EAU 2022

(UroToday.com) The 37^th Annual European Association of Urology Congress held in Amsterdam, the Netherlands between July 1^st,and 4^th 2022 was host to a prostate cancer “Game Changing Session”. Dr. Lih-Ming Wong discussed the results of PEDAL: A Phase III study comparing diagnostic accuracy of mpMRI prostate to 18F-DCPyL PSMA PET/CT.

(UroToday.com) The 37^th Annual European Association of Urology Congress held in Amsterdam, the Netherlands between July 1^st, and 4^th 2022 was host to a prostate cancer “Game Changing Session”. Dr. Jochen Walz led a discussion session following Dr. Lih-Ming Wong’s presentation: “Phase III study comparing diagnostic accuracy of mpMRI prostate to 18F-DCPyL PSMA PET/CT.”

(UroToday.com) The 2022 EAU annual meeting featured a game changing session, including a discussant presentation by Dr. Juan Gomez Rivas discussing exploratory endpoints from PROpel, a phase III trial of abiraterone + olaparib versus abiraterone + placebo in first-line mCRPC. Dr. Gomez Rivas notes that there is an evolving treatment paradigm for prostate cancer. Among patients diagnosed with localized prostate cancer, 90% of those patients are treated with radiotherapy, surgery or active surveillance, leading to a cure in ~75% of those patients, with the remaining 25% being treated with androgen deprivation therapy (ADT) in the setting of biochemical recurrence. Among these patients, a proportion will develop M0 castration resistant prostate cancer (CRPC), for which the SPARTAN trial,¹ PROSPER trial,² and ARAMIS trial³ demonstrated a survival benefit vs placebo for apalutamide, enzalutamide, and darolutamide, respectively. For patients that have metastatic castration sensitive prostate cancer (mCSPC), docetaxel (CHAARTED,⁴ STAMPEDE⁵), abiraterone (LATITUDE,⁶ STAMPEDE⁷), enzalutamide (ARCHES,⁸ ENZAMET⁹), and apalutamide (TITAN¹⁰) have all improved survival. However, patients may progress to require additional treatments in the M1 CRPC setting, including several additional lines of therapy:

(UroToday.com) The 2022 EAU annual meeting featured a game-changing session, including a presentation by Dr. Noel Clarke discussing exploratory endpoints from PROpel, a phase III trial of abiraterone + olaparib versus abiraterone + placebo in first-line mCRPC. There is a need to improve patient outcomes in the first-line mCRPC treatment setting. Previously, the PROfound trial of olaparib monotherapy demonstrated significantly longer radiographic progression free survival (rPFS) and overall survival (OS) in patients with mCRPC post-NHA treatment with selected HRR gene alterations (BRCA1, BRCA2, and ATM).^1,2 Furthermore, a phase II trial combining abiraterone + olaparib versus abiraterone + placebo has shown prolonged rPFS in patients with mCRPC following docetaxel and irrespective of HRR mutational status (HR 0.65, 95% CI 0.44-0.97).³ The PROpel primary results have been published,⁴ demonstrating a significant improvement in rPFS with abiraterone + olaparib over abiraterone + placebo as first-line treatment in mCRPC, and the presentation by Dr. Clarke at EAU 2022 adds additional efficacy data from exploratory endpoints of the trial.

(UroToday.com) The 37th Annual European Association of Urology Congress held in Amsterdam, Netherlands between July 1st, and 4th 2022 was host to a session addressing controversies in urologic oncology. Professor Alberto Briganti was tasked with arguing in favor of metastasis-directed therapy in prostate cancer patients with PET-detected oligorecurrent prostate cancer.

(UroToday.com) The 37th Annual European Association of Urology Congress held in Amsterdam, Netherlands between July 1st, and 4th 2022 was host to a session addressing controversies in urologic oncology. Dr. Christopher Sweeney was tasked with arguing in favor of systemic therapy in prostate cancer patients with PET-detected oligorecurrent prostate cancer.

(UroToday.com) The 37th Annual European Association of Urology Congress held in Amsterdam, Netherlands between July 1st, and 4th 2022 was host to a session about innovative future treatment options for metastatic castration-resistant prostate cancer (mCRPC). Dr. Alicia Morgans was tasked with discussing prostate-specific membrane antigen (PSMA) theranostics and novel approaches to treatment of metastatic castration-resistance prostate cancer (mCRPC).

(UroToday.com) The 37^th Annual European Association of Urology Congress held in Amsterdam, the Netherlands between July 1^st,and 4^th 2022 was host to a session about the management of metastatic hormone sensitive prostate cancer (mHSPC). Professor Noel W. Clarke was tasked with arguing in favor of targeted therapy for both the primary disease and metastatic sites in the management of de novo metastatic hormone sensitive prostate cancer (mHSPC) patients with oligometastatic disease (cT3N+M1a).

