6th EMUC: Selected oral abstract presentations examine new diagnostics

The latest studies on prostate and kidney cancer diagnostics and treatment of bladder cancer were highlighted during the selected presentations of oral abstracts. Five abstracts were presented in the morning session in the second day of the 6th European Multidisciplinary Meeting on Urological Cancers (EMUC) in Lisbon, Portugal.

The study led by Bogdan Geavlete was chosen as the best in the five selected oral abstracts, Below are summaries of the highlighted oral abstracts:

Radiation therapy of high-risk PCa

A European study showed that primary radiation therapy followed by medical or drug castration in men with high-risk prostate cancer improved their chances of surviving up to about five years without showing clinical progression of their disease.

Prof. Michel Bolla, radiation oncologist, will disclose his team’s findings at the upcoming 6th European Multidisciplinary Meeting on Urological Cancers (EMUC) to be held in Lisbon, Portugal from 13 to 16 November. The EMUC is an annual event co-organised by the European Association of Urology (EAU, the European Society for Medical Oncology (ESMO) and the European Society for Therapeutic Radiology and Oncology (ESTRO) in an attempt to share updates and benefit from multi-disciplinary treatment strategies.

“This research may be considered as a significant trend in daily practice since the clinical progression free survival – that is, the likelihood to be alive at five years without biochemical or clinical relapse or death by any cause- is improved from 80.8 % to 88.7%,” said Bolla of the Clinique Universitaire de Cancérologie-Radiothérapie, Centre Hospitalier Universitaire in Grenoble, France. “But it is too early to evaluate the impact on overall survival,” he added.

Three out of 10 men with so-called intermediate or high-risk prostate cancer usually develops signs of the disease or relapse within five years following radiotherapy treatment. In their study, conducted under the auspices of the European Organisation for Research and Treatment of Cancer (EORTC, Trial 22991), the researchers recruited 819 patients (staged cT1b-c with PSA ≥ 10ng/ml or Gleason ≥7 or cT2a (UICC TNM 1997) N0 M0 with PSA≤ 50 ng/ml) who were divided into two groups. Aside from patients in France, patients were also recruited in Spain, Cyprus, the UK, Belgium and the Netherlands.

Sunitinib in papillary kidney cancer

Sunitinib, a frontline targeted therapy used for kidney cancer, may benefit patients who are suffering from a variant form of advanced kidney cancer called metastatic papillary renal cell carcinoma, according to a new international study led by Israeli researchers. Sunitinib is one of the agents in so-called targeted therapy that involves the vascular endothelial growth factor (VEGFR) inhibitor, an important signalling protein that has a key role in vascular growth and formation of blood vessels. Targeted therapy is a drug treatment that leaves normal cells alone while destroying (or targeting) specific cancer cells.

Daniel Keizman and his colleagues said the results of the study showed that sunitinib-induced hypothyroidism and hypertension (HTN) occurred in 30% and 43% of patients, respectively. Around 70% achieved clinical benefit, or so-called “partial response and stable disease” while 30% of patients experienced a progression of their disease within the first three months of therapy. 27% of the patients had progression-free survival (PFS) of less than one year, while 26% survived less than two years.

The toxicity or side effects from the therapy are similar to patients with clear cell renal carcinoma who received sunitinib, such as tiredness, weakness, fever and gastrointestinal symptoms, including diarrhea, nausea, and vomiting.

With the findings doctors can perhaps further refine their selection of specific patients who may benefit from the treatment. But due to the small number of patients included or reviewed in this study, the team cannot extend or apply the same results to a more general or bigger (mixed) patient group.

“This is an important question and limitation of our study. Larger and prospective trials are needed in order to confirm our findings,” said Keizman.

NBI diagnostics in bladder cancer

Using a combination of Narrow Band Imaging (NBI) cystoscopy and bipolar plasma vaporization (BPV), Romanian researchers have found a more effective way, compared to current techniques, to optimise bladder cancer diagnostics and treatment.

White light cystoscopy (WLC) and monopolar transurethral resection of bladder tumors (TURBT), are the so-called “golden standards” used by doctors to diagnose and treat bladder tumours. In their study, which will be presented at the oral poster sessions during the 6th European Multidisciplinary Meeting on Urological Cancers (EMUC) to be held in Lisbon, Portugal from 13to 16 November, the researchers conducted a prospective, randomized study between NBI cystoscopy and bipolar plasma vaporization (BPV) versus standard whitelight cystoscopy (WLC) and TURBT.

“NBI cystoscopy displayed significantly improved diagnostic accuracy and BPV emphasized superior efficacy, reduced morbidity and faster postoperative recovery in large NMIBT cases. The NBI-BPV technique provided a lower Re-TUR residual tumors’ rate as well as reduced 1, 2, 3 and 4 years’ recurrence rates compared to the standard approach,” the researchers said.

Bogdan Geavlete, lead study investigator, said more tumors are found when using NBI vision while providing a complete ablation of all existing malignant lesions. He added that by combining NBI with BPV the latter “…removes more tumor tissue faster, while also minimizing bleeding.”

In their study, a total of 220 patients with at least one apparently (NMIBT) over 3 cm were included in the trial based on abdominal ultrasound, computer tomography and flexible WLC. In one arm, 110 patients underwent WLC, NBI cystoscopy and BPV, while cases in the second arm only benefited from WLC and TURBT.