Expert discussion: Best of EAU24 Abstracts

The session on the final day of EAU24 was chaired by EAU Secretary General Prof. Arnulf Stenzl (DE) and outgoing SCO Chairman Prof. Peter Albers (DE). This session concentrated on best abstracts, as selected at the time of submission. Later in the afternoon, a traditional “souvenir session” featuring take-home messages from the entire Paris congress would round off the scientific programme.

This article links to all the relevant abstracts and provides a short summary of the comments given by the discussants.

Oncology – Renal Cancer

Discussed by Dr. Maria Carmen Mir Maresma (ES)

• A0271 Enhancing immunotherapy in renal cell carcinoma by engineering cytotoxic T lymphocytes with chimeric costimulatory switch proteins – Dr. J. Linxweiler, Homburg/Saar (DE)
  “New approach, future exploration of a very promising field, with a lot of work ahead.” 

• A0474 Active Surveillance versus Primary Intervention for Clinical T1a Kidney Tumors: Contemporary results after Fourteen-Year Experience of the DISSRM Prospective Comparative Study – Dr. K. Alkhatib, Elmhurst (US)
  “Potential for better patient counseling”
• A0471 Reclassification of small renal masses according to the EAU Guidelines newly-proposed TNM classification for suspected renal cell carcinoma: implications for decision-making – Dr. C. Palumbo, Novara (IT)
  “Better identification of ‘true’ T1a RCC”

• A0270 A potential tumor-marker from urinary microbiota – focusing on renal cell carcinoma – Prof. Dr. Dr. S. Kajioka, Fukuoka (JP)
  “Very well-done study, showing significant differences. Potential for identification of tumour makers for RCC.”
• A0458 Artificial intelligence links pre-operative multi-phase CT images to pathologic features, survival outcomes and biological behaviors of renal masses using real-world data – Dr. Y. Xiong, Shang Hai (CN)
  “Deep learning models can non-invasively predict likelihood of malignancy. There’s a future for improved algorithms for renal tumour identification.”

Oncology – Urothelial Cancer

Discussed by Prof. Joost Boormans (NL)

• A0352 Development and external validation of an artificial intelligence-based tool for PROGression Risk assessment in Non-muscle invasive Bladder Cancer (PROGRxN-BCa) – Dr. J. Kwong, Toronto (CA)
  “Novel AI-based tool for prediction of progression risk in IR-NMIBC, addressing current need for better prognosticators.” 

• A0876 Cancer vaccine improves the efficacy of immune checkpoint inhibitor against refractory cancers – Dr. S. Ueda, Fukuoka (JP)
  “Going to address current need to improve efficacy of anti-PD-1 therapy in mUC with new algorithm” 

• A0148 Development and validation of a highly specific digital PCR test using hypermethylated circulating tumour DNA in invasive urothelial carcinoma – Dr. D. Prost, Paris (FR)
  “Easy-to-use 3-methylation markers dPCR to detect ctDNA that correlated to stage and survival.”

Oncology – Prostate Cancer

Discussed by Prof. Derya Tilki (DE)

• A0563 A novel approach to identify aggressive prostate cancer via DNA-Methylation signatures from prostate needle biopsy – Dr. M. Kaneko, Glendale (US)
  “Attempts to address current paucity of studies on the combination of DNA methylation signatures using needle biopsy samples to identify aggressive PCa. The authors identified 12 DNA-methylation CpGs associated with clinically significant PCa on prostate biopsy core samples.” 

• A0659 Organised prostate cancer testing in Sweden – results from the first three years of inviting 50-year-old men – Ass. Prof. A. Lantz, Danderyd (SE)
  “Interregional differences in PSA distribution, MRI and biopsy results highlight the need for standardization of PSA assays and MRI readings.”
• A0679 High intensity focused ultrasounds vs. radical prostatectomy: Carcinologic results of the HIFI study – Dr. G. Ploussard, Toulouse (FR)
  “Non-inferiority trial, comparing HIFU (70% of prostate volume) and RP. Salvage therapy-free survival after HIFU was not inferior to that reported after surgery at the pre-planned 30-month follow-up.” 

• A0645 Fracture-related hospitalisations in de novo advanced or metastatic hormone-sensitive prostate cancer: Secondary analysis of the STAMPEDE abiraterone acetate plus prednisone +/- enzalutamide and M1|RT phase 3 trials using health systems data – Mr. C. Jones, Cheadle (GB)
  “AAP +/- enzalutamide significantly reduces fracture risk.”

Non-Oncology – Functional urology

Discussed by Prof. Jean-Nicolas Cornu (FR)

• A0240 Unveiling the long-term survival outcomes of artificial urinary sphincter: A twelve-year study from the French National Health Insurance database – Dr. L. Lenfant, Paris (FR)
  “Innovative database analysis. French NHI database very convenient due to exhaustive coding. Important issue: we have identified a problem with coding of slings and sphincters which can skew results.” 

