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Highlights from the 36th Annual EAU Virtual Congress |
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| Prostate Cancer Screening 2021 Algorithm |
| Monique Roobol, MD |
| Monique Roobol summarized the current state of PSA screening in Europe followed by the recently published recommended screening algorithm by the EAU. Based on the current knowledge of prostate cancer screening, Dr. Roobol and other experts in Europe have developed in individually and geographically tailored cancer screening algorithms which is unique in the cancer screening arena. |
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| Risk-Adapted Screening with Age and Baseline-PSA: PROBASE Trial |
| Christian Arsov |
| Christian Arson presents on the PROBASE trial, a risk-adapted screening study for prostate cancer based on age and baseline PSA alone. This is a preliminary presentation of early results for an ongoing study. The distribution of baseline PSA values in PROBASE matched almost exactly that of other cohorts and allows us to define different risk groups and screening intervals. |
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| Risk-Adapted screening with 4K and MRI: PROSCREEN Trial
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| Anssi Auvinen, MD, Ph.D.
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| Anssi Auvinen of Finland presented the PROSCREEN trial, which is an ongoing risk-adapted screening based on 4K score and MRI. The PROSCREEN study is a population-based randomized screen trial initiated in 2018. The accrual goal was 60,784 men from Finland. It allowed for a flexible screening interval – if baseline PSA < 1.5, men were invited back after 6 years. If between 1.5-3.0, screening interval 4 years. If PSA >3.0 (screen-positive), re-screened after 2 years.
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| Risk-Adapted Screening with Genomics and MRI: STHLM3 MR Phase 2 Trial |
| Tobias Nordstrom, MD, Ph.D. |
| Tobias Nordstrom presented on the Stockholm3 MRI trial, which is a risk-adapted screening protocol incorporating genomics and MRI. The aim of this study was to compare traditional screening with web-based risk prediction combined with MRI-targeted biopsies for prostate cancer screening. This was a population-based screening-by-invitation noninferiority trial. |
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| Risk-Adapted Screening with SNPs: ProCaRis Trial |
| Jacob Fredsoe, Ph.D. |
| At the 2021 European Association of Urology annual meeting, Dr. Jacob Fredsoe presents the ProCaRis trial, which is a risk-adapted screening trial for prostate cancer utilizing single nucleotide polymorphisms (SNPs). He reviewed the pitfalls of prostate cancer screening, the issues with no screening, and the need to improve current screening strategies. |
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| Risk-Adapted Screening with MRI Only: MVP Trial |
| Robert Nam, MD |
| Robert Nam presents the Canadian study entitled MVP (MRI vs. PSA) Trial, which compares MRI directly against PSA as an initial screening strategy in screening naïve men. This study, which is currently in the process of publication, was a phase 3 randomized study directly comparing prostate MRI to PSA testing in a population of screening naïve man. The primary outcome was the diagnosis of prostate cancer and specifically clinically significant prostate cancer. Men were randomized in a 1:1 fashion to either prostate MRI or PSA testing. |
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| Patient Statement: Active Surveillance |
| Cosimo Pieri |
| Cosimo Pieri from Italy kicked off the session on active surveillance for intermediate risk prostate cancer with a patient testimonial. As mentioned by the session chairs, he has been a strong proponent of active surveillance in Italy, Europe, and even internationally. Mr. Pieri is the General Secretary of EuropaUomo, a European advocacy movement for men with prostate cancer, representing 27 national patients’ groups. |
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| How to Quantify Biopsy Gleason Grade 4 for Active Surveillance |
| Geert Van Leenders, MD, Ph.D. |
| Geert Van Leenders of the Netherlands provides the Pathology perspective on quantifying Gleason pattern 4 for active surveillance (AS). First, he highlights the fact that Gleason pattern for disease is a heterogeneous subset. Historically Gleason pattern 4 was a single entity – but recent research has demonstrated that Gleason pattern has multiple histologic subsets. |
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| Point-Counterpoint Session Should We Do Active Surveillance in ISUP GG 2? |
Pro: Sigrid Carlsson, MD, Ph.D., MPH
Con: Grégoire Robert, MD, Ph.D. |
| In this point-counterpoint session, Dr. Sigrid Carlsson and Dr. Grégoire Robert debate the topic of active surveillance (AS) for ISUP GG2 prostate cancer. Dr. Carlson argues for active surveillance while Dr. Robert argues against it. |
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| 5-Year Outcome of MRI-Visible vs. Non-Visible Lesions Under Active Surveillance: GAP3-Results
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| Jonathan Olivier, MD, MSc
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| At the 2021 European Association of Urology (EAU) annual meeting, Dr. Jonathan Olivier presents the outcomes of an active surveillance cohort stratified by MRI visible and non-visible lesions. This is part of the work from the GAP3 consortium.
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| Characteristics of MRI Lesions Allowing Active Surveillance and How to Monitor |
| Francesco Giganti, MD, Ph.D. |
| n this talk by Francesco Giganti, he reviews characteristics of MRI lesions that favor active surveillance and helps to monitor MRI lesions in patients on active surveillance. Dr. Giganti concluded that there needs to be further initiatives to better understand the tumor microenvironment and growth rate, radiomics and radiogenomics. But, ultimately, there also needs to be standardization (PRECISE criteria) and good quality MRI for it to be effective as a tool to monitor patients on AS. |
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| Are PSA Kinetics and Other Biomarkers Able to Replace per Protocol Biopsies? |
| Antti Rannikko, MD, Ph.D., FEBU |
| Antti Rannikko reviewed the potential for PSA kinetics and other biomarkers as potential replacements for per protocol prostate biopsies for men on active surveillance. While AS protocols can be tailored to individual risk using a compilation of clinical data into an algorithm/tool (as described by Cooperberg et al.), there remains significant unexplained heterogeneity between centers’ progression rates despite accounting for clinical variables. |
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| To view our full coverage of the 2021 EAU Virtual Congress, visit the Conference Coverage section on UroToday.com
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