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HIGHLIGHTS FROM THE 2024 AMERICAN UROLOGICAL ASSOCIATION ANNUAL MEETING |
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Kidney Cancer: Advanced (Including Drug Therapy) II
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| Survival is Dramatically Improved for mRCC Patients with Sarcomatoid Features who are Treated with Cytoreductive Nephrectomy and Immune Checkpoint Inhibitors Regardless of Treatment Sequence |
| Daniel Shapiro, MD |
| Daniel Shapiro presented findings from a multicentric retrospective study on mRCC patients with sarcomatoid features who underwent cytoreductive nephrectomy and explored survival outcomes with immune checkpoint inhibitors or targeted therapy. They found significantly improved overall survival with IO therapy compared to non-IO treatment, regardless of treatment sequence. Upfront CN followed by TT was associated with reduced mortality, while the timing of IO therapy did not correlate with OS. |
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| Tumor Size Reduction (≥10% ) Resulting from Pre-Surgical Systemic Therapy Predicts Improved Survival Following Cytoreductive Nephrectomy
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| Daniel Shapiro, MD
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| Daniel Shapiro presented findings from a multicentric study on patients with synchronous mRCC treated with pre-surgical systemic therapy followed by cytoreductive nephrectomy at the AUA 2024 annual meeting. They observed that patients treated with immunotherapy had greater tumor size reduction and improved overall survival compared to those treated with targeted therapy.
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| Outcomes of Minimally Invasive Nephrectomy Following Immune-Checkpoint Inhibitor Therapy: Data from a Multicenter Study
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| Alireza Ghoreifi, MD
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| Alireza Ghoreifi presented data from a multicenter study on patients with RCC who underwent nephrectomy following immune checkpoint inhibitor therapy. The study included 158 patients, with 76 undergoing minimally invasive surgery (MIS) and 82 undergoing open nephrectomies. MIS nephrectomy showed advantages such as lower blood loss, shorter operative time, and reduced length of stay compared to open nephrectomy, suggesting that MIS could be a safe option for appropriately selected patients with advanced or locally advanced RCC following ICI therapy.
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| Society of Urologic Oncology (SUO) |
| Risk Stratification for Adjuvant Therapy with High-Risk RCC |
| Tian Zhang, MD |
| Tian Zhang discussed risk stratification for identifying high-risk renal cell carcinoma (RCC) patients suitable for adjuvant therapy. She highlighted the evolution of prognostic indicators and nomograms for RCC, including UCLA integrated staging score, Mayo Clinic/Leibovich score, and ASSURE nomogram, emphasizing their utility in predicting disease-free survival and overall survival. |
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| Radiation Oncology for RCC: Localized Disease, Oligometastatic Disease, and the Future |
| Leslie Ballas, MD |
| Leslie Ballas discussed the evolving role of radiation therapy (RT) in renal cell carcinoma (RCC) at AUA 2024, focusing on localized and oligometastatic disease, and potential future indications. She outlined various indications for RT, including intracranial and extracranial disease, primary RCC, and salvage post-surgery or thermal ablation. |
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| Bladder Cancer: Upper Tract Transitional Cell Carcinoma I |
| Efficacy and Safety of Padeliporfin Vascular Targeted Photodynamic Therapy for Treatment of Low-Grade Upper Tract Urothelial Cancer: Phase 3 Preliminary Results
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| Ronald Kaufman Jr., MD
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| Ronald Kaufman presented preliminary results from a phase 3 trial evaluating the efficacy and safety of padeliporfin vascular targeted photodynamic therapy (VTP) for low-grade upper tract urothelial carcinoma. The trial aims to demonstrate the effectiveness and durability of padeliporfin VTP in ablating LG UTUC lesions in the kidney and ureter. Early findings suggest that padeliporfin VTP shows promise in achieving complete or partial responses in treated patients, with manageable adverse events.
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| Diagnostic Performance of Photodynamic Diagnosis with Oral 5-Aminolevulinic Acid for Bladder and Upper Tract Urothelial Carcinoma: A Single-Center, Retrospective Analysis |
| Takeshi Sano, MD, Ph.D., FRCS |
| Takeshi Sano presented findings from a retrospective analysis comparing the diagnostic performance of photodynamic diagnosis (PDD) with oral 5-aminolevulinic acid for bladder and upper tract urothelial carcinoma. The study showed that PDD had superior sensitivity, specificity, and area under the curve in diagnosing upper tract disease compared to bladder tumors. |
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| Surgical Technology & Simulation: Artificial Intelligence II |
| Development and Validation of Generalizable Interpretable AI Biomarkers to Predict Clinical Outcomes in BCG-Treated Patients with Non-Muscle Invasive Bladder Cancer |
| Stephen Williams, MD, MS, FACS |
| Stephen Williams presented the development and validation of interpretable AI biomarkers predicting clinical outcomes in BCG-treated non-muscle invasive bladder cancer. This AI model, validated across 12 centers and various patient subgroups, identifies features in the tumor microenvironment associated with recurrence and progression, demonstrating superior prognostic ability compared to traditional scoring systems. |
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| Bladder Cancer: Non-invasive II |
| Predicting Response to Intravesical BCG in High-Risk NMIBC Using an Artificial Intelligence-Powered Pathology Assay: Development and Validation in an International 12 Center Cohort
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| Yair Lotan, MD
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| Yair Lotan presented findings on an AI-powered pathology assay for predicting response to intravesical BCG in high-risk NMIBC. The computational histologic AI assay, developed and validated across 12 international centers, demonstrated significant clinical implications. It aids in selecting optimal candidates for BCG versus alternative therapies, identifies patients less likely to benefit from BCG, and determines those at high risk of progression, guiding early cystectomy decisions.
