Phillip Koo: Hello, my name is Phillip Koo, and I'm the editor of the Imaging Center of Excellence for UroToday. We're very fortunate to have with us today, Dr. Faina Shtern, who's the president of the AdMeTech foundation, which is an organization that has had a very significant impact on prostate cancer, especially when it comes to imaging. So thank you very much for joining us, Dr. Shtern.

Faina Shtern: Thank you for the opportunity, Phil.

Phillip Koo: Great. So, AdMeTech is familiar to some of us in the prostate cancer community, but probably not as familiar overall to many of those, perhaps in urologic oncology or medical oncology. Can you give us a little bit of an overview of how AdMeTech started and sort of the goals and aims of the organization?

Faina Shtern: Absolutely AdMeTech started actually when I was still head of diagnostic imaging at the National Cancer Institute. And our national international consensus panels identified prostate cancer research, particularly prostate cancer imaging at that time at mid nineties as the next top national priority. Unfortunately, there was no funding at the National Cancer Institute to provide at that time at mid nineties for a research to advance imaging. And I was right in the middle of national programs in breast cancer, digital mammography, breast MRI, many other programs creating these technologies. And I was shocked when I looked closer at prostate cancer. I was shocked that prostate cancer was blind. There was no imaging. The only thing we had was standard ultrasound that could identify prostate, not any local lesions. So this had become the driving force first for creating national or international research initiative to develop an implement imaging technologies for prostate cancer. When NCI could not fund it several leaders of industry and academia behind the regional consensus panel that identified prostate cancer as a priority, they created a foundation in a private sector.

Phillip Koo: Wow. So, I first became introduced to AdMeTech given the pioneering work that you were able to do with pyrites and prostate MRI. It's interesting to learn about the influence and impact you've had on PSMA imaging as well. Can you talk specifically about the role with PSMA imaging?

Faina Shtern: Absolutely. With pleasure. We actually initiated our first research programs at AdMeTech foundation in early 1998. Largely we support this Department of Defense and US Congress. And in 1998, we initiated a program in creating high precision MRI. Largely jointly this university of Pennsylvania, Mitch Schnall, who is currently the chair of radiology. I worked with Mitch Schnall who pioneered the breast MRI. So when you looked at the range of technologies, MRI figured very prominently. The second technology that figured very prominently was great, and we had great hopes for was molecular imaging. In 2001, we initiated the molecular imaging research program, largely based on a multidisciplinary brain trust that we had on molecular imaging that was supported by Prostate Cancer Foundation. As the result of that brain trust, we identified PSMA imaging as one of the most promising directions. And we funded original work in PSMA imaging at Johns Hopkins, Martin Pomper.

Phillip Koo: Wow, that's amazing. And it's amazing to see where it was a couple decades ago, where it is today. So, it's wonderful to sort of see that story about PSMA come to fruition and actually now see it widely being used in the clinics, which is wonderful. So I know that you host and put together a wonderful global summit on precision imaging and prostate cancer. Can you give the viewers an overview of the meeting and sort of the purpose and give us sort of what to expect at this meeting that's going to be held in September?

Faina Shtern: Absolutely. Actually, if I can have your permission to say a few words about why we created this global summit. A global precision diagnosis and treatment of prostate cancer in 2016. I feel, as you mentioned, we were pretty much leading in the international and national efforts at AdMeTech foundation in standardization, after initial stages of research and development. We pretty much led pyrite standardization. For that, we had AdMeTech foundation international prostate MRI working role. That drove development of pyrites that right now are standard everywhere that made it possible to do clinical trials. That made it possible to improve quality of care, both imaging physician, and then interpretation in MRI. And stimulated clinical implementation, when people started understanding each other. We had some of the most remarkable MRI leaders in this working group. And I would go to AUA. I would go to ask a meetings and I would come back with great excitement about baseline PSA, about evolving liquid diagnostics, et cetera. And as well as a new members of the MRI working group for years. All my excitement, all my description fell on deaf ears.

