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The Latest Research on Urology Imaging

ASCO GU 2019

ASCO GU 2019: TIVO-3: A Phase III, Randomized, Controlled, Multicenter, Open-label Study to Compare Tivozanib to Sorafenib in Subjects with Refractory Advanced Renal Cell Carcinoma

San Francisco, CA (UroToday.com) Tivozanib is a selective oral VEGFR 1, 2, and 3 tyrosine kinase inhibitor which has been studied in numerous solid tumors including hepatocellular carcinoma, recurrent glioblastoma, and soft tissue sarcoma1-3. Tivozanib has also been studied in the first line setting for metastatic RCC in a large phase III trial with 517 patients, randomly assigned to tivozanib or sorafenib4.  

ASCO GU 2019: JAVELIN Renal 101: Outcomes for Avelumab + Axitinib vs Sunitinib in Advanced Renal Cell Carcinoma (RCC)

San Francisco, CA (UroToday.com) While immunotherapy has entered both the first- and second-line treatment options for patients with metastatic renal cell carcinoma, the majority of patients do not have an objective response to single agent immunotherapy. Even with dual checkpoint inhibition as demonstrated in CheckMate 214, 58% of patients did not have an objective response1. Thus, several combination therapies are now being evaluated in this space, combining checkpoint inhibition with VEGF/VEGFR inhibition. JAVELIN Renal 101 is a global phase III study of avelumab plus axitinib versus sunitinib alone. During ASCO 2017, results from the avelumab + axitinib phase 1b study demonstrated that 58% of patients had an objective response (5% complete response, 53% partial response), and 45 out of 53 patients experienced tumor shrinkage2. This abstract provides the subgroup analysis of JAVELIN 101.

ASCO GU 2019: Multidisciplinary Tumor Board: Case-Based Discussion on Kidney Cancer

San Francisco, CA (UroToday.com) Dr. Toni Choueiri chaired the advanced/metastatic kidney cancer panel, presenting a case from his practice for discussion. This patient was a 63-year-old female with a 3-month history of bloating, malaise, weight loss, inability to concentrate, and intermittent gross hematuria. Her medical history was significant for hypertension, arthritis, and CAD. Pertinent medications included 325 mg aspirin and methotrexate and her images are as follows demonstrating an infiltrative right renal mass with peri-aortic lymphadenopathy.

ASCO GU 2019: Efficacy and safety of Nivolumab on Patients with Non-Clear Cell Renal Cell Carcinoma: Results from the Phase IIIb/IV CheckMate 374 Study

San Francisco, CA (UroToday.com) Nivolumab monotherapy is approved for the treatment of patients with advanced renal cell carcinoma (aRCC) who received prior antiangiogenic therapy. In the phase 3 Checkmate 025 trial in patients with previously treated aRCC, Nivolumab monotherapy demonstrated higher objective response rate and superior overall survival compared to everolimus (HR 0.79, p=0.002), with a lower incidence of treatment-relatedgrade 3-4 adverse events (19% vs. 37%).

ASCO GU 2019: Results from KEYNOTE-427 Cohort Bb - First-line Pembrolizumab Monotherapy for Advanced Non-Clear Cell RCC

San Francisco, CA (UroToday.com) Most renal cell carcinoma (RCC) histology is clear cell (80%), however clinical trial data for non-ccRCC are limited as many of these patients are often excluded from clinical trials. Therapies specifically approved by the FDA for advanced non-ccRCC are lacking, resulting in a substantial unmet need for safe and effective treatment options. PD-1/L1 pathway inhibitors are effective in clear cell RCC, but efficacy of PD-1 inhibitors (or any therapy) in non-ccRCC has not been established. KEYNOTE-427 is a single-arm, open-label, phase 2 study of pembrolizumab monotherapy in patients with advanced ccRCC (cohort A) and non-ccRCC (cohort B).

ASCO GU 2019: Final Analysis from the NIVOREN GETUG AFU 26 Study

San Francisco, CA (UroToday.com) The final presentation of GU ASCO 2019 featured Dr. Laurence Albiges presenting results from the final analysis of the NIVOREN GETUG AFU 26 study. This was a French multicenter prospective study to evaluate the safety and efficacy of nivolumab in a broad “real world setting” in mRCC after failure of 1 or 2 tyrosine kinase inhibitors.

