H. Van Poppel MD, PhD

EMUC18: Synergy of disciplines for optimal genitourinary cancer care

SUMMARY

Marking its decade-long dedication to the goal of pursuing multidisciplinary collaboration, the 10^th European Multidisciplinary Congress on Urological Cancers (EMUC18) examined the best practices, advances and future prospects in managing genitourinary malignancies. The congress also identified current dilemmas and addressed gaps in clinical practice.

(BELG J MED ONCOL 2019;13(2):63–65)

Oncological topics presented at EAU 2018

At the occasion of the Annual Congress of the European Association of Urology (EAU), a number of new trial protocols with new immuno-oncology drugs were presented for bladder and renal cancer next to the results of studies on adjuvant and neo-adjuvant chemotherapy for upper tract transitional cell carcinoma. In prostate cancer, the value of prostate-specific antigen screening and multiparametric MRI at first diagnosis was investigated, and the results of clinical trials with enzalutamide and apalutamide were reported.

(BELG J MED ONCOL 2018;12(7):339–341)

Multimodality treatment for high-risk prostate cancer: New perspectives

High-risk prostate cancer represents the most aggressive form of the disease worldwide. In the past it was largely treated without curative intent but during the last years there has been a paradigm shift with an increase of curative procedures (particularly radical prostatectomy) for high-risk patients and, vice versa, active surveillance for low-risk disease. For this reason the high-risk group represents the novel target for contemporary research. The pre-operative risk groups are considered homogeneous in terms of prognosis and therapeutic response but there are grey zones within each group that have not been adequately studied. The main hypothesis of this PhD thesis (ISBN-NUMBER: 9789082757606 for the printed version and 9789082757613 for the e-version) is that not all high-risk prostate cancer patients have the same outcomes after surgery and also not the same response to multimodality therapies. In this context, novel treatments or their combinations should be tested. We analysed the largest high-risk database in the world demonstrating that not all high-risk patients after surgery have the same outcome according to their postoperative pathologic features. The European Multicentre Prostate Cancer Clinical and Translational Research group classifier was then defined as three different prognostic groups to predict cancer specific death. Interestingly, patients in these groups did not respond homogenously to adjuvant radiotherapy and/or androgen deprivation therapy. We also analysed the survival impact of neoadjuvant hormonal therapy before surgery, showing that patients who need adjuvant radiotherapy and were exposed to neoadjuvant hormonal therapy have the best prognosis. This outcome opens new perspectives for neoadjuvant treatment with or without other treatment combinations. The ARNEO trial is a phase II randomised, double blind, placebo controlled trial to study the association of apalutamide and degarelix before surgery for intermediate and high-risk disease.

(BELG J MED ONCOL 2018:12(3):130–132)

Risk factors associated with bladder cancer occurrence and recurrence: an epidemiological and clinical approach

SUMMARY

Age, gender and smoking habits are the most important risk factors for bladder cancer. Selenium supplement, in addition to standard care, does not diminish recurrence in bladder cancer patients compared to placebo and increases the risk of bladder cancer with 6% for each increase of 10 mcg/L of blood selenium level. Each extra daily portion of vegetables decreases the risk of bladder cancer with 6%. Neither diabetes nor metformin was associated with bladder cancer risk in the Clinical Practice Research Datalink.

(BELG J MED ONCOL 2017;11(8):393-395)

Evans blue as a diagnostic tool for non-muscle-invasive bladder cancer: a preclinical study

Summary

The diagnosis of non-muscle-invasive bladder cancer using the standard white-light cystoscopy technique is not optimal and leads to underdiagnosis of some of the tumours. Therefore, in this thesis, the use of Evans blue dye as a diagnostic tool to aid bladder cancer detection during white-light cystoscopy was investigated using a rat orthotopic bladder cancer model. The results show that Evans blue might have great potential to assist detection of bladder cancer in a clinical setting.

(BELG J MED ONCOL 2016;10(7):281–284)

Selected highlights from the 31^st European Association of Urology Annual Congress

Summary

The 31^st European Association of Urology Annual Congress took place in March 2016 in Munich. In prostate cancer the early use of chemotherapy in addition to androgen deprivation therapy in men with primary metastatic disease is a clinical practice changing concept that needs implementation through collaboration between urologists and medical oncologists.
The role of MRI and fusion biopsies in early detection, diagnosis and active surveillance strategies is becoming more and more important. In bladder cancer, non-urothelial tumour types got a lot of attention and specific treatment strategies were presented. Furthermore, immunological treatment came forward to perhaps replace chemotherapy in the management of advanced urothelial bladder cancer.

(BELG J MED ONCOL 2016;10(6):228–231)

Highlights from the 13^th meeting of the EAU Section of Oncological Urology

Summary

The 13^th meeting of the EAU Section of Oncological Urology took place in Warsaw in January 2016. The most important newcomers were the checkpoint inhibitors in metastatic renal cell carcinoma and in bladder cancer. In prostate cancer, early administration of docetaxel in newly diagnosed metastatic prostate cancer was the major practice changing news, next to whole exome and transcriptome sequencing that will become important

(BELG J MED ONCOL 2016;10(4):143–146)