Silke Gillessen: Hi. Yes. Thank you very much for taking the time to talk to me.
Neeraj Agarwal: Same to you. Thank you for taking the time to talk about the APCCC meeting, which is coming up. We are excited. So, I'd like to tell our audience today, worldwide, about APCCC and what made you start APCCC. As we know, you have built APCCC into one of the most influential consensus meetings in prostate cancer. So, what inspired you to start this meeting?
Silke Gillessen: Yeah. So, at the time when I started it, I actually worked in St. Gallen. And St. Gallen, as you may know, is very famous for the consensus conference in early breast cancer. So, a lot of my friends were working in this consensus meeting. And all of a sudden we were drinking coffee and I was telling ours, actually there are also a lot of unanswered questions in prostate cancer, not only breast cancer. Right? That was probably 2013. And then we started to talk to our colleagues who have organized the consensus medical oncology, and then they gave us some advice. And we started up out of nowhere. We just invited some friends and were creating the questions and it turned out quite nicely. So the first one was in 2015. So it's our 10-year anniversary, if you want to say, this time, end of April, because we had to leave one out for COVID. So that's why we have a year too many. And then we learned. We learned how to phrase the questions. Really, the panel grew bigger and bigger because we thought the more panelists we have, the more relevant are the voting results. So we are very interested to have a large panel, an international panel, a multidisciplinary panel. And also we realized that the better you phrase the questions, the more clear are the answers, and the better you can maybe use it then in clinical daily practice. So it was a process.
Neeraj Agarwal: And yes. Well, congratulations on 10th year anniversary of APCCC. Can't believe, time has flown so fast.
Silke Gillessen: Yeah, yeah. So the first one in 2015, so yeah, APCCC has really become a bit my baby. It is really nice. We are really looking forward to it. We're working two years to try to improve it and to make it relevant for people who have interest in managing patients with prostate cancer and also for patients, of course.
Neeraj Agarwal: Yeah. And that is a nice segue to the next question. What makes APCCC different from other major oncology meetings focusing on prostate cancer? What makes it unique?
Silke Gillessen: So actually, you have to answer the question. I'm totally biased. Right? So what makes it unique for me is that we really try to concentrate on daily clinical practice. So we want to make it really very pragmatic, very practical. How are you treating patients who come into your clinic? And there is no data to really give them a good advice what to do. And so I think this was always our focus. So we wanted to focus on real questions that we had at our MDMs when we talked to patients. And I think that makes it a bit unique because it's not about what is also interesting, what are the drugs that we will have in five years? It's really things that you can use in daily practice. We also tried to concentrate on the side effects sometimes to really say, so how we can improve management of side effects? That's usually in a lot of conferences also understandably not a big topic. Right? Because we are going there for seeing new results, for seeing the efficacy. We are not so much in how can we maybe make these treatments tolerated better. So I think this is one. And then I think personally for me, the atmosphere is really good. So people talk to each other. I mean, a lot of ideas have been created at APCCC. Lots of projects have started there. The discussions with the nuclear medicine colleagues that have been in our conference since the beginning in 2015 with the radiologist, because that is all your colleagues you need in daily clinical practice. And I think this is really one of the things that I like a lot.
Neeraj Agarwal: So coming together of all different kinds of specialists taking care of prostate cancer patients, that's unique. As you said, not every clinical question can be answered by a randomized phase-three trial or phase-two trial. There are so many clinical issues we encounter on a day-to-day basis for which there are no answers from the clinical trial, including side-effect management. And I agree with you, this is what makes the conference unique because we get insights on how to manage those patients where evidence is not backed by level-one evidence, and we need the top experts in the world to come up with a consensus on how to treat those patients or use the current technology to address those clinical issues. So that makes me ask you, what do you think APCCC recommendations are shaping practice across the world? I know every world, every country has different approvals, many are resource-constrained countries, many countries have one approval, but for different indication. So how have you seen APCCC recommendations shape clinical decision-making across the world?
