UROonco24 report: PCa, BCa and RCC updates from key opinion leaders

With approximately 650 delegates and faculty in attendance, UROonco24 took place in Budapest, Hungary from Thursday, 20 June to Saturday, 22 June 2024. Key opinion leaders presented critical updates and insights on onco-urological issues with the collective goal to improve patient care. In its second edition, the meeting was organised under the guidance of the EAU Section of Oncological Urology (ESOU), and featured multiple plenary sessions, interactive roundtable update sessions, hands-on training, and the STEPS programme for young urologists.

Thu, 4 Jul 2024
Prostate CancerBladder CancerKidney CancerOncologyUR Oonco 24EAU Section Of Oncological Urology

In this report, we feature several lectures, and include open access to some selected webcast presentations for you to watch.

LG NMIBC: Patient selection is key for de-intensification

Dr. Benjamin Pradere (FR) presented the lecture ‘Overtreatment and oversurveillance for low-grade non-muscle invasive bladder cancer (LG NMIBC): Strategies for de-intensification’ and concluded that the easiest and cheapest way to implement intensification is to simply follow the EAU Guidelines in clinical routine. “Do not consider low-grade as low-risk, be careful and focus on intermediate-risk for performing the intensification. By following the EAU Guidelines, you will probably de-intensify treatment without any effort. Treatment for intermediate-risk (IR) NMIBC must be individualised to the index tumour. De-intensfication is here to stay, and patient selection is key.” Watch webcast presentation.

Tools for bladder tumour removal

Dr. Juan Luis Vásquez (DK) presented study results on chemoablation and laser ablation in his lecture ‘Outpatient laser/chemoablation of recurrent NMIBC’. “Chemoablation has been implemented in Denmark already and is in the local guidelines.” Dr. Vásquez cited the DaBlaCa-13 study (Lingren M et al) results, where long-term data achieved a 57% of complete responses, and illustrated significantly less side effects with chemoablation than TURBT. According to him, the next step is the new Danish study, COBRA NMIBC, which will start recruitment soon.

He also highlighted the Diode laser randomised controlled trial (Pedersen G et al) with 206 patients, all intermediate-risk, low-grade tumours. In terms of recurrence, he suggested that laser ablation was not inferior to TURBT. There were fewer side effects, 98% of the patient’s preferred laser over TURBT, and resources were significantly less in comparison to TURBT. Watch webcast presentation.

RCC: Patient engagement is key!

Uro-oncologist Prof. Michael Jewett (CA) presented the lecture ‘IKCC (International Kidney Global Patient Survey: What is the patient perspective on RCC diagnosis and treatment?’, highlighting the importance of patient engagement, and why it enhances a better quality of urologic care. “Engagement involves activating patients to manage their own health care with a variety of interventions and activities to increase patients’ awareness, skills and self-management competencies. Qualitative research has shown that patient engagement may lead to improved emotional wellbeing, coping strategies, physical wellbeing (less fatigue), general and disease related quality of live (QoL), self-care, shorter hospital stays, and less medicolegal action.” He cites a research letter in JAMA (Basch, E) where overall survival results from a trial assessing patient-reported outcomes for symptom monitoring during routine cancer treatment were positive. Watch webcast presentation.

1st line combination treatment

“Is there any way to make a choice between all the different combinations?” asked Prof. Camillo Porta (IT) in his presentation ‘Trial updates on 1st line combination treatment in metastatic RCC from ASCO GU’. He stated that the ASCO GU Guidelines on immune-based combinations are not so different to the EAU Guidelines and provided some tips to find the best treatment for each individual patient. These tips are based on the latest results he outlines from all the first-line combo studies, including a breakdown of results for good risk patients only, considerations to make, IMDC classification/complex biology, debunking the myth of the plateau of the immune combo in RCC, and treatment duration. Watch webcast presentation.

PCa: The role on genomics

Dr. Ursula Vogl (CH) presented on the role of genomics in patients with advanced prostate cancer. In her opinion, both somatic and germline testing should be done. “Somatic testing should be done early (already in hormone sensitive metastatic prostate cancer) and testing with cell free DNA in patients where tissue is of low quality or re-biopsy is not feasible (reserve for high burden of active disease). Germline testing is indicated in metastatic and high-risk localised prostate cancer. Treatment with PARP-Inhibitors should be prioritised for BRCA1 and 2: (CDK12 and PALB-2 alterations), not for other HRR defects”. Watch webcast presentation.

High-risk BCR

During the clinical trial session, Prof. Stephen Freedland (US) shared results of the EMARK trial, aimed to evaluate enzalutamide in combination with leuprolide acetate and enzalutamide monotherapy in patients with high-risk biochemical recurrence (BCR). In summarising the results, he stated “In patients with high-risk BCR, compared with leuprolide acetate, both enzalutamide combination and enzalutamide monotherapy demonstrated a statistically significant and clinically meaningful improvement in MFS, time to PSA progression and time to first new antineoplastic therapy. Neither had a negative affect on HRQoL and there were no new safety signals observed to date with enzalutamide treatment.” Watch webcast presentation.

Access more UROonco24 content

All webcast presentations are currently accessible via the UROonco24 Resource Centre. Delegates have full access. If you did not attend, you can still register for on-demand access to explore all scientific content shared during the congress. Please note that accreditation is no longer valid. For more details, visit UROonco24 Resource Centre.