ASCO GU 2019: PIVOT-02 Study of NKTR-214 with Nivolumab in Metastatic Urothelial Carcinoma

San Francisco, CA (UroToday.com) Immune checkpoint inhibitors are approved both in the first line and second line for patients with metastatic urothelial carcinoma. In the first line, KEYNOTE 052 showed that pembrolizumab has significant anti-tumor activity for cisplatin ineligible patients with UC1, for a 38% objective response rate for patients with a combined positive score of 10% or more (PD-L1 positive). Further analysis last year found that the benefit to checkpoint inhibition in the first line was restricted to patients with a high PD-L1 expression, as defined by CPS≥10 or PD-L1 IC ≥5%. In the second line, KEYNOTE 045 improved median overall survival compared with chemo (10.3 v 7.4 months; HR, 0.70; P < 0.001)2.

ASCO GU 2019: Health-Related Quality of Life Reporting in Phase III Randomized Controlled Trials of Metastatic Prostate Adenocarcinoma and Urothelial Carcinoma

San Francisco, CA (UroToday.com) Health-related quality of life (HRQOL) reflects the patient’s subjective perception of several functional domains: physical, psychological, cognitive, social, and general well-being. HRQOL is central to assessment of efficacy and guides decision at a regulatory level, especially when drug impacts on overall survival is limited.

ASCO GU 2019: Study of Durvalumab Given with Chemotherapy, Durvalumab in Combination with Tremelimumab Given with Chemotherapy, or Chemotherapy in Patients with Unresectable Locally Advanced or Metastatic Urothelial Cancer

San Francisco, CA (UroToday.com) Bladder cancer is the ninth most common cancer diagnosis worldwide. Over 5% of patients present with metastatic disease. Approximately 70% present with non-muscle invasive disease (NMIBC) and 30% are muscle invasive (MIBC). Nearly 40% of NMIBC progress to MIBC. Combining immunotherapy with chemotherapy could be a key option for improving clinical outcomes in advanced urothelial carcinoma patients.

ASCO GU 2019: Gemcitabine-Carboplatin versus Gemcitabine-Oxaliplatin In Cisplatin Un-Fit Advanced Urothelial Carcinoma: Randomized Phase II Study-COACH Study

San Francisco, CA (UroToday.com) The first line chemotherapy in advanced metastatic urothelial carcinoma is cisplatin-based. The two most accepted options are gemcitabine + cisplatin (GC) or Methotrexate, Vinblastine, Doxorubicin, Cisplatin (MVAC).  In patients who are unfit to receive cisplatin-based chemotherapy (approximately 30-50% of patients), the available options include gemcitabine and carboplatin, or immune checkpoint inhibitors such as pembrolizumab or atezolizumab for patients with high PD-L1 expression. Gemcitabine and carboplatin have been shown to harbor significant adverse events such as neutropenia (52.5%), thrombocytopenia (48.3%), febrile neutropenia (4.2%), grade 3 or 4 infections (11.8%), and severe acute toxicity (9.3%).1,2

ASCO GU 2019: RENAVIV: Pazopanib with or without Abexinostat in Patients with Locally Advanced or Metastatic Renal Cell Carcinoma

San Francisco, CA (UroToday.com) Abexinostat (ABEX) is a potent, orally bioavailable pan-HDAC inhibitor. Pazopanib (PAZO) is a standard front line VEGF tyrosine kinase inhibitor (TKI) for the treatment of locally advanced or metastatic renal cell carcinoma (mRCC). A prior phase 1 study of PAZO +ABEX demonstrated durable anti-tumor activity in heavily pretreated RCC patients.1

ASCO GU 2019: PROSPER: Comparing Perioperative Nivolumab versus Observation in Patients with Localized Renal Cell Carcinoma Undergoing Nephrectomy

San Francisco, CA (UroToday.com) There is currently no standard adjuvant systemic therapy proven to increase overall survival (OS) over surgery in renal cell carcinoma (RCC). There is controversy over the efficacy of adjuvant targeted therapy given one positive phase 3 study demonstrating a >1 year disease-free survival (DFS) benefit with adjuvant sunitinib in higher risk, clear cell disease (S-TRAC), but 3 other phase 3 studies showing no DFS or OS benefit to 1 year of adjuvant VEGF blockade, with sunitinib (ASSURE), Pazopanib (PROTECT), or Axitinib (ATLAS).

ASCO GU 2019: Gemcitabine Plus Axitinib in Patients with Sarcomatoid Type Renal Carcinoma

San Francisco, CA (UroToday.com) Sarcomatoid renal cell carcinoma is a rare but very aggressive type of RCC with a median overall survival (OS) of 3-10 months. The treatment option for sarcomatoid renal cell carcinoma are very limited, however, there have been anecdotal reports of very good responders to gemcitabine or vascular endothelial growth factor receptor tyrosine kinase inhibitors (VEGFR TKI)1. 

