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Neal Shore: Hi, everyone. Great to talk to you today. I'm Neal Shore and I'm the Medical Director of Carolina Urologic Research Center. What a pleasure to introduce the co-founders and innovators for the Advanced Prostate Cancer Consensus Conference, Silke Gillessen and Aurelius Omlin. They should not be strangers to anyone who has been monitoring educational awareness in advanced prostate cancer since 2015. Today, they are going to talk about a little bit of the history of the APCCC, why it is such an innovative program, the bi-annual presentations and meetings that we've had in 2015, '17, and '19, and how we are now pivoting around the pandemic. Then maybe lastly, comment on some of the most contemporaneous unmet needs in advanced prostate cancer. With that, it is really a great pleasure for me to turn the program over to Silke and Aurelius. Thank you both.

Silke Gillessen: Thanks, Neal, to you, as you have been really one of the early friends of APCCC and we are very grateful as always. As you already mentioned, we started in 2015 with bi-annual conferences where the focus is really on practical questions. So, what are we as experts really doing in situations where we don't have high evidence, but situations that we see every day in clinics? And this year, obviously, is a very special year because the last APCCC we had was in 2019, and it was planned to do one this year in 2021, but with the pandemic, we decided to postpone it a bit until, we hope, at least, the situation will be again under control and we can do it face-to-face because the interaction is also very important in that Congress.

But then a lot of people, I think including you, Neal, said, "Oh no, that is too long. We can't wait three years. There is so much ongoing." And obviously, as always, you were right. We decided to do a focused digital session of APCCC on the 9th of October this year, 2021, and really focus on the hype topics that are hot topics right now. We will have a live moderation there by panelists and probably also voting there. Registration is opening very soon.

And now, I will give it over to Aurelius to discuss a bit more about what APCCC is for the ones that do not know.

Aurelius Omlin: Thank you and welcome, also, from my side. It's a pleasure, Neal, to do this recording with you. Here, you will see the last publication from 2019, and it's available open access in European Urology. As you can see, it's 39 pages long, so it's more like a novel than a summary of the last findings of the Consensus Conference. I think it's an important publication, around 10 issues in advanced prostate cancer, and as you can see, it has a very good ranking for citations and social media captures. The authors are all members of the panel involved in APCCC 2019.

Silke Gillessen: I'll show you now, all the panel members for 2021. You see here, there are a lot of people in the States, and again, we should have made Neal really, really larger here, but okay. We are really for equality, as you see. But we have a lot of people from all around the world as panelists, I think you see that here. And yes, our trademark, the Swiss cow with the cowbells.

Neal Shore: I just want to make one comment about the map, and this is really a credit to you and Aurelius. When we first started, it was maybe predominantly European and maybe predominantly medical oncology, but you have both done such a great effort to make it broadly more multidisciplinary and truly global, representing virtually every continent on the planet, and really expanding, not only the multidisciplinary approach here but also the topics. This is really such a highly-sought invitation to be part of this panel because it's so invigorating and so truly diverse. Congratulations to the two of you. I'm really excited, and I know everyone who you see on this map and those who attend are incredibly excited for the presentation in the fall in Zurich, and then again next spring in 2022 in Lugano.

Silke Gillessen: Thanks, Neal. This time we even have here, I showed that maybe, Caroline Clarke, and she is a health economist. We really, as you said, also with all the feedback we got from you, from the audience, we tried really to broaden also the people that are there that have information and knowledge that maybe not all of us have and can really help us to make the right decisions. So, yes, thank you.

I now go to the program in October to make everyone a bit hungry to really be a part of it, Aurelius, I give that to you.

Aurelius Omlin: We have seen a lot, and this is the first topic, alot of developments in metastatic hormone-sensitive prostate cancer and we expect more at ASCO and ESMO this year. APCCC 2021 will be shortly after ESMO and we will target the available options of triplet therapy, ADT plus radiation of the primary plus additional systemic therapy, or the combination of systemic therapies. Also, different subgroups, and maybe also an important topic: are there still patients out there who can be treated with ADT alone? Whether this is an appropriate option.

Silke Gillessen: I can really tell you that it was very difficult to find a speaker for that topic, but we will see what we will hear there, I think it is really important. The next one, that is obviously also a very hot topic, especially with the press release about the VISION data that tested lutetium-PSMA in the phase 3 setting. PSMA not only in therapy but also in diagnostics because that really changes our daily life. I know in the States, you probably did a bit less than we did until now, but in at least in some countries in Europe, PSMA PET-CT has really taken over in diagnostics because it is so accurate. You see here, we want to hear a bit about the background, but we also want to be a bit critical because I mean, there is a lot of hype around PSMA PET-CTs, but I guess we need to be also, as always a bit critical with new modalities if they in the end really improve the outcomes of our patients. This is one of the, I think, really important talks.

Then, also PSMA PET-CT as all imaging is not perfect. We want to learn a bit from Stefano Fanti, really one of the pioneers probably about the pitfalls of the different tracers. Because I think we are already very proud that we found out that there are all different tracers, but we do not know the plus and contrast of the different tracers that we, not only use actually in the clinics. And then, obviously, it's not so easy to select the right patients for the PSMA lutetium treatment so we will go and look for that. Then also, when should we treat our patients with lutetium PSMA optimally. Then we also, because we need to know a bit about the future, want to hear about the novel PSMA targeted agents as well. Then again, the voting. 

Aurelius Omlin: In the last session, we call it, PARP inhibitors and beyond. Last time at APCCC 2019, we just did not have the profile data available to discuss, which are now out and even have shown an overall survival benefit. We will talk about germline testing at the beginning and then somatic testing, what needs to be included in this panel diagnostics, to molecular testing of liquid versus tissue-based testing. And Then, Johann de Bono will talk about DNA repair defect aberrations, the differences between them, what is the impact on management. We have different regulatory approvals for olaparib and rucaparib in the US compared to Europe, and I think that is an important issue to discuss. Again, Eric Small will also go on to novel and maybe not so novel target agents, such as platinum, and where to place them in the treatment sequence.

Silke Gillessen: Perfect. So, this will be a really hot topic program for October. I hope a lot of you are interested and will come and join us. Again, as always we will have the voting about the consensus questions and discuss them also in that short meeting of half a day.

Here again, so that you don't forget, the 9th of October, and that will be a very focused hot topic meeting. The real meeting, the face-to-face meeting, that we really hope can take place, and we will do it as a hybrid so that also people who can't really fly into Lugano, you see some of Lugano here and it's beautiful, can also participate again, like in this hybrid event, even if they can't fly to Lugano, but I hope most of you would come, and that will be the end of April 2022.

And, again, something new, we decided to have a translational symposium the day before. That will be separate from the real APCCC conference, but everyone who has an interest in translational questions in prostate cancer can also go and participate in the translational symposium. With that, I will give this over again to Neal, if there are some other questions. Again, thank you for giving us the opportunity to present here.

Neal Shore: Thank you both. What an exceptionally innovative and unique program going back to 2015, '17, and '19. I encourage everyone to get the open-access EU 2019 AP triple C publication. It really is, as Aurelius said it is a book of amazing information. Credit to both of you and congratulations for pivoting around the pandemic and now having two programs that are recognizing how things are changing and hopefully for the better globally, in terms of our ability to access and get to Lugano in the spring of 2022. But rest assured, we are going to have a really exciting, full-throated discussion and debate and voting on the hot topics you've presented. Silke and Aurelius, congratulations for all your hard work, and thank you very, very much for everyone who takes care of patients with advanced prostate cancer.

Silke Gillessen: Thanks, Neal.

Aurelius Omlin: Thank you.