People were so focused on MRI. It became almost a silo. And I would go to meetings outside of imaging. There was no conversation about MRI, not much in 2016. So there was this silo surrounding imaging, MRI. Silo of MRI, even the same imaging silo of molecular imaging PSMA Onoxoban. There was a silo of liquid biomarkers. There was a silo of genetic tissue markers, et cetera. And there was no cross disciplinary dialogue that would make an impact. So we created summit in order to take down the silos, to bring everything together. To educate each other at the level of leaders in our fields, in radiation oncology, urology, medical oncology, imaging, et cetera. But also to educate medical community at large. The second major goal was to create a brain trust multidisciplinary brain trust that would actually look at the emerging best clinical practices and research priorities.

So that's how summit was created. And we were actually a little, even I, in my Moroccan Origination was a little stunned by what happened at the first summit when we brought everyone together and everyone was shocked. Just about every expert, shocked by what they learned from the neighboring expert area. And this in a very short period of time, we started seeing significant impact like approval of MRI before first biopsy. Within six months of the first summit, we started seeing impact. Not only clinical guidelines, but many people met each other at the summit and started working together from various fields. So we also, after the first time, we strongly supported radio genomics. It became very obvious that the future of patient care is integrating diagnostics, integrating clinical expertise, not competing with each other. Until today, I have a little bit of concern when I see clinical studies comparing various diagnostic modalities, let's say ultrasound and MRI. Instead of looking at the impact of an integrated approaches.

Because prostate cancer is so complex biologically, we need an integrated approach to a precision diagnosis and treatment. So that's how summit was created. I apologize if my introduction was a little bit longer than intended. And we have been really pleased. We have seen many leaders of urology, radiation, oncology who did not necessarily pay attention to imaging becoming champions. Not only of imaging, but image guided focal treatment. Same thing people in imaging who did not understand liquid diagnostics or novel therapeutic methodologist, they understood how imaging can be used to actually assist our clinical colleagues in selecting appropriate care. So that's what actually happened. And we certainly expect that it will be happening at our next summit on September 26th to 24th virtually. It'll take place virtually. It's a global summit. And when we are saying global, we have representation. There is not a part of the universe that does not have not a single continent that does not have representation at the summit.

We have people from Australia. We have people from Japan, China, of course, all, all over Europe, all over United States, candidates cetera. So we are very pleased that about the geography of participation, because you know, every nation brings its own perspective on patient care in prostate cancer. I am, we have so many exciting speakers. A lot of people are, are asking me how I manage to bring all these incredible speakers who are essentially standard setters for each field, how we were able to bring them together. And I think we are able to bring them together, not only because of our committee multidisciplinary committee of which you are a member, and you brought a very exciting speakers from molecular imaging to the summit, but also because when people come to the summit, they very rarely leave. They come back and bring their friends because they're excited about what they learn at.

At first, we actually were wondering if you should have summit every two years. Because we were afraid that they would not be enough progress in a year to present. To our surprise, every year brings such exciting developments that we'll continue to learn. And our incredible faculty continues to expand. For example, in session one of summit 2022, we will have an extended panel that will have PI of every major clinical trial in smart screening. Meaning integration of PSA with MRI or liquid diagnostics. I don't think we left... Nine or ten trials will be represented. And this will be an exciting opportunity for people to hear hot of the press. Not only instead of waiting for publications to come out, which takes a while, people will hear hot of the press from many leading PIs in this clinical trials. What is happening? What is the progress? What is emerging data?

Phillip Koo: Absolutely. I can attest to the fact that the breadth and scope of this meeting is wonderful. And you've been able to really assemble an amazing group of speakers and to really come together and speak about these topics from a multidisciplinary perspective. And also help us chart the future in the next step. So we really thank you for being that glue and that leader that can make this all happen. Any last words that you have for the viewers?

Faina Shtern: I hope you will join us, because when people attend the summit it's very rare for them not to come again. And I hope that you will share our experience since 2016. When everyone learned something that impacted either clinical practice or the research strategy or strategically research collaborations.

Phillip Koo: Well, that's great. So if you're a medical oncologist, radiation oncologist, urologic oncologist, imaging expert, researcher, whoever you might be, if you're interested in prostate cancer and diagnostics, make sure you sign up and attend this meeting. Which is virtually this year. So thank you very much Dr. Shtern for joining us. And we look forward to another wonderful meeting.

Faina Shtern: Thank you so much for your support, Phil. Have a great day.