recurrence-free survival rates were low, and treatment-specific survival was 26.5 months. Dr. Golijanin highlighted the treatment's high toxicity, and poor tolerability, and emphasized the importance of early discussion about radical surgery in the treatment guidelines for this condition. |
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| Urological Follow-up of Lynch Syndrome: Upper Tract Urothelial Carcinoma Incidence and Mutational Patterns in a Dedicated Outpatient Clinic |
| Federica Cattani, MD |
| Federica Cattani presented findings on upper tract urothelial carcinoma (UTUC) incidence and mutational patterns in Lynch Syndrome patients at EAU 2024. Among 30 patients, UTUC was the third most common manifestation, with MSH2 mutations prevalent in both colorectal cancer and UTUC cases. The establishment of a dedicated Lynch Syndrome clinic facilitated early diagnosis and informed follow-up strategies, potentially improving UTUC detection in this population. |
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Metastatic Urothelial Cancer
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| Membranous NECTIN-4 Expression in Metastasis Versus Matched Primary Tumor More Accurately Predicts Enfortumab Vedotin Response |
| Thomas Büttner |
| Thomas Büttner presented findings on membranous NECTIN-4 expression in metastasis compared to the primary tumor and its association with enfortumab vedotin response at EAU 2024. In a retrospective multicenter cohort, analysis of distant metastasis showed higher predictive value for enfortumab vedotin response compared to primary tumors. Membranous NECTIN-4 expression in distant metastases may offer a more precise indicator for treatment response and inform decision-making in metastatic urothelial carcinoma therapy. |
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| First-Line Maintenance Therapy in Patients with Locally Advanced or Metastatic Urothelial Carcinoma in Routine Care in Germany: Preliminary Results of the Prospective CARAT-UBC Registry |
| Peter Goebell, MD, Ph.D. |
| Peter Goebell discussed preliminary results of the prospective CARAT-UBC registry assessing first-line maintenance therapy in patients with locally advanced or metastatic urothelial carcinoma in routine care in Germany. The CARAT-UBC interim results reveal that currently in real-world approximately one third of patients with advanced urothelial carcinoma are progression-free following first-line platinum-based chemotherapy and, thus, qualify for maintenance therapy. |
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| TiP: Phase 3 Study of Disitamab Vedotin with Pembrolizumab Versus Chemotherapy in Patients with Previously Untreated Locally Advanced or Metastatic Urothelial Carcinoma That Expresses HER2 (DV-001) |
| Thomas Powles, MBBS, MRCP, MD |
| Thomas Powles discussed DV-001, a phase 3 trial of disitamab vedotin with pembrolizumab versus chemotherapy in patients with previously untreated locally advanced or metastatic urothelial carcinoma that expresses HER2. The primary objective was to compare the efficacy of disitamab vedotin in combination with pembrolizumab to chemotherapy, with the primary endpoints of progression-free survival and overall survival. |
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Living with Advanced Kidney Cancer and Urothelial Cancer
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| Moving Towards Intensified Treatment Paradigms in First Line Metastatic Kidney Cancer: Triplet Combinations at Any Cost - Is More Always Better? Yes, the More the Merrier
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| Laurence Albiges, MD, Ph.D.
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| The 2024 European Association of Urology annual meeting featured a plenary session on living with advanced kidney cancer and urothelial cancer, and a presentation by Laurence Albiges discussing that for first-line metastatic kidney cancer, we should be using triplet combinations at any cost.
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| Moving Towards Intensified Treatment Paradigms in First Line Metastatic Kidney Cancer: Triplet Combinations at Any Cost - Is More Always Better? No, Less Is More |
| Sarah Psutka, MD, MSc |
| In her discussion about the first-line treatment of metastatic renal cell carcinoma, Sarah Psutka argued against using triplet combinations for intensified systemic therapy, suggesting that sometimes less is more. |
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| State-of-the-Art Lecture: New Standard Treatment for Metastatic Bladder Cancer Based on EV-302/KEYNOTE-A39? |
| Andrea Necchi, MD |
| Andrea Necchi discussed whether there is a new standard treatment of metastatic bladder cancer based on EV-302/KEYNOTE-A39. Dr. Necchi started his presentation by highlighting the first-line therapy for metastatic urothelial carcinoma prior to the ESMO 2023 meeting, emphasizing both negative and positive trials in this disease space. |
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