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HIGHLIGHTS FROM THE 2024 EUROPEAN ASSOCIATION OF UROLOGY ANNUAL MEETING |
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Plenary Session: Risk-Adapted Screening and Treatment of Screen-Detected Prostate Cancer
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| Challenging EAU Guidelines on Prostate Cancer Risk Definition in the Screening Setting: Insights from the PROBASE Trial |
| Peter Albers, MD |
| Peter Albers presented insights from the PROBASE trial at the EAU 2024 meeting, challenging current guidelines on prostate cancer risk definition in the screening setting. The trial focuses on risk-adapted prostate cancer early detection, with low risk defined as a baseline PSA < 1.5 ng/mL. Preliminary data show that men aged 45 with a baseline PSA < 1.5 ng/mL have a very low risk of developing prostate cancer within the next five years, supporting potential adjustments to screening protocols. |
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| Comparison of Biparametric and Multiparametric MRI for Prostate Cancer Detection: The PRIME Study |
| Veeru Kasivisvanathan, MBBS |
| Veeru Kasivisvanathan presented findings from the PRIME study at the EAU 2024 meeting, comparing biparametric and multiparametric MRI for prostate cancer detection. The study showed that biparametric MRI, without dynamic contrast enhancement, was non-inferior to multiparametric MRI in detecting clinically significant prostate cancer. Additionally, biparametric MRI resulted in similar rates of biopsy indications, cancer detection, and treatment decisions, making it a potentially more accessible and cost-effective option for prostate cancer diagnosis. |
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| Results from the First Screening Round of the ProScreen Screening Trial with PSA, Kallikrein Panel, and MRI |
| Anssi Auvinen, MD, Ph.D. |
| Anssi Auvinen presented the first round results of the ProScreen screening trial at the EAU 2024 meeting, comparing PSA, kallikrein panel, and MRI for prostate cancer detection. The trial demonstrated higher detection of high-grade cancers compared to low-grade cancers, suggesting an improved balance of benefits and harms compared to PSA-based screening. |
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| Familial Prostate Cancer: Does It Influence the Screening and Management? |
| Alicia Morgans, MD, MPH |
| Alicia Morgans discussed familial prostate cancer and its implications for screening and management at the EAU 2024 meeting. She highlighted the EAU guidelines recommending germline testing for metastatic and localized patients with a family history, particularly identifying BRCA mutations, which may become more common. |
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Plenary Session: Personalised Approaches in High-Risk and Metastatic Prostate Cancer
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| Negative Staging PSMA in High-Risk Disease: Can We Skip Extended PLND? the Guidelines' View |
| Johan Stranne, MD, Ph.D,. FEBU |
| Johan Stranne presented on the use of PSMA PET in high-risk prostate cancer staging. He highlighted that while extended pelvic lymph node dissection (PLND) is accurate for staging, it comes with higher morbidity rates. PSMA PET/CT is suggested as an alternative, offering better accuracy in staging but may still miss small lymph nodes. |
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Metastatic Prostate Cancer
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| PEACE V – Salvage Treatment of OligoRecurrent Nodal Prostate Cancer Metastases (STORM): 24-Months Toxicity Results of a Randomized Phase II Trial |
| Thomas Zilli, MD |
| Thomas Zilli presented the 24-month toxicity results of the PEACE V-STORM trial, comparing salvage treatments for oligoRecurrent nodal prostate cancer metastases. The trial compared metastasis-directed therapy with elective nodal pelvic radiotherapy, both combined with ADT. The study found that both treatment modalities showed acceptable toxicity rates, with no clinically meaningful differences observed in gastrointestinal or genitourinary side effects or decline in bowel quality of life scores compared to baseline over the 24-month follow-up period. |
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| Impact of Disease Volume on Survival Efficacy of Triplet Therapy for Metastatic Hormone-Sensitive Prostate Cancer: A Systematic Review, Meta-analysis, and Network Meta-Analysis |
| Akihiro Matsukawa, MD |
| Akihiro Matsukawa presented findings on the impact of disease volume on the survival efficacy of triplet therapy for metastatic hormone-sensitive prostate cancer (mHSPC). This systematic review, meta-analysis, and network meta-analysis showed that triplet therapy (androgen receptor signaling inhibitors plus docetaxel plus ADT) improved overall survival compared to docetaxel-based doublet therapy, regardless of disease volume |
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| PIONEER: Development of a Predictive Model for Death Amongst Patients with mHSPC Treated with One of the Approved Treatment Plans Based on Characteristics Present at Admission Using Big Data |