ASCO GU 2019: Novel Predictive Models of Early Death Less than One Year in Patients with Metastatic Renal Cell Carcinoma Treated with First-Line Tyrosine Kinase Inhibitors

San Francisco, CA (UroToday.com) The International Metastatic Renal Cell Carcinoma Database Consortium (IMDC) is a useful model for predicting overall survival outcomes in patients with metastatic RCC. However, this model may be problematic in patients who experience early death less than one year after initial treatment with tyrosine kinase inhibitors (TKI). 

ASCO GU 2019: Results of a Phase II Study to Evaluate the Safety and Efficacy of RX-0201 in Combination with Everolimus in Subjects with mRCC

San Francisco, CA (UroToday.com) At the renal cell cancer poster session at ASCO GU 2019, Neeraj Agarwal, MD and colleagues presented results of a phase Ib/2 clinical trial assessing RX-0201 in combination with everolimus to treat metastatic renal cell carcinoma. RX-0201 is a novel 20-mer oligonucleotide that binds to mRNA coding for AKT-1, thus preventing AKT-1 expression and limiting the amount of downstream p-AKT. In vitro, RX-0201, in combination with everolimus, additively inhibited Caki-1 cell growth. The mechanism of action is as follows:

ASCO GU 2019: A Phase II study of Cabozantinib as First-line Treatment in Metastatic Collecting Duct Carcinoma: The BONSAI Trial

San Francisco, CA (UroToday.com) Metastatic collecting duct carcinoma is a rare and aggressive disease, characterized by a poor prognosis. This histology of kidney cancer is diagnosed based on several histologic features: high-grade atypia, desmoplastic stromal reaction, medullary location, infiltrative growth, tubular architecture, and exclusion of clear cell and translocation cell carcinoma. These tumors have been characterized by upregulation of genes involved in T-cell activation and proliferation, as well as those involved in lymphocyte infiltration1.  

ASCO GU 2019: CheckMate 9UT - Nivolumab or Nivo Plus BMS-986205 with or without Intravesical Bacillus Calmette-Guerin in BCG-Unresponsive, High-Risk, Non-Muscle Invasive Bladder Cancer

San Francisco, CA (UroToday.com) Immune checkpoint inhibitors, including the anti-PD1 monoclonal antibody nivolumab, have demonstrated favorable tolerability and efficacy profiles, ushering a new treatment paradigm for advanced bladder cancer. Nivolumab has a meaningful clinical benefit in patients with advanced bladder cancer, whose disease progressed or recurred following treatment with platinum-based chemotherapy (objective response rate of 20%), and a manageable safety profile. However, an unmet need exits for new effective treatment options in an earlier stage of the disease, including patients with BCG-unresponsive, high risk- non-muscle invasive bladder cancer (NMIBC). 

ASCO GU 2019: POTOMAC Study - Durvalumab and BCG versus BCG Alone in High-risk, BCG-Naïve Non Muscle-Invasive Bladder Cancer

San Francisco, CA (UroToday.com) Urothelial carcinoma is the most common type of cancer of the bladder, urethra, and urachus, accounting for 90% of primary malignancies of the urinary tract. Standard treatment for patients with high-risk tumors is transurethral resection (TURBT) followed by intravesical BCG. Despite the efficacy of BCG, recurrence rates are as high as 50% in the first three years of follow-up and can be even higher for aggressive histologic subtypes.  Antitumor immune response has been shown with the targeting of the programmed cell death ligand-1/programmed cell death-1 (PD-L1/PD-1). The response rates have shown to be doubled with immunotherapy targeting PD-1 and PD-L1 compared to standard chemotherapy.

ASCO GU 2019: Renal Function Preservation in Kidney Cancer: Current Techniques and Biomarkers

San Francisco, CA (UroToday.com) Dr. Breau gave a talk discussing function preservation in kidney cancer, focusing on current techniques and biomarkers. We continue to have this discussion, even at ASCO GU 2019, because urologists are fixated on renal preservation – but Dr. Breau argues that in our drive to preserve nephrons, we may have lost sight of the bigger picture. 

ASCO GU 2019: Phase II Study of Ribociclib in Men with Unresectable, Incurable Teratoma with Recent Progression

San Francisco, CA (UroToday.com) Most patients with teratoma are managed by surgery and no standard medical therapy exists for progressive and unresectable teratoma. Little progress has been made in the treatment of progressive and unresectable disease, and no standard therapy exits. Teratomas have a functional expression of retinoblastoma protein, and clinical activity was observed with CDK4/6 inhibition.1 Ribociclib is an orally bioavailable small molecule inhibitor of CDK 4/6, approved for the use in patients with hormone receptor positive, human epidermal growth factor 2 negative advanced breast cancer. Given its mechanism of action, it may have potential therapeutic activity in patients with teratomas. 
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Physician-Scientist Review Articles
State of the Evidence Review Articles
Written by Rashid Sayyid, MD MSc, & Zachary Klaassen, MD MSc
October 19, 2022

Although definitive local therapy in the form of radical prostatectomy or radiation therapy with or without ADT offers excellent long-term outcomes for the majority of patients with clinically localized prostate cancer, patients with high-risk disease experience primary treatment failure rates approaching 65%.1 Disease persistence/recurrence in such patients may be restricted to the prostatic fossa, pelvic lymph nodes, non-regional lymph nodes (M1a), bones (M1b), or the viscera (M1c).

