Periop EV-Pembro | Do we even need cystectomy anymore?? EV-303 with Christof Vulsteke

Big day at the EAU Annual Meeting n London today, as our colleague Dr James Buteau (Nuclear Medicine Physician, Peter MacCallum Cancer Centre, Melbourne), reads out the PRIMARY 2 RCT at the Practice-Changing Plenary in London. Plus a simultaneous publication in Lancet Oncology. Big news for the early detection of prostate cancer, especially for patients with normal or equivocal MRI scans. We are joined by James and senior author, Prof Louise Emmett (St Vincent's Hospital, Sydney), to discuss the journey from our first PSMA PET/CT scans in 2014, to the proPSMA trial, the PRIMARY trial, and now the PRIMARY 2 RCT. We discuss why this should now mean that patients with a PIRADS 2 or 3 prostate MRI, and a persisting suspicion such as high PSA density, should be considered for a PSMA PET/CT, rather than a systematic biopsy. Huge congratulations to all the investigators across Australia for seeing this trial through to successful completion, and to all the patients who participated. Acknowledgements:Sponsored by Peter MacCallum Cancer Centre, with financial support from the Prostate Cancer Foundation (PCF), St Vincent’s Curran Foundation, ProsTIC, Peter Mac Foundation, NHMRC and ANZUPLinks:PRIMARY 2 trial in Lancet Oncology

We bring you highlights from a fantastic two day meeting at the ORSI Academy in Belgium, focussing on the hot topic of intra-operative margin assessment (IOMA), especially during prostate cancer surgery. Following on from the publication of the Neurosafe Proof RCT last year, there has been a surge in interest in new technologies to facilitate IOMA, in particular the Histolog confocal laser microscope (Samantree Medical). Day one consisted of a Delphi consensus meeting with a gathering of world-leading experts in IOMA, discussing how novel technologies like Histolog can be used to assess surgical margins in real time, and thereby improve nerve-sparing surgery. Day 2 consisted of a 12 hour World Robotic Surgery Event (WRSE) run by Surgquest, the digital arm of ORSI Academy, during which very many surgeries used Histolog to assess surgical margins. Just outstanding! Your usual hosts Declan Murphy and Renu Eapen participated in the Delphi and caught up with many experts to discuss IOMA. A wonderful overview of this hot topic - enjoy!This one definitely best appreciated on our YouTube channel.Links:ORSI Academy Surgquest Histolog website

Yes that's right, our great APCCC giveaway is back! We are sending three lucky winners to Lugano to attend the world's best prostate cancer meeting - the Advanced Prostate Cancer Consensus Conference. Just send us a 60 second video to enter. Closing date Fri 13th June 9pm GMT. Winners will be announced at the GU Cast Live Event at the EAU in London on Sun 15th March 2026.Full details at gucast.org Check out APCCC at apccc.org

Welcome to Episode 6 of our monthly GU Cast Journal Club! Two important papers in upper tract urothelial cancer (the POUT trial of adjuvant chemo post nephro-ureterectomy), and metastatic testicular cancer (the SEMS trial of surgery for early metastatic seminoma). We are delighted to welcome back our GU Cast Journal Club Editors, Dr Carlos Delgado (Melbourne, AUS), and Dr Elena Berg (Munich, GER), along with main GU Cast Hosts, Renu Eapen and Declan Murphy. No prostate cancer today, and go easy on Declan he is struggling with man flu!Links to papers below:1. Adjuvant chemotherapy in upper tract urothelial carcinoma (the POUT trial): a phase 3, open-label, randomised controlled trial Lancet 20202. Surgery in Early Metastatic Seminoma: A Phase II Trial of Retroperitoneal Lymph Node Dissection for Testicular Seminoma With Limited Retroperitoneal Lymphadenopathy J Clin Oncol 2023GU Cast Journal Club is supported by our Partner, MSD, through an unrestricted educational grant.Even better on our YouTube channelAbout GU Cast Journal Club:Each month, two papers are discussed, each of which are of importance to the GU Oncology community. These may be recent papers, or occasionally we will chose a classic landmark paper in GU Oncology. The objective is to draw attention to important papers in GU Oncology, and critique these in a robust manner. The key target audience is trainees working in Urology, Medical Oncology, Radiation Oncology, Nuclear Medicine, and diagnostic specialties such as Radiology and Pathology. But any of our regular audience are likely to enjoy this Journal Club series.