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| Development and External Validation of an Artificial Intelligence-Based Tool for PROGression Risk Assessment in Non-Muscle Invasive Bladder Cancer (PROGRxN-BCa) |
| Jethro Kwong, MD, MSc |
| Jethro Kwong presented findings on an artificial intelligence-based tool, PROGRxN-BCa, for predicting tumor progression in non-muscle invasive bladder cancer (NMIBC) at AUA 2024. Developed and validated across multiple institutions, PROGRxN-BCa outperformed existing prediction models, achieving higher accuracy and net benefit. It demonstrated consistent performance across subgroups and effectively stratified intermediate-risk NMIBC patients, offering insights for treatment intensification. |
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| Response to Primary Chemoablation With UGN-102 in Patients with New or Recurrent LG IR NMIBC: Post-hoc Analysis of the ATLAS Trial |
| William Huang, MD |
| William Huang presented findings from a post hoc analysis of the ATLAS trial at AUA 2024, focusing on the response to primary chemoablation with UGN-102 in patients with low-grade, intermediate-risk NMIBC. Despite early trial termination, results demonstrated similar disease-free survival rates and durations of response between newly diagnosed and recurrent patients treated with UGN-102 +/- TURBT. |
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| Bladder Cancer: Invasive III |
| Nivolumab plus Gemcitabine-Cisplatin vs Gemcitabine-Cisplatin Alone in Patients with Previously Untreated Unresectable or Metastatic Urothelial Carcinoma: Results of Analyses to Characterize Benefit in Responders from the CheckMate 901 Trial
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| Guru P. Sonpavde, MD
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| Guru Sonpavde presented the results of the CheckMate 901 trial focusing on the characterization of responders to the combination therapy of nivolumab plus gemcitabine/cisplatin vs gemcitabine/cisplatin alone in patients with previously untreated unresectable or mUC. The study demonstrated significant and clinically meaningful benefits in overall survival and PFS with NIVO+GC compared to GC alone. Moreover, the objective response rate was higher, and the complete response rate was almost doubled with NIVO+GC.
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| First Results of NURE-Combo: A Phase 2 Study of Neoadjuvant Nivolumab and Nab-Paclitaxel Followed by Postsurgical Adjuvant NIVO in Patients with Muscle-Invasive Bladder Cancer |
| Chiara Mercinelli, MD |
| Chiara Mercinelli presented the first results of the NURE-Combo trial at AUA 2024, focusing on a phase 2 study of neoadjuvant nivolumab plus nab-paclitaxel followed by postsurgical adjuvant nivolumab in patients with muscle-invasive bladder cancer. The trial showed promising outcomes, with a significant proportion of patients achieving pathological complete response or major pathological response (pPR) after neoadjuvant therapy. |
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| Avelumab First-Line Maintenance for Advanced Urothelial Carcinoma: Long-Term Outcomes from JAVELIN Bladder 100 in Subgroups Defined by First-Line Chemotherapy Regimen and Analysis of OS from Start of First-Line Chemotherapy |
| Shilpa Gupta, MD |
| Shilpa Gupta presented long-term outcomes from the JAVELIN Bladder 100 trial at AUA 2024, focusing on subgroups defined by first-line chemotherapy regimen and overall survival from the start of first-line chemotherapy. The analysis showed that avelumab first-line maintenance provided similar overall survival and progression-free survival benefits in patients with advanced urothelial carcinoma without progression after first-line cisplatin- or carboplatin-based chemotherapy. |
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| Computer Vision Analysis of Upper Tract Urothelial Carcinoma to Predict High vs Low-Grade Pathology
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| Bryn Launer, MD
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| Bryn Launer presented research on using artificial intelligence-based computer vision to predict the grade of upper tract urothelial carcinoma during flexible ureteroscopy. By analyzing video frames from fURS procedures, a convoluted neural network demonstrated an accuracy of 0.73, sensitivity of 0.72, and specificity of 0.73 in predicting low-grade or high-grade pathology.
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| Comprehensive Evaluation of Response to Immune Checkpoint Blockade in Primary Tumor: Radiographic and Radiomic Features Predict Pathologic Response in Primary Tumor |
| Mark Dawidek, MD |
| Mark Dawidek and colleagues presented research on the evaluation of primary tumor response to immune checkpoint blockade in metastatic RCC patients. They found that radiographic response in the primary tumor predicted time to next treatment and overall survival. Additionally, discrepancies between radiological and pathological assessments highlight challenges in assessing response to immunotherapy, suggesting the need for further evaluation of radiomic features for more accurate predictions of treatment response and residual disease. |
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