AUA 2018: Can Active Surveillance Really Reduce the Harms of PSA Testing PRIAS-Study Implicates Caution
San Francisco, CA (UroToday.com) Prostate cancer screening using the prostate specific antigen (PSA) serum test has proven controversial in part due to the large burden of over diagnosis and over treatment. Active surveillance has been proposed as a way of mitigating the harms of PSA screening while retaining its potential benefits. In fact, the US Preventative Services Task Force has recently recommended selective PSA screening on the basis of such an approach. Dr Drost and colleagues report of data from the PRIAS study, focusing on the limitations of active surveillance (AS) to achieve such reductions in over treatment.
AUA 2018: Phase 3 Study of Vicinium in BCG-Unresponsive Non-Muscle Invasive Bladder Cancer: Initial Results
San Francisco, CA (UroToday.com) Radical cystectomy remains a major operation with significant implications on patient quality of life (QOL). For non-muscle invasive bladder cancer, especially high-grade disease, the mainstay of the therapy is intravesical BCG – while it has been demonstrated to help reduce progression to muscle-invasion, we have limited alternative options for patients who progress despite BCG. Many agents are in development, but few have demonstrated adequate efficacy and tolerability to become an established therapy.
AUA 2018: Results of CALIBER: A Phase II Randomized Feasibility Trial of Chemoablation vs Surgical Management in Low Risk Non-Muscle Invasive Bladder Cancer
San Francisco, CA (UroToday.com) Non-muscle invasive bladder cancer represents approximately 70% of bladder cancer diagnoses. In addition to preventing progression to muscle-invasive disease, a significant focus of management is reducing recurrence rates – unfortunately, due to high rates of recurrence, patients undergo frequent surveillance with cystoscopy and intermittent upper tract evaluations. These repeated interventions are not without risks, and anything to reduce recurrence and thereby reduce the need for interventions has significant patient and the health system implications.
AUA 2018: Non-Surgical Management of Low Grade Upper Tract Urothelial Cancer: an Interim Analysis of the International Multicenter OLYMPUS Trial
San Francisco, CA (UroToday.com) Upper tract urothelial carcinoma (UTUC) is a difficult disease process to manage. With understaging, a major problem in the evaluation of patients, and biopsy of lesions technically difficult, management is often based on biopsy, urine cytology, and imaging. Management options are also broad, depending on risk stratification. High grade disease is recommended for radical nephroureterectomy due to the risk of understaging. However, for low-grade UTUC, management options are more varied – nephron-sparing options are preferred, as patients are at persistent risk of bladder and contralateral disease.
AUA 2018: CG0070, an Oncolytic Adenovirus, for BCG-Unresponsive Non-Muscle-Invasive Bladder Cancer: 12 Month Interim Results from a Multicenter Phase II Trial
San Francisco, CA (UroToday.com) CG0070 is a selective oncolytic adenovirus that targets bladder tumor cells through their defective retinoblastoma pathway. It is a cancer selective, replication competent adenovirus. Burke et al.1 first demonstrated its safety and efficacy as an intravesical therapy in a phase I study – they assessed single vs. multiple doses of CG0070 in 35 patients with NMIBC. Four dose levels were assessed (1 × 1012, 3 × 1012, 1 × 1013 or 3 × 1013 viral particles).
AUA 2018: Long-Term Outcomes of Active Surveillance for Prostate Cancer - Memorial Sloan Kettering Cancer Center Experience
San Francisco, CA (UroToday.com) Active surveillance is a well accepted treatment paradigm for patients with low risk prostate cancer. However, long-term outcomes are limited to a relatively small number of centers with differing inclusion criteria. Therefore, increasing knowledge regarding these outcomes is valuable. In a podium presentation at the American Urologic Association Annual Meeting, Dr. Benfante and colleagues present a 17-year experience with active surveillance (AS) at the Memorial Sloan Kettering Cancer Center.
AUA 2018: Effect of Selection and Referral Biases for the Treatment of Localized Prostate Cancer with Surgery or Radiation
San Francisco, CA (UroToday.com) Multidisciplinary consultation has been widely advocated in many oncologic tumor sites. This is notably true for patients with localized prostate cancer for whom a number of viable treatment options, surgery, radiotherapy, and surveillance, exist. While it may be expected that multidisciplinary consultation involving both radiation oncologists and urologists would change the distribution of active treatment choices compared to consultation with a urologist alone, the effect of surveillance rates is unclear. In a podium presentation at the American Urologic Association Annual Meeting presented by Dr. Nam on behalf of his colleagues, population-based data from Ontario, Canada were used to assess this question.