Highlights of the five-day 32nd Annual EAU Congress were reported today in the concluding session with members of the EAU Scientific Committee presenting the most noteworthy developments and conclusions in prostate disease, urological cancers, systemic therapy in GU cancer, basic science, andrology, imaging, urolithiasis, paediatric, imaging and functional urology, amongst others.
Professors Piotr Radziszewski (PL), Chris Bangma (NL), Peter Albers (DE), Morgan Roupret (FR), Marc-Oliver Grimm (DE), Maria De Santis (GB), Zoran Culig (AT), Jens Sonksen (DK), Wouter Feitz (NL), Arnauld Villers (FR), Thomas Knoll (DE), and Dr. John Heesakkers (NL) presented the highlights they collated from the various Abstract, Plenary and Thematic sessions, and EAU Section Offices meetings.
Below are some selected take-home messages:
Prostate cancer: Early detection and screening
Bangma, who spoke on active surveillance (AS) and detection, gave the following key messages:
- Screening the population: window is around 55 years of age;
- For individual detection: use volume-based ERSPC Risk Calculator;
- If PSA <1, screen only once every five years;
- Genetic profiles of targeted biopsies correspond with radical prostatectomy (RP);
- Use of MRI up-front in AS improves earlier risk assessment but increases costs; and
- MRI as a base for individual first screening is not yet justifiable.
Prostate cancer: Localised and advanced disease
Albers presented the highlights in localized PCa and discussed radical prostatectomies outcomes, patients’ expectations and focal treatment, amongst others. He quoted M. Cooperberg who said: “As long as we don’t fight overtreatment, we will not be accepted to promote screening.” He gave the following the messages:
- In low-risk disease, delay treatment as long as possible;
- In high-risk disease, there is 87% survival with multimodal treatment;
- Regarding patient’s expectations, doctors should be honest about complications.
Culig discussed key issues in personalised medicine such as targets, models, timing and patient selection. In personalized therapies, he noted the findings in anti-cytokine, radiation and anti-ERG therapies. Regarding the role of miR-373 in metastases, he mentioned the following:
- In addition to inhibitors of ERG, IL-6 and CS, miRNA AGOMIRS are being developed;
- Multiple targets are available;
- miR373 – tumor suppressor;
- May inhibit epithelial to mesenchymal transition; and
- Has a role in anti-Stemness approach.
Imaging in urology
Villers summarized the highlights of imaging’s role in urology and discussed MRI, PSMA PET/CT and their impact on active surveillance (AS). Among his key messages are:
- MRI should be standard for AS selection;
- MRI and PSA density (PSAD) may influence biopsy indication during AS;
- Increase the confidence in quality of MRI reporting and targeted biopsies;
- Quality, expertise, training and standards are of utmost importance, and
- The EAU and ESUR have started a quality initiative.