Written by Rashid Sayyid, MD MSc, & Zachary Klaassen, MD MSc
October 20, 2022
Conventional imaging using CT and bone scan has limited sensitivity when staging men with high-risk localized prostate cancer. Findings of extraprostatic spread in the form of extraprostatic extension and/or lymph node, visceral, or bone metastasis can influence treatment planning, and thus, potentially, patient outcomes.
Written by Rashid Sayyid, MD MSc, & Zachary Klaassen, MD MSc
October 13, 2022

Imaging plays a significant role in the diagnosis and management of prostate cancer. While transrectal ultrasound and, subsequently, multiparametric magnetic resonance imaging (mpMRI) have become well-established modalities in the initial diagnosis of prostate cancer, numerous techniques for the distant staging of prostate cancer have all suffered from significant limitations.

Written by Zachary Klaassen, MD, MSc
June 22, 2021
An accurate assessment of the extent of disease is critical to the care of patients with cancer, across the natural history of disease including initial evaluation, following local treatment, and assessing response to systemic therapy. Thus, improvements in radiographic imaging may revolutionize
Written by Zachary Klaassen, MD MSc
April 15, 2021
Prostate-specific membrane antigen (PSMA) is a type II transmembrane glycoprotein which functions as a zinc metalloenzyme and is found on prostatic epithelium. In normal prostate tissue, PSMA expression and localization focuses on the cytoplasm and apical side of the epithelium surrounding prostatic ducts.
May 20, 2020
The purpose of this document is to describe the appropriate use of imaging in the diagnostic evaluation of patients with BCR after definitive primary treatment. The imaging modalities that were considered included CT, bone scan, and the U.S. Food and Drug Administration (FDA)–approved PET radiotracers that track malignancy-induced lipogenesis (11C-choline) and amino acid metabolism (18F-fluciclovine). 
Conference Coverage
Conference Highlights Written by Physician-Scientist
Presented by Daniela-Elena Oprea-Lager, MD, PhD
 The 2024 European Society of Medical Oncology (ESMO) Annual Congress held in Barcelona, Spain was host to the session Biochemical failure post-local therapy: An opportunity for tailored treatment? Dr. Daniela E. Oprea-Lager discussed if PSMA PET could be a game changer for treatment decision-making in patients with biochemical failure post-local therapy.
Presented by  Michael S. Hofman, MBBS (Hons), FRACP, FAANMS
The 2024 ESMO annual meeting included a session on prostate cancer, featuring a presentation by Dr. Michael Hofman discussing Prostate Cancer Working Group 4 (PCWG4) preliminary criteria using serial PSMA PET/CT for response evaluation.
Presented by Jiarou Wang, MD
At the 2024 SNMMI annual meeting Dr. Jiarou Wang discussed the diagnostic performance of 68Ga-P16-093 in newly diagnosed prostate cancer. 68Ga-P16-093 is a novel PSMA-targeted radiopharmaceutical that has a labeling reaction compatible with various Ge/Ga generators and has a simple labeling method of heating at 95 degrees Celsius for 5 minutes, leading to high radiochemical purity. As a targeting agent in prostate cancer patients,
Presented by Luke Nordquist, MD
(UroToday.com) The 2024 Society of Nuclear Medicine & Molecular Imaging (SNMMI) annual meeting featured a session on prostate cancer, and a presentation by Dr. Luke Nordquist discussing results of COBRA, an assessment of the safety and efficacy of 64Cu-SAR-bisPSMA in patients with biochemical recurrence of prostate cancer following definitive therapy.
Presented by Jean-Mathieu Beauregard, MD, MSc, FRCPC
The 2024 SNMMI annual meeting featured a session on prostate cancer, and a presentation by Dr. Jean-Mathieu Beauregard discussing a sub-analysis of the 3TMPO study assessing eligibility for PSMA radioligand therapy based on dual FDG/PSMA-PET. Eligibility criteria for PSMA radioligand therapy are currently debated, particularly with respect to the role of FDG-PET in patient selection.
Presented by Linlin Li, PhD
The 2024 SNMMI annual meeting featured a session on prostate cancer, and a presentation by Dr. Linlin Li discussing the dosimetry and pilot therapy study of novel PSMA-targeting agents, 177Lu-P17-087 and 177Lu-P17-088, in metastatic castration-resistant prostate cancer patients. 
Presented by Thomas Hope, MD