Silke Gillessen: That's a very good question. So as you know well, so we have our conference, the original APCCC, is really based on the assumption you would have everything available. So what is of course not realistic, that would be a dream. But so the assumption you would have everything available for diagnostics, for treatment, for everything, what would you do then in the best of all worlds? But of course, we all don't live in the best of all worlds. So what happened then is that there is a lot of satellites of APCCC. So for example, every time we have an APCCC in France the year after or the same year, they do a French APCCC where they pick some of the questions and they let them answer for their reality. Same thing happened in the Middle East, same thing happened for less developed countries, in Brazil. So there's a lot of these satellites ongoing where they take our questions, but then say, "Yeah, but what are we doing now? What are we doing with the resources we have?" Because as you said correctly, also the resources, if you have less resources, doesn't mean these less resources are all over the world the same. So Australia, that's really a rich country, didn't have an RP for a long time for patients with metastatic hormone-sensitive disease, same in Italy, but they have other things. They had lutetium PSMA long before us. Right?
So I think it's quite interesting because it doesn't always mean that if you have less access, that everyone who has less access has access to the same things. What is quite interesting. Right? Also, the treatments don't cost the same everywhere. So also that is sometimes very interesting. So I think it makes a lot of sense that we are doing one general one in the sense, what would you do when you have everything? But then there are satellites locally where they ask really the questions for their countries.
Neeraj Agarwal: That's very interesting that every country, every region within the same country, there are populations which have access to everything versus not. So all those satellite symposiums can address the unique challenges posed by the local constraints, resource constraints, and make the question uniquely answered by each one of those satellite symposiums. And I'm so glad this is happening because as you said, as we discussed, many countries, many populations have different resources. So talking about this conference, which is coming up in few weeks. What are you most excited about?
Silke Gillessen: So yeah, first of all, I'm really excited about the 10-year kind of ... We try to do something a bit special because it's the 10-year kind of edition. For the first time, we have questions, sorry, abstracts. So we will have abstracts from people in different settings of the disease. I think that's very nice. What we also changed is that we have now more patient representatives. So we have one patient representative talking in each session so that the panel is really complete with a patient representative. We always have patients involved, but this time we really have them also on the panel for each of the sessions we have. So I think this is some of the newer things, but I'm also quite excited about there is the day one and a half days before APCCC is the International Prostate Cancer Symposium, IPCS.
Neeraj Agarwal: And that's new, right?
Silke Gillessen: That is new. We had some translational smaller thing before, but now it's really officially one and a half days of early-phase trials of translational research and some basic research. So we have made it a bit more comprehensive. So the people who come to Lugano who are interested only in clinics, they go on in the second part. There are also people who come only to the first part because they're interested more in the translational research part. And then there are lots of people who come from the participants, what I saw, they come for both. So it's nice because we have an addition now ongoing. Right? So I think it's quite nice for some people to also be there that we have very, very good abstract also in the translational one. And we are totally honored because AACR is sponsoring the International Prostate Cancer Symposium. So it's really high level of research that will be shown there. So I'm really happy about that as well. So we hope it's going to work out. And if we see people are happy with it, we are going to do it also in 2028.
Neeraj Agarwal: That's wonderful. International Prostate Cancer Conference added to the APCCC meeting this year sponsored by AACR. We get to see the most latest data and new data, if you will, beyond the clinical discussion. For those considering attending or following APCCC this year, what would you say to them and what has been most rewarding for you personally in leading this meeting? So final words from Dr. Gillessen.
Silke Gillessen: So yeah, come all to APCCC. It's really nice. And I think, yes, we have a hybrid option, so you can of course also just follow it online, but sometimes it's easier. But I think what is really unique is the atmosphere, how easy there you get contact with the key opinion leaders that are there, where you can discuss with them. I'm really ecological, I think. I think we shouldn't fly too much, but also I have to totally admit that some of these meetings are so much more fruitful when you have this personal contact and you can talk and you can share ideas. And for that, I really hope a lot of you who are listening can come to Lugano and be a part of this 10-year edition. So I really hope to see a lot of you, of course, specifically Neeraj, also you, and you can see also Dr. Agarwal there. So you can contact him, you can talk to him when you have ideas. I think it's really nice that we have this meeting where we can really internationally talk about our passion, right, prostate cancer.
Neeraj Agarwal: Thank you so much. We are all looking forward to the 10th anniversary of APCCC meeting this year and looking forward to another exciting meeting. So thank you so much, Silke, for taking the time today.
Silke Gillessen: Thank you very much, also to UroToday and to you, of course. Thanks.