• A0782 A preliminary analysis of the comparing UroLift Experience Against Rezūm (CLEAR) randomized controlled trial (RCT) suggests a superior early patient experience with UroLift – Dr. M. Rochester, Norwich (GB)
  “Very accurate outcome analysis despite low number of participants. UroLift PUL subjects preferred it over CLEAR.” 

• A0379 A prospective paired comparison trial on mirabegron and anticholinergics in patients with low bladder compliance – Dr. H.S. Son, Seoul (KR)
  “Potential of improving compliance in neurogenic bladder, but with some caveats.” 

• A0918 Volume variability in orthotopic neobladder: the Impact of the ileal width and the AADAPT formula tested on the animal model – Dr. F. Annino, Arezzo (IT)
  “Width of great importance for volume of neobladders. Formula tested by creating pouches with animal samples. Formula successfully predicted capacity of the pouch. Human studies also needed.” 

• A0927 Novel 3D bioprinting for urethral reconstruction – Dr. A.T. Olsen Ekerhult, Gothenburg (SE)
  “Very promising new tissue source for urethral surgery, but highly preliminary.”

Non-Oncology – Urolithiasis

Discussed by Prof. Thomas Knoll (DE)

• A0768 Break wave lithotripsy for urolithiasis: Results of the first-in-human international multicenter clinical trial – Ass. Prof. B.H. Chew, Vancouver (CA)
  “Shockwave disappearing even in Germany. Break-wave lithotripsy might be a game changer. We can’t rely on ESWL concepts from forty years ago and need technical progress if it is to continue to be useful.”

• A0400 Comparison of the intestinal microbiota of patients with primary hyperparathyroidism with and without urinary system stone disease – Dr. A. Gudeloglu, Ankara (TR)
  “Apart from concepts about supersaturation, all sorts of acids are associated with stone forming, possible link to intestinal microbiota.”

• A0455 A prospective clinical trial on temperature profiles during flexible ureteroscopic laser lithotripsy – Mr. M.S.R. Asoy, Bergen (NO)
  “Didn’t believe it myself for years, but now I too see the danger of the 42°C upper limit. Intrarenal temperature shows a direct correlation with renal pelvic APD.”

Non-Oncology – Andrology

Discussed by Dr. Maarten Albersen (BE)

• A1092 Treatment of Erectile Dysfunction using Digital Health Applications (DiGA) – Results of a Prospective, Randomized, Controlled, Single-Blind Study (RCT) (EDDIG Study) – Prof. Dr. M. Zitzmann, Münster (DE)
  “To be interpreted with care, but initial results are promising as an add-on to our armamentarium in ED”

Prize-winning abstracts: Oncology

Discussed by Prof. Arnauld Villers (FR)

• First prize A0603: PSMA-PET guided intensification of salvage radiotherapy after radical prostatectomy: A phase 2 randomized controlled trial – C. Belliveau, et al., Montreal (CA)
  “Metastatsis-free survival based on conventional imaging and in overall survival, but need longer follow-up.”
• Second prize A0825: 25-year outcomes for men on active surveillance after screen detected prostate cancer in the Göteborg-1 trial – E. Palmstedt, et al., Gothenburg (SE)
  “Investigating outcomes beyond 15 years is crucial. PCa deaths were uncommon over 25 years. Large proportion needed treatment, 41% failed active surveillance. Men with long remaining life expectancy should be informed about the long-term outcomes of active surveillance before they start.”

• Third prize A0526: A patient-derived bladder cancer organoid biobank for translational research and precision oncology – M. Garioni, et al., Basel (CH)
  “BCa heterogeneity poses an ongoing challenge for an appropriate management. This abstract describes the successful generation of a series of PDO models.”

Prize-winning abstracts: Non-Oncology

Discussed by Prof. Christian Gratzke (DE)

• First prize P375: PUrE RCT 1: Clinical and cost-effectiveness of flexible ureterorenoscopy and extracorporeal shockwave lithotripsy for lower pole stones ≤10 mm – O. Wiseman, et al., Cambridge (GB)
  “RCT comparing ESWL and FURS. Large sample size, assessing both clinical and cost effectiveness. However, only relatively short follow-up period focusing on general health.”
• Second prize A1013: LIM kinase inhibitor: A novel pharmacological strategy in the treatment of mixed symptoms in mixed LUTS? – Dr. Q. Yu, et al., Guangzhou (CN)
  “Novel target for treatment of male LUTS. Has become difficult to translate findings into clinical practice due to so many targets.”
• Third prize A0111: Efficacy and safety of mirabegron compared with solifenacin in treatment of non-neurogenic voiding dysfunction in children: A randomized controlled trial – Dr. I. Mansour, et al., Mansoura (EG)
  “RCT of 128 children, which is rare. Good use of questionnaires. Long-term durability of symptoms is unknown.”

Delegates can watch back the webcasts of this session for much more detailed commentary as soon as it becomes available in the EAU24 Resource Centre.