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HIGHLIGHTS FROM THE 2024 AMERICAN UROLOGICAL ASSOCIATION ANNUAL MEETING |
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Prostate Cancer: Advanced (Including Drug Therapy) II
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| Rates and Predictors of False Node-Positive PSMA-PET in Patients Treated with Radical Prostatectomy and Extend Pelvic Lymph-Node Dissection: Results From a Large, Multi-Institutional Database
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| Francesco Barletta, MD
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| Francesco Barletta presented findings on false node-positive PSMA-PET in 129 patients undergoing radical prostatectomy with extended pelvic lymph node dissection. Despite initial positive PSMA-PET findings, final pathology revealed no lymph node involvement in 48% of cases. Preoperative Briganti nomogram lymph node involvement risk was associated with a lower risk of false positive PSMA-PET, emphasizing the importance of integrating multiple factors for accurate staging.
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| The Role of PSA Doubling Time in the Stratification of Patients with a Negative PSMA PET After Biochemical Recurrence of Prostate Cancer: Implications for Tailored Salvage Treatment Strategies |
| Daniele Robesti, MD |
| Daniele Robesti presented findings on patients with a negative PSMA-PET for biochemical recurrence after radical prostatectomy, focusing on the role of PSA doubling time (PSADT) in predicting early clinical progression. Among 136 patients analyzed, those with PSADT ≤ 6 months and/or ISUP grade ≥ 4 were identified as higher-risk candidates for early metastatic progression despite negative PSMA-PET results. |
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| Clinical Characterization of mHSPC According to Real World Data: Can Randomized Clinical Trials Be More Reliable? Data from the European Network of Excellence for Big Data in Prostate Cancer (PIONEER)
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| Rossella Nicoletti, MD
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| Rossella Nicoletti presented findings from the PIONEER study, evaluating real-world trends and outcomes for European patients with metastatic hormone-sensitive prostate cancer (mHSPC). Analyzing data from over 94,000 patients, the study highlighted that despite guidelines recommending treatment intensification, only 28% received combination therapies, with most patients receiving androgen deprivation therapy (ADT) alone.
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| Development of a Prediction Model of Survival Amongst Patients with mHSPC Using Big Data: Interim Results from the European Network of Excellence for Big Data in Prostate Cancer (PIONEER)
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| Rossella Nicoletti, MD
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| Rossella Nicoletti presented interim results from the PIONEER study, aiming to develop a prediction model for survival among patients with mHSPC using big data. Analyzing data from over 94,000 patients, the study identified demographic and clinical variables associated with increased odds of mortality, including age over 90, non-adenocarcinoma variants, and the presence of visceral metastasis.
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| Identifying The Optimal Candidate for Concomitant Androgen-Deprivation Therapy Among Patients Receiving Metastasis-Directed Therapy For Positive PSMA PET and Primary or Secondary Biochemical Recurrence from Prostate Cancer |
| Elio Mazzone, MD, Ph.D. |
| Elio Mazzone presented data on 383 patients who underwent PSMA-PET staging for biochemical recurrent prostate cancer following radical prostatectomy, aiming to identify optimal candidates for concomitant ADT among those receiving metastasis-directed therapy (MDT). The study revealed that patients with ≥2 nodal or distant PSMA spots benefited from concomitant ADT, regardless of primary or secondary biochemical recurrence after radical prostatectomy. |
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| The Added Value of Concomitant Whole-Pelvis Salvage Radiation Therapy in Oligo-Recurrent Prostate Cancer Patients Treated with Metastasis-Directed Therapy for Distant Positive Uptakes at PSMA PET |
| Elio Mazzone, MD, Ph.D.
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| Elio Mazzone presented a retrospective study exploring the efficacy of concomitant whole-pelvis salvage radiation therapy (WPRT) in patients with oligo-recurrent prostate cancer receiving metastasis-directed therapy (MDT) based on positive PSMA-PET findings. Dr. Mazzone concluded that while MDT alone can be effective for some patients, adding WPRT can be beneficial for reducing the risk of clinical recurrence in certain individuals. |
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| Exploring the Dual Impact to Treatment Outcomes in Patients with Short Time to Nadir PSA Under Androgen Receptor Pathway Inhibitors for Metastatic Hormone-Sensitive Prostate Cancer |
| Hsin-Ho Shih, MD |
| Hsin-Ho Shih presented findings from a retrospective cohort study focusing on patients with de novo mHSPC treated with ADT and androgen receptor pathway inhibitors. They explored the impact of time to nadir (TTN) PSA and deep PSA response on treatment outcomes. Results showed that achieving a deep PSA response (<0.2 ng/ml) was associated with a reduced risk of PSA progression, while TTN was predictive only if a deep PSA response was not achieved. |
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| The Impact of Delayed Administration of Androgen-Receptor Signaling Inhibitors (ARSI) on Prognosis for mHSPC
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| Ryuma Tanaka, MD |
| Ryuma Tanaka presented findings from a retrospective study on metastatic hormone-sensitive prostate cancer, focusing on the impact of delayed administration of androgen receptor pathway inhibitors (ARPIs) on prognosis. The study included 621 patients treated with either androgen deprivation therapy (ADT) + complete androgen blockade or ADT with upfront ARPIs. Patients were stratified based on the time of ARPI initiation.