The 2024 SNMMI annual meeting was host to the session Novel Approaches and Combination Therapies; Pre-Targeting Approaches. Dr. Thomas Hope discussed the combination treatment of prostate cancer using Pembrolizumab with PSMA-based radioligands.
Presented by Nat Lenzo, MD, EMBA, FRACP, FAANMS, GAICD
At the 2024 SNMMI annual meeting, Dr. Nat Lenzo presented preliminary results of ProstACT SELECT, specifically the safety, tolerability, and dosimetry of TLX591 with best standard of care in patients with PSMA-expressing metastatic castration resistant prostate cancer.
Presented by Michael S. Hofman, MBBS (Hons), FRACP, FAANMS, FICI
The 2024 SNMMI annual meeting featured the Therapy Center of Excellence Saul Hertz Lecture and Award, and a presentation by Dr. Michael Hofman discussing bridging evidence-based medicine and precision oncology. Saul Hertz (1905-1950) conceived and brought from bench to bedside radioactive iodine for medical uses based on the 1936 question “Could iodine be made radioactive artificially?” This was followed by the 1937 radioactive iodine studies assessing thyroid physiology, tracer qualities, dosimetry, and thyroid carcinoma. 
Presented by James Buteau, MD, FRACP, FRCPC
Th SNMMI 2024 Annual Meeting was host to a prostate cancer novel approaches and combination therapies session. Dr. James Buteau discussed novel approaches of combination PSMA-based radiopharmaceutical treatments for prostate cancer.
Presented by David Chen, PhD
At the SNMMI 2024 Annual Meeting, David Chen presented the results of a prospective analysis of the ProsTIC registry evaluating the oncologic and quality-of-life outcomes of metastatic castration-resistant prostate cancer (mCRPC) patients with a stable or poor initial PSA response to [177Lu]Lu-PSMA-617, and the prognostic value of baseline imaging biomarkers and dosimetry.
Presented by Meryam Losee, BS
At the SNMMI 2024 Annual Meeting, Dr. Meryam Losee presented the results of a study evaluating the effect of bone marrow disease on hematologic toxicity and PSA response to 177Lu-PSMA-617 therapy. 
Presented by Benjapa Khiewvan, MD
At the SNMMI 2024 Annual Meeting Dr. Benjapa Khiewvan presented the first Thai experience with Lu-177-PSMA-I&T treatment for patients with metastatic castrate-resistant prostate cancer (mCRPC).
Presented by Fuad Novruzov, MD, PhD
At the SNMMI 2024 Annual Meeting Dr. Fuad Novruzov presented the results of a prospective phase 3 randomized study from Azerbaijan evaluating 225Ac-PSMA + 177Lu-PSMA tandem therapy for metastatic castration-resistant prostate cancer (mCRPC).
Presented by Vishnu Murthy
At the SNMMI 2024 Annual Meeting Vishnu Murthy presented the results of a US expanded access program evaluating the efficacy and toxicity of 177Lu-PSMA-617 for metastatic castration-resistant prostate cancer (mCRPC) in a real-world setting and compared these results to those from the phase 3 VISION trial.
Presented by Oliver Sartor, MD
At the SNMMI 2024 Annual Meeting Dr. Oliver Sartor presented the updated results of PSMAfore, a phase 3 trial of [177Lu]Lu-PSMA-617 in taxane-naive patients with metastatic castration-resistant prostate cancer (mCRPC).
Presented by Oliver Sartor, MD
The SNMMI 2024 Annual Meeting was host to a prostate-specific membrane antigen (PSMA) radioligand therapy (RLT) tumor board session. Dr. Oliver Sartor discussed whether earlier use of PSMA RLT in earlier settings is of clinical benefit.
Presented by Josef Zahner, PhD
At the SNMMI 2024 Annual Meeting, Dr. Josef Zahner presented the first dosimetry results of a study evaluating the influence of androgen receptor pathway inhibitors (ARPIs) on absorbed doses in metastatic castrate-resistant prostate cancer (mCRPC) patients undergoing 177Lu-PSMA-617 therapy.
Presented by  Michael Gorin, MD
The 2024 ASCO annual meeting was host to a presentation by Dr. Michael Gorin, who presented CLARIFY, a phase III diagnostic study of positron emission tomography (PET) using 64Cu-SAR-bisPSMA in patients with high-risk prostate cancer prior to radical prostatectomy.
Presented by Luke Nordquist, MD, FACP
The 2024 ASCO annual meeting featured a session on prostate cancer, and a presentation by Dr. Luke Nordquist discussing results of COBRA, an assessment of the safety and efficacy of 64Cu-SAR-bisPSMA in patients with biochemical recurrence of prostate cancer following definitive therapy.
Presented by Rui M. Bernardino, MD
The 2024 European Association of Urology (EAU) annual meeting featured a session on adverse pathology and imaging for risk assessment and local staging, and a presentation by Dr. Rui Bernardino discussing intraductal prostate cancer affinity for lymphatic-predominant metastases through 18F-DCFPyL-PSMA-PET/CT scans in pre-treatment prostate cancer patients.