(UroToday.com) The 37^th Annual European Association of Urology Congress held in Amsterdam, the Netherlands between July 1^st,and 4^th 2022 was host to a session about the management of metastatic hormone sensitive prostate cancer (mHSPC). Dr. Eleni Efstathiou was tasked with discussing the current state of doublet versus triplet combination therapy in the management of metastatic hormone sensitive prostate cancer (mHSPC).

(UroToday.com) The 37th Annual European Association of Urology Congress held in Amsterdam, Netherlands between July 1st, and 4th 2022 was host to a prostate cancer “Game Changing Session”. Dr. Bertrand Tombal discussed results from the Phase 3 ARASENS trial evaluating overall survival with darolutamide versus placebo in combination with androgen deprivation therapy (ADT) and docetaxel by stratification factors.

(UroToday.com) The 37th Annual European Association of Urology Congress held in Amsterdam, the Netherlands between July 1st, and 4th 2022 was host to prostate cancer “Game-Changing Session”. Professor Jan Philipp Radtke led a discussion session following Dr. Tombal’s presentation: “Overall Survival with Darolutamide versus placebo in combination with androgen deprivation therapy and docetaxel by stratification factors in the phase 3 ARASENS trial”.

(UroToday.com) The 37^th Annual European Association of Urology Congress held in Amsterdam, the Netherlands between July 1^st, and 4^th 2022 was host to a session about management of metastatic hormone sensitive prostate cancer (mHSPC). Dr. Eugen Jan Karol Axcrona was tasked with discussing future perspectives in the management of metastatic hormone sensitive prostate cancer (mHSPC).

(UroToday.com) The 37th Annual European Association of Urology Congress held in Amsterdam, Netherlands between July 1st, and 4th 2022 was host to a session about the management of metastatic hormone-sensitive prostate cancer (mHSPC). Dr. Eleni Efstathiou was tasked with arguing in favor of systemic combination therapy in the management of de novo metastatic hormone-sensitive prostate cancer (mHSPC) in patients with oligometastatic disease (cT3N+M1a).

(UroToday.com) The 2022 EAU annual meeting featured a session on improvements in metastatic prostate cancer focusing on imaging and treatment, including a presentation by Dr. Roderick Clark discussing the lifetime risk of prostate cancer death among high-risk germline mutation carriers. Indeed, prostate cancer is a leading cause of death, ranking second only to lung cancer in male cancer deaths. Approximately one in eight men who are diagnosed with prostate cancer will die of it. It has been well established that certain germline pathogenic variants confer both an increased risk of being diagnosed with prostate cancer and dying of prostate cancer. Contemporary data demonstrate that mutations that disrupt the function of genes involved in repairing DNA damage are associated with aggressive prostate cancer. The objective of this study presented by Dr. Clark at EAU 2022 was to estimate the prostate cancer-specific mortality burden among individuals carrying high-risk germline mutations.

(UroToday.com) The 37^th Annual European Association of Urology Congress held in Amsterdam, the Netherlands between July 1^st, and 4^th 2022 was host to an advanced bladder cancer abstract session about staging, predicting factors, and systemic therapy options. Dr. Taoka presented the results of his group’s study evaluating the association of prior treatment history for non-muscle invasive bladder cancer (NMIBC) on efficacy of pembrolizumab for patients with metastatic urothelial carcinoma (mUC).

(UroToday.com) The 37^th Annual European Association of Urology Congress held in Amsterdam, the Netherlands between July 1^st, and 4^th 2022 was host to an advanced bladder cancer abstract session about staging, predicting factors, and systemic therapy options. Dr. Roberto Iacovelli presented results of the ARIES trial evaluating first line avelumab in cisplatin-ineligible, Programmed Cell Death Ligand 1 (PD-L1) positive patients with metastatic or locally advanced urothelial carcinoma (aUC).

(UroToday.com) The 37^th Annual European Association of Urology Congress held in Amsterdam, the Netherlands between July 1^st, and 4^th 2022 was host to a session about the management of metastatic hormone sensitive prostate cancer (mHSPC). Dr. Christopher Sweeney addressed the significant clinical differences between synchronous and metachronous metastatic hormone sensitive prostate cancer (mHSPC).

(UroToday.com) The 2022 EAU annual meeting featured a session on improvements in metastatic prostate cancer focusing on imaging and treatment, including a presentation by Dr. Hyunho Han discussing PSA levels at presentation for men with BRCA1/2 and ATM mutated metastatic prostate cancer. PARP inhibitors have previously shown survival benefits in mCRPC patients with homologous recombination repair (HRR) genes (BRCA1/2, and ATM) mutations. Germline panel test of the HRR genes and tumor tissue next generation sequencing are guideline recommended in men with metastatic prostate cancer. Furthermore, the reported incidences of BRCA1/2 and ATM gene mutations are 5-10%, yet it is unclear whether the mutations are enriched in advanced cancer and associated with clinical features. In this study, Dr. Han and colleagues assessed the incidences and clinical characteristics of HRR genes BRCA1/2 and ATM mutated prostate cancer.