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Highlights from The 2025 LUGPA Annual Meeting |
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| NMIBC – Navigating the Options and Future Directions |
| Piyush Agarwal, MD |
| Nonmuscle-invasive bladder cancer still makes up ~70% of bladder cancer at diagnosis, and standard care remains TURBT with peri-operative chemotherapy, but many new bladder-sparing intravesical options are emerging. For intermediate-risk disease, data on UGN-102, intravesical FGFR-targeted TAR-210, and oncolytic cretostimogene (PIVOT-006) are promising and could expand beyond traditional BCG or gemcitabine/docetaxel. |
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| MIBC – What You Should Be Doing Today and What We Will Be Doing Tomorrow |
| Joshua Meeks, MD, PhD |
| Joshua Meeks reviewed how muscle-invasive bladder cancer care is evolving across the neoadjuvant, local, and adjuvant phases — highlighting that perioperative immunotherapy is producing unprecedented signals, including record pathological complete response rates in KEYNOTE-905/EV-303. He emphasized that ctDNA is emerging as the most important biomarker to guide adjuvant therapy and duration, with IMvigor011 showing ctDNA-informed treatment can identify who truly benefits from adjuvant immunotherapy. |
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| Recent Updates in Immunotherapy in Bladder Cancer
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| Suzanne Merrill, MD, FACS
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| Suzanne Merrill reviewed how immunotherapy is reshaping both NMIBC and MIBC. In NMIBC, the CREST and POTOMAC phase 3 studies showed that combining BCG with checkpoint inhibitors improves event-free survival compared to BCG alone, while ALBAN did not meet its primary endpoint. In MIBC, NIAGARA and KEYNOTE-905/EV-303 both demonstrated major improvements in pathologic complete response, event-free survival, and early overall survival signals – marking the strongest peri-operative immunotherapy data yet.
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| Prostate MRI 101
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| Aytekin Oto, MD, MBA
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| Aytekin Oto reviewed core prostate MRI anatomy and fundamentals of PI-RADS v2.1 interpretation, emphasizing that DWI is dominant for peripheral zone lesions and T2-weighted imaging is dominant in the transition zone. He highlighted common pitfalls (hemorrhage, prostatitis, BPH nodules), current variability in MRI quality/performance, and the growing role of structured quality frameworks and AI tools to standardize imaging and improve accuracy.
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| How to Read a PSMA PET Scan
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| Steven Rowe, MD, PhD
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| Steven Rowe reviewed how to interpret PSMA PET scans, highlighting that while PSMA PET has very high specificity, its sensitivity remains moderate for preoperative nodal staging. He summarized key landmark trials (OSPREY, LIGHTHOUSE, CONDOR, SPOTLIGHT) showing strong performance in biochemical recurrence detection and emphasized practical pitfalls such as uptake in ganglia, fractures, Paget’s disease, and post-radiation changes.
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| Genetic Testing in Prostate Cancer |
| Pedro Barata, MD, MSc, FACP |
| Pedro Barata emphasized the growing importance of genetic testing across the prostate cancer continuum, highlighting that ~25–30% of patients have actionable genomic alterations. He reviewed key evidence supporting PARP inhibitor use and newer targeted strategies in both mCRPC and mHSPC, including AMPLITUDE and CAPItello-281. Despite this, real-world testing rates remain low, underscoring a major unmet need in identifying patients who could benefit from targeted therapies and immunotherapy. |
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