| Rossella Nicoletti, MD |
| Rossella Nicoletti presented preliminary results from the PIONEER project, which aims to develop a predictive model for death among patients with metastatic hormone-sensitive prostate cancer (mHSPC) based on characteristics present at admission using real-world data. |
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| Efficacy and Safety of Darolutamide in Combination with ADT and Docetaxel in European Patients from the Phase 3 ARASENS Trial |
| Bertrand Tombal, MD, Ph.D. |
| Bertrand Tombal presented the efficacy and safety results of darolutamide in combination with ADT and docetaxel in European patients from the phase 3 ARASENS trial. In this trial, darolutamide demonstrated a significant improvement in overall survival, with a 37% reduction in the risk of death compared to placebo. Additionally, darolutamide showed benefits in key secondary endpoints such as time to CRPC and time to pain progression. |
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| PARP Inhibitor Plus Androgen Receptor Pathway Inhibitor Combinations for 1st Line mCRPC: A Systematic Review and Meta-Analysis |
| Rashid K. Sayyid, MD, MSc |
| Rashid Sayyid presented a systematic review and meta-analysis of first-line PARP inhibitor plus androgen receptor pathway inhibitor combinations for metastatic castrate-resistant prostate cancer (mCRPC). The analysis showed significant improvements in radiographic progression-free survival across patient subgroups, particularly in BRCA1/2 mutation patients. While significant overall survival benefits were observed, the combination therapy was associated with a six-fold increase in grade ≥3 anemia. |
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Intensify Treatment for Better Prostate Cancer Control
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| Two-Year Quality of Life (QoL) Outcomes of the Randomized Phase II Trial ARNEO: Neoadjuvant Degarelix with or without Apalutamide Prior to Radical Prostatectomy for High-Risk Prostate Cancer
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| Alexander Giesen, MD
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| Alexander Giesen presented the two-year QoL outcomes of the ARNEO trial, a phase II study investigating neoadjuvant degarelix with or without apalutamide before radical prostatectomy for high-risk prostate cancer. The study found no significant differences in QoL outcomes, assessed by ICIQ-UI, IIEF-5, and QLQ-C30 questionnaires, between patients receiving degarelix + apalutamide versus degarelix + placebo during the two years of follow-up.
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| Neoadjuvant Pamiparib plus Abiraterone and ADT for High-Risk/very High-Risk Localized Prostate Cancer: Results of a Prospective Study |
| Junlong Zhuang |
| Junlong Zhuang presented the results of a phase II single-arm trial evaluating neoadjuvant pamiparib plus abiraterone acetate and androgen deprivation therapy for high- and very high-risk localized prostate cancer prior to radical prostatectomy. Thirty patients were enrolled, with 29 completing the treatment and undergoing surgery. Eight patients achieved pathological com |
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| Early Oncological Outcomes Following Radical Prostatectomy of Patients with Pelvic Lymph Node-Positive Prostate Cancer at Preoperative PSMA PET/CT |
| Lotte Zuur, MD |
| Lotte Zuur presented findings from a retrospective analysis of patients with prostate-specific membrane antigen (PSMA) positron emission tomography computed tomography (PET/CT)-positive pelvic lymph node disease who underwent radical prostatectomy with extended pelvic lymph node dissection. Among the 64 patients included, >70% experienced early biochemical recurrence within one year post-surgery. |
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| Avoiding Overtreatment using PSA Doubling Time Kinetics: Long-Term Management of BCR Following RARP |
| Joshua Tran, MS |
| Joshua Tran presented findings from a retrospective cohort analysis assessing the use of PSA doubling time kinetics to guide management decisions in patients with biochemical recurrence (BCR) following radical prostatectomy. Among 105 patients managed with "active observation" without immediate salvage androgen deprivation therapy (ADT) or radiotherapy, 82% avoided salvage therapy over 9 to 21 years of follow-up. |
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| Identifying the Optimal Definition of PSA Response After Metastasis Directed Therapy in Men with Oligo-Recurrent Prostate Cancer Detected at PSMA PET |
| Elio Mazzone, MD |
| Elio Mazzone presented findings from an analysis aiming to identify the optimal definition of PSA response following metastasis-directed therapy (MDT) in men with oligo-recurrent prostate cancer detected on PSMA PET/CT. Among 116 patients who underwent MDT, the first PSA value measured 3 months post-MDT was found to be a significant predictor of clinical recurrence. |
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