In a significant gathering at the European Association of Urology (EAU) Congress 2024, held in the vibrant city of Paris, two esteemed figures in the field of urology, Dr. Félix Guerrero Ramos （Hospital Universitario 12 de Octubre, Madrid Spain）and Dr. Xuefeng Qiu（Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing China）, engaged in a thought-provoking dialogue. This session, part of a broader senior international dialogue initiative, offered a platform for sharing groundbreaking research findings and fostering discussions on the advancements in the treatment of bladder and prostate cancer. The dialogue not only highlighted the innovative strides being taken in these domains but also set the tone for future explorations and collaborations in urological cancer research.
Innovations in Bladder Cancer Treatment
Dr. Xuefeng Qiu initiated the conversation by probing into the advancements in bladder cancer research unveiled at the congress. Dr. Félix Guerrero Ramos responded with enthusiasm, delineating three pivotal studies that mark significant milestones in the journey towards more effective bladder cancer treatments.
1. Nivolumab’s Leap Forward: A standout moment at the congress was the discussion of the CheckMate 274 study’s results[i]. This study’s approval came on the heels of its success in markedly increasing recurrence-free survival in patients undergoing radical cystectomy. Dr. Félix Guerrero Ramos underscored the anticipation for forthcoming consequences on overall survival, highlighting the potential for Nivolumab to redefine adjuvant treatment paradigms in bladder cancer.
2. The Promise of Personalized Medicine: Another significant highlight was Dr. Thomas Powles’ presentation on ctDNA-negative patients post-radical cystectomy from the IMvigor011 study[ii], revealing an impressively low recurrence rate and nearly perfect overall survival statistics. This breakthrough suggests a move towards a more personalized approach to cancer treatment, where the decision to administer adjuvant therapy is carefully considered against the potential for adverse effects, thereby sparing patients from unnecessary treatments.
3. The BladderGATE Study[iii]: Dr. Félix Guerrero Ramos took particular pride in discussing the BladderGATE study, which is a pioneering phase Ⅰb/Ⅱ research endeavor assessing the efficacy and safety of combining Bacillus Calmette-Guérin (BCG) with systemic immunotherapy (Atezolizumab) in BCG-Naïve High Risk Non-Muscle Invasive Bladder Cancer （NMIBC） Patients . With a 17% local recurrence rate in high-grade bladder cancer patients and 19% local recurrence rate in all patients at two years and a commendable safety profile, the study points to a promising new direction in bladder cancer therapy.
Advancements in Prostate Cancer Diagnostics
Turning the focus to prostate cancer, Dr. Xuefeng Qiu shared exciting developments from a study conducted at their center aimed at refining the diagnostic process for detecting clinically significant prostate cancer. By recommending MRI scans and PSMA-PET/CT before biopsy, the study demonstrated a substantial reduction in unnecessary biopsies, improving the accuracy of prostate cancer detection and exemplifying a leap towards more efficient and patient-friendly diagnostic protocols.
Reflections and Future Directions
As the session drew to a close, both experts expressed their anticipation for the congress. Dr. Guerrero Ramos, with his specialized focus on bladder cancer, shared his eagerness to explore the upcoming research presentations, acknowledging his concentrated expertise in bladder cancer while expressing openness to become familiar with innovations in other areas of urology. Dr. Xuefeng Qiu mirrored this sentiment, reflecting on the promising start to the congress and the potential for future discoveries.
This insightful dialogue at the EAU Congress 2024 not only underscored the significant progress being achieved in the treatment of urological cancers but also emphasized the critical role of international collaboration and knowledge exchange in advancing medical science. As researchers and clinicians continue to build on these foundational discoveries, the future of urological cancer treatment appears increasingly hopeful, promising improved outcomes and quality of life for patients worldwide. The dialogue between Dr. Félix Guerrero Ramos and Dr. Xuefeng Qiu exemplifies the dynamic and evolving nature of cancer research, where each new finding paves the way for the next breakthrough, driving the global medical community towards the ultimate goal of conquering cancer.
[i] Matthew Galsky, et al. Extended Follow-up from CheckMate 274 Including the First Report of Overall Survival Outcomes. EAU 2024.
[ii] Powles T, Assaf ZJ, Degaonkar V, et al. Updated Overall Survival by Circulating Tumor DNA Status from the Phase 3 IMvigor010 Trial: Adjuvant Atezolizumab Versus Observation in Muscle-invasive Urothelial Carcinoma. Eur Urol. 2024;85(2): 114-122.
[iii] Félix Guerrero Ramos, et al. First Results of the Phase Ib-II BladderGATE Clinical Trial: Intravenous Atezolizumab + Intravesical Bacillus Calmette-Guérin (BCG) Upfront Combination in BCG-Naïve High Risk Non-Muscle Invasive Bladder Cancer Patients. EAU 2024.
