Editorial Note: The 39th Annual European Association of Urology (EAU24) Congress took place from April 5-8, 2024, in Paris, France, focusing on global urological oncology hotspots and the forefront of Chinese urological research. At the event, “Oncology Frontier” invited Professor Wei Zhai from Renji Hospital, affiliated with Shanghai Jiao Tong University School o,(f Medicine, to share his insights and the latest developments in urological oncology research.
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Oncology Frontier: Could you share your impressions and takeaways from this conference?
Professor Wei Zhai: The European Association of Urology (EAU) Annual Congress is one of the most influential urology events worldwide. This year, the 39th EAU Congress in Paris attracted over 20,000 urology experts and related professionals from 110 countries. The conference featured a rich array of content, including live surgeries, training courses, reports on the latest research developments, real case discussions, and debates. Interestingly, this year also included special sessions for nursing and patient representatives who have undergone various surgeries and treatments, fostering closer communication between medical staff and patients. This collaboration helps advance the treatment and development of urological tumors and diseases.
Attending the EAU allowed me to engage with outstanding urology colleagues from Europe and around the world, gaining insights into the latest research developments and surgical techniques. I also met a group of international friends with shared interests, which greatly aids in promoting global multicenter clinical research and amplifying the voice of the Chinese urology community on the international stage.
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Oncology Frontier: The conference revealed several research advances in renal cell carcinoma, urothelial carcinoma, and prostate cancer. Which studies left the deepest impression on you?
Professor Wei Zhai: In the field of renal cell carcinoma, there was a dedicated session for the differential diagnosis of early small renal tumors. The EAU recently updated its guidelines, reducing the threshold for cT1a from 4 cm to 3 cm. Retrospective studies from European hospitals indicated that if a tumor exceeds 3 cm or the annual growth rate exceeds 0.5 cm on imaging, it signals the need for active intervention.
For urothelial carcinoma, the most striking update was the four-year follow-up from the Checkmate274 study, analyzing nivolumab as adjuvant therapy for high-risk muscle-invasive urothelial carcinoma patients post-surgery. The updated results confirmed that this regimen continues to provide long-term stable clinical benefits.
In prostate cancer, what impressed me most was the use of an advanced immediate pathology diagnostic system during surgery. Surgeons can quickly diagnose the surgical margins using this system, determining whether further surgery is needed. This tool holds significant potential as an auxiliary aid in surgical treatment.
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Oncology Frontier: With the rapid development of clinical research and technology, which advancements do you think could change future clinical practice?
Professor Wei Zhai: In surgery, the latest fifth-generation robots offer tactile feedback, addressing a shortcoming of robotic surgery. This development is expected to significantly promote the application of robotic surgery in urological oncology.
In clinical research, breakthroughs are anticipated in the comprehensive treatment of non-clear cell carcinoma, neoadjuvant therapy for locally advanced disease, and immunotargeted therapy for advanced metastatic renal cell carcinoma. Extensive clinical trials or multimodal diagnostic tools will help establish molecular subtypes, allowing for personalized precision treatment.
For the differential diagnosis of early renal cancer, techniques have expanded beyond traditional CT and MRI scans to include artificial intelligence, liquid biopsies from blood and urine, and gut microbiome assessments. These innovations bring new directions for preoperative diagnosis. For instance, a study found that for patients with advanced metastatic renal cell carcinoma receiving immunotherapy, the addition of CBM588 gut microbiome treatment increased immunotherapy efficacy.
Moreover, breaking away from FDG-standard PET-CT diagnostics, new markers like FAPI and CD70 can more effectively determine the nature of primary and metastatic lesions, providing more efficient clinical diagnostic methods for these patients.
Professor Wei Zhai
- MD, Postdoctoral Researcher in the USA
- Associate Chief Physician, Researcher, and Doctoral Supervisor at Renji Hospital, Shanghai Jiao Tong University School of Medicine
- Young Yangtze Scholar by the Ministry of Education
- Head of the Oncology Systems Medicine National Key Laboratory Project Group
- Member of the Basic Group of the Chinese Urological Association
- Member of the Translational Group of the Chinese Medical Doctor Association Urology Branch
- Member of the Laparoscopic Robotics Branch of the Chinese Anti-Cancer Association
- Member of the Medical-Engineering Integration Branch of the Chinese Medical and Health Culture Association
- Deputy Director of the Youth Committee of the Shanghai Urological Association
- Recipient of Shanghai Young Scientific and Technological Talent, Shanghai Top Young Talent, and Shanghai Pujiang Talent awards
- Recipient of the Shanghai Youth May Fourth Medal and the New Era Shanghai Shining Youth award
- Outstanding Young Medical Talent by the Shanghai Municipal Health Commission, Jiang Yi Xinglin Talent Award
- Expert Reviewer for the National Natural Science Foundation of China
- Key Member of the Ministry of Education Key Laboratory of Anesthesiology
- Associate Editor of Cellular Oncology, CUA Renal Cancer Guidelines Editorial Board Member, EAU/UAA Member
