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Highlights from the 2024 Society of Urologic Oncology Annual Meeting |
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| Advances in RCC Molecular Imaging and Theranostics |
| Brian Shuch, MD |
| Brian Shuch discussed advances in molecular imaging and theranostics for RCC, emphasizing the role of nuclear medicine in addressing unmet needs, such as characterizing renal masses and identifying distant disease. Emerging tools like 89Zr-DFO-girentuximab PET/CT have shown promise in detecting clear cell RCC with high sensitivity and specificity, while theranostics leveraging CAIX and PSMA are advancing as potential treatments. Ongoing trials aim to optimize these approaches for local and systemic therapy, paving the way for improved RCC management. |
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| Artificial Intelligence in RCC Diagnosis and Treatment |
| Nicholas Kavoussi, MD |
| Nicholas Kavoussi discussed the role of artificial intelligence (AI) in renal cell carcinoma (RCC) diagnosis and treatment, emphasizing its data-driven predictive capabilities. AI applications in RCC include improved renal mass characterization, pathology prediction, and staging, with performance metrics ranging from moderate to high accuracy. Challenges include the "black box" nature of AI models, lack of data standardization, and validation concerns. |
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| In-Depth Characterization of the Safety Profile of Belzutifan Monotherapy in Patients with Renal Cell Carcinoma: A Pooled Analysis of Four Clinical Trials
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| Eric Jonasch, MD
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| Eric Jonasch presented a pooled safety analysis of belzutifan monotherapy across four trials involving 576 patients with advanced RCC. The study highlighted a generally manageable safety profile, with anemia (84.2%) and hypoxia (16.3%) as the most common treatment-related adverse events (AEs). These AEs typically occurred within the first three months and were managed with supportive care, including erythropoiesis-stimulating agents, blood transfusions, and supplemental oxygen.
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| Updates to Testicular Cancer Epidemiology |
| Katherine McGlynn, PhD, MPH |
| Katherine McGlynn's presentation at SUO 2024 highlighted key trends in testicular cancer epidemiology, noting that incidence rates among Hispanic men have risen to match those of non-Hispanic White men, while non-Hispanic Black men face lower incidence but higher rates of advanced-stage diagnosis and lower survival. Seminoma and NSGCTs peak in different age groups (35–39 and 25–29 years, respectively), with risk factors like occupational exposures and PFAS under investigation. |
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| Spotting Metastatic Masqueraders: How to Avoid Inappropriate Chemotherapy Administration for Testicular Cancer |
| Samuel Funt, MD |
| Samuel Funt presented strategies to avoid inappropriate chemotherapy in testicular cancer, focusing on "metastatic masqueraders" through seven clinical cases. These included conditions like sarcoidosis, benign retroperitoneal lymph nodes, and post-orchiectomy hematomas that mimic metastases, emphasizing the importance of thorough diagnostic evaluations to prevent overtreatment. He highlighted scenarios where careful observation, histological confirmation, and trending tumor markers can guide optimal management, reducing unnecessary chemotherapy and associated long-term risks. |
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| Top Papers in Testicular Cancer 2024
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| Meredith Metcalf, MD
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| Meredith Metcalf highlighted key advancements in testicular cancer research: the EAU Guidelines Panel developed a new risk stratification model for stage I seminoma, improving relapse prediction; the COTRIMS trial supported primary retroperitoneal lymph node dissection (RPLND) for early metastatic seminoma as a safe alternative to chemotherapy, reducing long-term toxicities; and serum miRNA371 was identified as a promising biomarker for detecting metastases and assessing residual masses post-chemotherapy, though its sensitivity varies with tumor burden. |
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| Setting the Stage – Overview of Emerging Intravesical Therapy Options: Mechanism of Action, Efficacy, Tolerability, Financial Considerations/Access
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| Mark Tyson II, MD, MPH
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| Mark Tyson presented emerging intravesical therapies for non-muscle invasive bladder cancer (NMIBC), focusing on their mechanisms, efficacy, and financial considerations. Key therapies for BCG-unresponsive disease include agents like cretostimogene, pembrolizumab, and TAR-200, which demonstrate varying response durations and safety profiles. While intravesical gemcitabine plus docetaxel remains a standard, radical cystectomy is still recommended for high-risk cases, with emerging treatments offering potential alternatives but varying in cost and accessibility.
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| Trial Design for BCG Unresponsive NMIBC: Time to Move Past Single Arm Registration Trials?
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| Joshua Meeks, MD, PhD
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| Joshua Meeks argued for moving beyond single-arm trials for BCG-unresponsive non-muscle invasive bladder cancer (NMIBC) treatments, emphasizing their limitations, such as the lack of comparisons to other therapies and the heterogeneous patient populations. He proposed that randomized trials with active drug arms, such as the SunRISe-5 trial comparing TAR-200 to standard intravesical chemotherapy, would be more appropriate for assessing the safety and efficacy of new drugs.
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| Disease-Free Survival and Overall Survival in Patients with High-Risk Muscle-Invasive Bladder Cancer Who Have Persistent Circulating Tumor DNA-Negative Biomarker Status Post-Cystectomy: IMvigor011 Study Surveillance Analysis
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| Joaquim Bellmunt, MD, PhD
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| Joaquim Bellmunt presented findings from the IMvigor011 study on high-risk muscle-invasive bladder cancer patients with persistent ctDNA-negative status post-cystectomy. The analysis suggested that serial ctDNA testing could better stratify relapse risk than landmark testing. Patients with persistent ctDNA-negative status had favorable disease-free survival (DFS) and overall survival (OS), potentially avoiding the need for adjuvant therapy, regardless of PD-L1 status.
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| The Efficacy of Salvage BCG for Recurrent Non-muscle Invasive Bladder Cancer After First-line Gemcitabine and Docetaxel
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| Ian M. McElree
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| Ian McElree presented a retrospective analysis evaluating the efficacy of salvage BCG for patients with recurrent non-muscle invasive bladder cancer (NMIBC) following failure of first-line gemcitabine plus docetaxel. This study, conducted at The Iowa Medical Center, included 19 NMIBC patients treated with a standard six-week induction regimen of intravesical BCG, sometimes combined with IFNα-2b or IL-2.
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| Biparametric or Noncontrast Approach of MRI, Incorporating Biomarkers
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| Soroush Rais-Bahrami, MD
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| Soroush Rais-Bahrami advocated for the adoption of biparametric MRI (bpMRI) as a cost-effective and safe alternative to multiparametric MRI (mpMRI) in prostate cancer detection. By eliminating the need for gadolinium contrast, bpMRI reduces risks, lowers costs, and optimizes MRI utilization, while maintaining strong diagnostic accuracy when combined with biomarkers like PSA density and emerging tools such as PSMA PET and microultrasound.
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| Real-World Treatment and Clinical Outcomes in Patients with mCRPC Treated with Olaparib in the United States |
| Daniel George, MD |
| Daniel George presented real-world outcomes for mCRPC patients treated with olaparib based on data from the ConcertAI Oncology Dataset. Among HRR mutation-positive patients, median real-world progression-free survival (PFS) and overall survival (OS) were consistent with the PROfound trial, even when olaparib was used in later treatment lines. The findings emphasized earlier biomarker testing and initiation of targeted therapy for improved patient outcomes. Limitations included the retrospective design and reliance on community oncology practice data. |
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