Presented by Ken Herrmann, MD
The 2024 European Association of Urology (EAU) annual congress held in Paris, France was host to a plenary session addressing imaging-related controversies for the staging of genitourinary cancers. Professor Ken Herrmann discussed the advantages and pitfalls of molecular imaging for prostate cancer characterization.
Presented by Henk G. van der Poel, MD, PhD
 The 2024 European Association of Urology (EAU) annual congress held in Paris, France was host to a plenary session addressing imaging-related controversies for the staging of genitourinary cancers. Professor Henk van der Poel discussed why patients with prostate-specific membrane antigen (PSMA)-detected M1a disease should be treated similarly to patients with conventional imaging-detected M0 disease.
Presented by Louise Emmett, MBChB, FRACP
In the Discussant session at the 2023 ASCO annual meeting, Dr. Louise Emmett discussed the current and future states of novel imaging modalities for advanced prostate cancer, highlighting three abstracts from this session.
Presented by Thomas A. Hope, MD
(UroToday.com) At the 2022 American Society of Clinical Oncology Annual Meeting held in Chicago and virtually, a breakout session assessing the best approaches and treatment updates in biochemically recurrent prostate cancer featured a presentation from Dr. Thomas A. Hope discussing the manner in which molecular-based imaging is defining the landscape of prostate cancer.
Presented by William J. Aronson, MD
In a podium presentation at the Friday morning plenary of the 2022 American Urologic Association Annual Meeting held in New Orleans and virtually, Dr. William Aronson presented a State-of-the-Art Lecture on prostate specific membrane antigen (PSMA) Diagnostics and Theranostics.
Presented by Michael Hofman, MBBS (Hons), FRACP, FAANMS, FICIS
The 2022 Advanced Prostate Cancer Consensus Conference (APCCC) Hybrid Meeting included a session on the management of metastatic hormone sensitive prostate cancer (mHSPC) and a presentation by Dr. Michael Hofman discussing how frequent low-volume disease on conventional imaging becomes high-volume on next-generation imaging. Dr. Hofman started his presentation by noting that there has been an explosion of PSMA PET publications per year from 2001 to 2021:
Presented by Michael Morris, MD
The 2022 Advanced Prostate Cancer Consensus Conference (APCCC) Hybrid Meeting included a session on the management of non-metastatic castrate-resistant prostate cancer (nmCRPC), and a presentation by Dr. Michael Morris discussing the advantages of using novel imaging in this disease space.
Presented by Ken Herrmann, MD, MBA
The 2022 Advanced Prostate Cancer Consensus Conference (APCCC) Hybrid Meeting included a session on high-risk and locally advanced prostate cancer and a presentation by Dr. Ken Herrmann discussing the impact of next generation imaging and the optimal tracer for PET-based imaging for staging.
Presented by Jason Efstathiou, MD
The 2022 Advanced Prostate Cancer Consensus Conference (APCCC) Hybrid Meeting included a session on high-risk and locally advanced prostate cancer and a presentation by Dr. Jason Efstathiou arguing for changes in management based on next-generation imaging.
Presented by Gerald L. Andriole, Jr, MD
The SUO annual meeting included a prostate cancer session and a presentation by Dr. Gerald Andriole discussing the impact of 18F-fluciclovine PET/CT on plans for ADT in patients with biochemical recurrence of prostate cancer. 
Presented by Robert Reiter, MD
The SIU 2021 annual meeting focused on the role of prostate-specific membrane antigen (PSMA) and theranostics in prostate cancer, Dr. Robert Reiter began with a presentation on the role of PSMA-based imaging as a diagnostic tool in the initial staging of patients with prostate cancer.
Presented by Ephraim E. Parent, MD
In a special session of the ASTRO and SNMMI held at the 2021 ASTRO Annual Congress, Dr. Parent presented on the role of molecular imaging and targeted radionuclide therapy using PSMA-based radiopharmaceuticals.
Presented by Bital Savir-Baruch, MD
In a special session of the American Society for Radiation Oncology (ASTRO) and Society of Nuclear Medicine and Molecular Imaging (SNMMI) held at the 2021 ASTRO Annual Congress, Dr. Baruch presented on the role of molecular imaging using Fluciclovine PET imaging.