It is the eve of the USANZ ASM here in Melbourne (which Renu is Convening!), and some of the 27 International guests are already into town. So we grabbed Anders Bjartell (Lund University/University Hospital Malmo, SWE), for a sit down chat in studio. Anders has been a huge name in prostate cancer research in Europe for the past couple of decades, including as a senior investigator on TITAN. so we decided to pick his brain on three topical areas in prostate cancer:1. ADT/ARPI doublets in mHSPC - can we adopt an intermittent approach before the trials read out? What about docetaxel triplet therapy?2. The SPARC consensus on PSMA PET/CT reporting - Anders led this initiative which recently publihsed in Eur Urol. What is this and why does it matter?3. Organised Prostate Testing - what is the difference between screening and organised prostate testing? With usual hosts Renu Eapen and Declan MurphyThis is a Themed Podcast supported by our Gold Partners, Johnson & Johnson. Links:SPARC consensus paper in European Urology 

Giant bladder cancer paper in NEJM this week with the highly anticipated results of the perioperative EV-Pembro trial (EV-303 / KN-905). Already we can say this is a landmark publicaion in bladder cancer that will change practice and even challenge the role of cystectomy (maybe)! Declan Murphy and Renu Eapen caught up with first author Christof Vulsteke (Integrated Cancer Centre, Ghent, BEL) when we were at ESMO Asia recently and had a chat about this work and how it will change practice. This is a Themed Podcast supported by our Platinum Partner, Astellas. Even better on our YouTube channelLinks:EV-303 in NEJM 

Following on from last week's episode on "toxicity", we are delighted today to welcome back two great friends of GU Cast from the world of radiation oncology - ASTRO President Dr Neha Vapiwala (University of Pennsylvania), and European Urology Associate Editor, Dr Amar Kishan (University of California, Los Angeles). We go through Amar and Neha's letter to the editor following the recent paper in Eur Urol Oncol from the IRRADIATE registry, and  dive into the opportunities we have working in multidisciplinary teams to look after our prostate cancer patients. Most enjoyable!Even better on our Youtube channelLinks:Letter to the editor (needs login) 

In case you missed it, or you've already abandoned Twitter (memo to self - must do that ourselves!), we witnessed some pretty toxic stuff over there in the past couple of weeks. Vile personal attacks, calls for resignations, accusations of nefarious behaviour etc etc, mostly triggered by an AI-generated infographic attempting to illustarte a recent paper in European Urology Oncology. We chat with first author Dr Riccardo Bertolo (University of Verona, ITA), about his first-hand experience of twitter toxicity, his take on that terrible infographic, and ,most importantly, we discuss the paper which he and his colleagues published on late GU toxicity following prostate cancer radiation. Your usual hosts are Renu Eapen and Declan Murphy, back with a bang after their summer break. Even better on our YouTube channel Links:Bertolo et al paper in European Urology Oncology 2026 Letter from the European Urology Editors Previous GU Cast on Radiation Cystitis 

Happy New Year and welcome to Episode 5 of our monthly GU Cast Journal Club! Today we focus on two classic papers in non-invasive bladder cancer and metastatic prostate cancer. The Lamm RCT of maintenance BCG is a landmark trial for all sorts of reasons, published in J Urol in 2000. And the CHAARTED paper of chemohormonal therapy is the landmark trial of combination therapy in mHSPC, published in NEJM in 2015.We are delighted to welcome back our GU Cast Journal Club Editors, Dr Carlos Delgado (Melbourne, AUS), and Dr Elena Berg (Munich, GER), along with main GU Cast Hosts, Renu Eapen and Declan Murphy. A very lively discussion!! Links to papers below:1. Maintenance bacillus Calmette-Guerin immunotherapy for recurrent TA, T1 and carcinoma in situ transitional cell carcinoma of the bladder: a randomized Southwest Oncology Group Study J Urol 20002. Chemohormonal Therapy in Metastatic Hormone-Sensitive Prostate Cancer NEJM 2015GU Cast Journal Club is supported by our Partner, MSD, through an unrestricted educational grant.Even better on our YouTube channelAbout GU Cast Journal Club:Each month, two papers are discussed, each of which are of importance to the GU Oncology community. These may be recent papers, or occasionally we will chose a classic landmark paper in GU Oncology. The objective is to draw attention to important papers in GU Oncology, and critique these in a robust manner. The key target audience is trainees working in Urology, Medical Oncology, Radiation Oncology, Nuclear Medicine, and diagnostic specialties such as Radiology and Pathology. But any of our regular audience are likely to enjoy this Journal Club series.

Another of our special Themed Podcasts focussed on prostate cancer in China, supported by our Gold Partner, Bayer. We are joined as ever by our China Editor, Dr Yao Zhu (Fudan University Shanghai Cancer Centre), and also special guest Dr Yige Bao (SCU Xiamen Hospital). Not only do we learn about pandas in West China, but also some great highlights from the recent ESMO Annual Meeting in Berlin! Hosted as ever by Dr Renu Eapen and Prof Declan MurphyEven better on our YouTube channel