The second Joint Session of the European Association of Urology (EAU) and the Société Internationale d’Urologie (SIU) highlighted the diagnostic and prognostic tools, as well as the therapies and new strategies for the future of metastatic renal cell carcinoma (mRCC), and metastatic castration-resistant prostate cancer (mCRPC).
Tobias Klatte (DE) opened the discussion with a presentation on the proper use of prognostic tools in metastatic RCC. For him, due to the heterogeneous nature of the patient population, it is important to establish prognostic models that assign divide patients into specific groups, so that personalised treatment is achieved. On the same line, Guillaume Ploussard (FR) wondered if there is an optimal sequence of systemic therapy. In his view, there have been advances pointing towards this, but the most important consideration is that doctors should not switch medication too fast when the growth of the tumour is slow. The first line choice “should always be based on initial prognosis assessment, and toxicity should be taken into account as well.”
To continue the discussion, Simon Tanguay (CA), presented his case for cytoreductive nephrectomy, saying that “surgery will always remain an essential step in order to achieve cure,” although the timing of the procedure may vary. Nephrectomy is a safe procedure, and is useful to palliate local symptoms. Moreover, the use of laparoscopy is of great help to reduce morbidity. To round off on mRCC, Vicenzo Ficarra (IT), advocated for precision medicine in mRCC, and closed his argument with a plea for “the right medication for the right patient.”