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| ARV-766, a PROTAC Androgen Receptor Degrader, Combined with Abiraterone in Novel Hormonal Agent (NHA)-Naïve Metastatic Prostate Cancer: Phase 1 Cohort (Part C) of a Phase 1/2 Study |
| Neal Shore, MD, FACS |
| Neal Shore presented the results of a phase 1 cohort of a phase 1/2 study evaluating ARV-766, a PROTAC androgen receptor degrader, combined with abiraterone in novel-hormone-agent (NHA)-naïve metastatic prostate cancer. ARV-766 targets wild-type AR and clinically relevant mutants, potentially enhancing the efficacy of abiraterone. The study assessed safety, tolerability, and drug-drug interactions of the combination therapy in patients with mCRPC or mCSPC. |
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| Enhancing Bone Health Screening for Prostate Cancer Patients Starting Androgen Deprivation Therapy: The Auto-Recruit Outpatient System |
| Chiayen Lin, MD |
| Chiayen Lin presented findings from a retrospective study focusing on bone health screening in prostate cancer patients initiating ADT. They implemented an auto-recruitment pop-up alert system in the outpatient electronic medical record to promote bone health surveillance. Analysis revealed that the system significantly increased bone health screening rates, with 34.3% of patients scheduled for screening post-implementation, compared to only 9.5% before. |
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| Plenary |
| Journal of Urology Lecture: Empowering Communities: Fostering Prostate Cancer Awareness and Resilience Among Men of Color |
| Quoc-Dien Trinh, MD |
| Quoc-Dien Trinh delivered the Journal of Urology lecture at AUA 2024, emphasizing the importance of fostering prostate cancer awareness and resilience among men of color. He highlighted the three-step process to mitigate racial disparities: detection, understanding, and reduction. Dr. Trinh discussed the significance of access to care in reducing disparities and presented data showing facility-level racial/ethnic variations in treatment rates. |
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| Prostate Cancer: Markers I |
| Genomic Signatures Associated with Adverse Pathologic Features at Radical Prostatectomy Among Active Surveillance Eligible Men |
| Eric Li, MD |
| Eric Li presented findings on genomic signatures associated with adverse pathologic features at radical prostatectomy among active surveillance-eligible men. The study aimed to identify biomarkers aiding in risk stratification and treatment decision-making for active surveillance candidates. Results showed that certain genomic signatures, including PTEN loss and activated CD4 activity, were significantly associated with adverse pathologic features, suggesting molecular heterogeneity among patients with similar clinical characteristics. |
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| High Decipher Score Defines the Subgroup Most at Risk of Metastatic Progression Among Patients with Lower Grade Tumors Classified as NCCN High-Risk Based on Elevated Prostate-Specific Antigen Level Alone |
| David Han, MD |
| David Han presented findings indicating that Decipher® scores better predict the risk of metastatic progression compared to serum PSA levels among patients with Grade Group 1 or 2 disease after prostatectomy at AUA 2024. In a retrospective analysis involving 453 patients, higher Decipher® scores were strongly associated with metastasis rates, regardless of operationalization, while PSA levels >20 ng/ml alone were not predictive of increased metastatic risk. |
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| Prostate Cancer: Detection & Screening IV |
| Decipher® Predicts Clinically Significant Upgrading on Final Radical Prostatectomy Pathology |
| John Sheng, MD |
| John Sheng presented findings at AUA 2024 indicating that the Decipher® genomic classifier score and the presence of Grade Group 3 disease on biopsy are significant predictors of upgrading on radical prostatectomy, while mpMRI (PI-RADS) score and PSA levels are not. In a retrospective analysis involving 104 patients, higher Decipher® scores were associated with an increased likelihood of upgrading on prostatectomy pathology. |
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| Society of Urologic Oncology |
| Whitmore Lecture – Optimizing Outcomes in High-Risk Localized Prostate Cancer – Cure is Possible when Cure is Necessary. |
| Martin Gleave, CM, MD, FRCSC, FACS |
| Martin Gleave delivered the Whitmore Lecture, focusing on optimizing outcomes in high-risk localized prostate cancer. He emphasized the importance of balancing the pursuit of cure with the need to minimize treatment-related morbidity, highlighting advancements in diagnosis, risk stratification, and treatment techniques. Dr. Gleave discussed the integration of multimodal therapy, including EBRT with ADT and radical prostatectomy, and presented data comparing their outcomes. |
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| Posters |
| Impact of 18F-DCFPyL on Accuracy of mpMRI in Men with Low and Intermediate Risk Prostate Cancer: Interim Analysis of a Phase II Diagnostic Trial |
| Marcelo Bigarella, MD |
| Marcelo Bigarella presented an interim analysis of a phase II diagnostic trial evaluating the impact of 18F-DCFPyL PSMA PET on the accuracy of mpMRI in men with low- and intermediate-risk prostate cancer. The study found that the addition of PSMA PET to mpMRI improved the detection of clinically significant prostate cancer, with increased specificity and overall accuracy. |
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