Presented by Alberto Bossi, MD
Dr. Alberto Bossi discussed radiotherapy after radical prostatectomy in the PSMA-PET era. Adjuvant radiotherapy is defined as immediate postoperative radiation in the case of extraprostatic extension, positive margins, seminal vesicle infiltration, high Gleason score, or pN+ disease. Salvage radiotherapy is defined as a wait-and-see policy in that radiation is only given in the case of a rising postoperative PSA.
Presented by obias Maurer, MD
The treatment for metastatic hormone-sensitive prostate cancer plenary session at the European Association of Urology 2021 Meeting included a presentation by Dr. Tobias Maurer discussing the role of imaging-guided surgical treatment for recurrent metastatic hormone sensitive prostate cancer (mHSPC).
Presented by Karim Fizazi, MD, Ph.D
Dr. Karim Fizazi finished off the thematic session of Treatment Sequencing in Metastatic Prostate Cancer with a presentation on the role of PSMA in diagnostics and treatment of metastatic prostate cancer.
Presented by Michael S. Hofman, MBBS (Hons), FRACP, FAANMS,
The game changing session of the European Association of Urology (EAU)’s 2021 annual meeting included a presentation by Dr. Michael Hofman from the Peter MacCallum Cancer Centre discussing the phase 2 trial of 177Lu-PSMA-617, TheraP, as well as important contrasts/differences between TheraP and VISION.
Presented by Johann De Bono, MD, MSc, Ph.D., FRCP, FMedSci
The EAU 2021 Annual Meeting included a presentation by Johann De Bono discussing the VISION trial, a phase 3 study of 177Lu-PSMA-617 in patients with mCRPC. As PSMA is highly expressed in prostate cancer and mCRPC lesions, the combination of PSMA-617 with the beta-emitter lutetium allows for the targeted delivery of ß-particle radiation to PSMA-expressing cells and the surrounding microenvironment.
Presented by Mary-Ellen Taplin, MD
Following Micheal Morris’s presentation of the results of the phase III VISION trial of lutetium-177-PSMA-617 in patients with metastatic castration-resistant prostate cancer in the Plenary Session of the 2021 ASCO, Dr. Mary-Ellen Taplin from the Dana Farber Cancer Institute provided a discussant overview of these data and helped to contextualize how we may apply them to our practices.
Presented by Micheal Morris, MD
In a plenary presentation at the 2021 ASCO Annual Meeting, Dr. Morris presented the first results of the VISION trial, a phase III study assessing lutetium-177-PSMA-617 in patients with metastatic castration-resistant prostate cancer.
Presented by Mike Machaba Sathekge, MD, Ph.D
In a plenary presentation in the Progress and Promise in Treatment Personalization for Advanced Prostate Cancer session at the 2021 American Society of Clinical Oncology Genitourinary (Cancers Symposium (ASCO GU), Dr. Sathekge provided a talk examining the role of Lutetium in prostate cancer.
Presented by James Wysock, MD, MSc
At the Society of Urologic Oncology (SUO) Annual Meeting, Dr. James Wysock gave an update on the imaging for primary prostate cancer. Dr. Wysock briefly touched on imaging strategies in both the screening and diagnosis of localized prostate cancer.
Presented by Matthew R. Cooperberg, MD, MPH and Tanya B. Dorff, MD
To conclude the advances in prostate cancer session Drs. Matthew Cooperberg and Tanya Dorff debated whether prostate-specific membrane antigen (PSMA) imaging should be routinely used in the clinical management of prostate cancer.
Presented by Declan Murphy, MB, BCH, BaO, FRACS, FRCS, Urol
At the 2020 virtual Society of Urologic Oncology's (SUO) prostate cancer session, Dr. Declan Murphy discussed the role of prostate-specific membrane antigen (PSMA) scanning in prostate cancer staging. Dr. Declan Murphy states that PSMA PET/CT is an obvious challenger to conventional imaging.
Presented by Declan Murphy, MB, BCH, BaO, FRACS, FRCS, Urol
(UroToday.com) During the Individualized Approach in Advanced Prostate Cancer session at the European Multidisciplinary Congress on Urological Cancers (EMUC) 2020 virtual meeting, Dr. Declan Murphy presents on using prostate-specific membrane antigen (PSMA) positron emission tomography (PET) for upfront staging in high-risk prostate cancer disease. Dr. Murphy states that PSMA PET/CT is an obvious challenger to conventional imaging.
Presented by Renu Eapen, MD
The Société Internationale d'Urologie (SIU) 2020 Virtual Annual Congress featured a debate discussing imaging definitions for oligometastatic prostate cancer. Dr. Renu Eapen from Australia argued that oligometastatic disease should be defined based on novel imaging modalities.
