At the 2026 European Association of Urology (EAU) Annual Congress held in London, leading experts from around the world gathered to discuss the latest advances and evolving clinical practices in genitourinary oncology. During the meeting, Oncology Frontier had the privilege of interviewing Professor Fred Saad from the Centre Hospitalier de l’Université de Montréal, who shared key insights into his team’s latest research, major breakthroughs in prostate cancer, and future therapeutic directions. 
01
Oncology Frontier: Professor Saad, what research advances has your team presented at this EAU meeting, and how might these findings impact current clinical practice?
Professor Fred Saad: At this year’s EAU congress, our team presented results from a randomized Phase II study conducted in Canada, focusing on patients with metastatic castration-resistant prostate cancer (mCRPC) who had progressed after androgen receptor pathway inhibitor (ARPI) therapy. The study compared the efficacy and safety of cabazitaxel versus docetaxel in this setting.
In our earlier FIRSTANA trial, which evaluated these two agents in unselected mCRPC patients, no significant difference in overall survival (OS) was observed. However, it is important to recognize that patients in that study had not previously received ARPI therapy. In current clinical practice, most mCRPC patients are treated with ARPIs before chemotherapy, and docetaxel tends to show limited efficacy after ARPI failure, often with rapid disease progression.
To address this gap, we conducted this randomized study, assigning patients in a 1:1 ratio to receive either docetaxel or cabazitaxel. The results demonstrated that cabazitaxel significantly improved radiographic progression-free survival (rPFS) and overall survival compared with docetaxel. Approximately 90% of patients in the cabazitaxel group were alive at one year, compared with around 50% in the docetaxel group.
In terms of safety, cabazitaxel showed a more favorable tolerability profile, with lower rates of alopecia and peripheral neuropathy, while hematologic toxicities were comparable between the two treatments.
Although this was a relatively small Phase II trial, the findings are clinically meaningful. For patients with mCRPC who progress after ARPI therapy, cabazitaxel appears superior to docetaxel in both efficacy and tolerability and may become the preferred chemotherapy option in this setting.
02
Oncology Frontier: Which studies or presentations at this EAU meeting impressed you the most, and how might they shape future treatment models?
Professor Fred Saad: Among the many important updates presented at this year’s meeting, the long-term results of the ARTO study were particularly striking.
This study focused on patients with oligometastatic prostate cancer and evaluated the role of metastasis-directed therapy (MDT). Earlier findings had already shown that adding MDT to standard systemic therapy—namely androgen deprivation therapy (ADT) plus ARPI—significantly improved radiographic progression-free survival compared with systemic therapy alone.
The updated long-term data presented at this congress demonstrated that MDT also provides a significant overall survival benefit in patients with oligometastatic castration-resistant prostate cancer.
This is a landmark finding. It reinforces the central role of MDT in the comprehensive management of oligometastatic disease and provides high-level evidence supporting its integration into standard treatment strategies. Going forward, MDT is likely to become a routine component of combination therapy in this patient population.
03
Oncology Frontier: Finally, could you share your outlook on the future of prostate cancer treatment and your expectations for EAU 2027?
Professor Fred Saad: I have visited China many times and truly value the opportunity to collaborate with Chinese colleagues. Chinese experts have made remarkable contributions to both clinical practice and global prostate cancer trials, and I would like to express my sincere respect.
Looking ahead, I am very optimistic about the future of prostate cancer treatment. The field is clearly moving toward more precise and individualized care, particularly in metastatic hormone-sensitive prostate cancer (mHSPC), where several major breakthroughs are expected.
Precision medicine is already transforming clinical practice. For example, patients with PTEN loss may benefit significantly from AKT inhibitors. Radiopharmaceutical therapies are also being introduced earlier in the disease course, potentially benefiting patients at earlier stages.
In addition, the TALAPRO-3 study is expected to provide important data on the role of PARP inhibitors in mHSPC patients with homologous recombination repair (HRR) gene mutations, particularly BRCA mutations. These findings may establish new standards for first-line therapy in this subgroup.
Radiopharmaceutical therapy is another rapidly evolving area. Actinium-225–based alpha-emitting therapies have shown promising activity across multiple stages of metastatic prostate cancer, including hormone-sensitive, castration-resistant, and even post–lutetium-177 settings.
Overall, I believe that treatment strategies for mHSPC will become increasingly refined and standardized. I am very much looking forward to the next wave of breakthroughs and to reconnecting with colleagues worldwide at the 2027 EAU Annual Congress.
Expert Profile
Fred Saad
Centre Hospitalier de l’Université de Montréal