Presented by Noel William Clarke, MD
The Société Internationale d'Urologie (SIU) 2020 Virtual Annual Congress featured a debate discussing imaging definitions for oligometastatic prostate cancer. Dr. Noel Clarke from the United Kingdom argued that oligometastatic disease should be defined based on standard imaging modalities.
Presented by Michael S. Hofman, MBBS (Hons), FRACP, FAANMS,
(UroToday.com) As part of the “Game-Changing Session 1” plenary presentation at the 2020 European Association of Urology (EAU) Virtual Annual Meeting, Dr. Michael Hofman presented results of the proPSMA study which was recently published in the Lancet.1
Presented by Scott T. Tagawa, MD, MS, FACP
There are currently significant imaging deficiencies for men with prostate cancer (Figure 1), with the hope that PSMA imaging-based modalities will address a significant gap in this field. Prostate-specific membrane antigen PSMA is a transmembrane glycoprotein with folate hydrolase activity.
Presented by Michael J. Morris, MD
Men with biochemically recurrent prostate cancer after definitive local therapy currently have limited imaging modalities in the United States which are sensitive or specific enough to detect tumor recurrence. PSMA PET scans can improve on this detection by detecting cells expressing PSMA protein on their cell surface.
Presented by Charles J. Ryan, MD, & Markus Graefen, MD
San Francisco, California (UroToday.com)  The first case presented was that of a 54-year-old otherwise healthy man who underwent radical prostatectomy after biopsy-confirmed prostate cancer.
Presented by Jeremie Calais, MD
San Francisco, California (UroToday.com) Advanced imaging is increasingly being used across all stages of prostate cancer. Dr. Jeremie Calais from UCLA Medical Center discussed
Presented by Claire M. De La Calle, MD
Washington, DC (UroToday.com) While PSA screening has resulted in decreasing prostate cancer mortality, PSA is also known to be a poorly specific test for the detection of clinically
Presented by Renu Eapen, FRACS
Athens, Greece (UroToday.com) Dr. Renu Eapen gave an overview of the role of PET- prostate-specific membrane antigen (PSMA) in prostate cancer and gave a preview of what is to come
Presented by Sigrid Carlsson, MD, PhD, MPH
Athens, Greece (UroToday.com) Dr. Carlsson gave an encompassing presentation on prostate cancer screening from the perspective of an epidemiologist.
Presented by Cora Sternberg, MD
Barcelona, Spain (UroToday.com)  Dr. Cora Sternberg summarized the findings from several posters, including three immunotherapy phase 1 or 2 trials, a phase 2 trial of 177Lu-PSMA-617,
Presented by Scott T. Tagawa, MD, MS
Barcelona, Spain (UroToday.com) PSMA is overexpressed in prostate cancer with limited expression in other organs. Furthermore, prostate cancer is radiosensitive with dose-response (
Presented by Stefano Fanti, MD
Barcelona, Spain (UroToday.com) Theranostics is an emerging field of medicine which utilizes targeted cancer therapy based on specific molecular-targeted diagnostic tests. As part of the Imaging in Prostate Cancer plenary session at the 2019 European Association of Urology (EAU) annual meeting in Barcelona, Spain
Presented by Olivier Rouvière, MD, PhD
Barcelona, Spain (UroToday.com) Dr. Rouviere presented the imaging specialist’s perspective on MRI use in prostate cancer. According to the European Association of Urology (EAU) guidelines prostate multiparametric MRI (mpMRI) was originally recommended after a negative prostate biopsy
Presented by Michael Hofman, FRACP, MBBS

San Francisco, CA (UroToday.com) PSMA is over-expressed in all prostate tissue, including prostatic carcinoma. Lutetium-177 (177Lu)-PSMA617 (LuPSMA) is a small radiolabeled molecule which binds to PSMA

Presented by Jeremie Calais, MD, MSc
San Francisco, CA (UroToday.com)  Salvage radiotherapy (SRT) for prostate cancer biochemical recurrence after radical prostatectomy (RP) is commonly administered to patients with PSA < 1 ng/mL, a threshold at which standard-of-care imaging 
Presented by Paul L. Nguyen, MD
Prague, Czech Republic (UroToday.com) Dr. Paul Nguyen took the stance for radiation therapy in this much-anticipated debate regarding appropriate local treatment in men with high risk localized prostate cancer. Dr. Nguyen notes that high-quality radiation therapy for high-risk disease needs long-term ADT and a brachytherapy boost.