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Exploring the future of tumour microenvironment

The Thematic Session “Hot debates in penile and testis cancer” provided participants with vital insights on therapeutic issues, challenges, and strategies in penile and testis cancer care. Chairs Dr. Oscar Brouwer (NL) and Prof. David Nicol (GB) led the session.

During one of the debates entitled “Overcoming chemoresistance in rare genital cancers: What lies ahead in the exploration of the tumour microenvironment”, speakers Dr. Jad Chahoud (US) and Prof. Daniel Nettersheim (DE) offered updates on penile cancer and germ-cell tumours, respectively. Both provided pre-recorded presentations as they were not able to attend the congress onsite.

In his state-of-the-art lecture on penile cancer, Dr.Chahoud explained the strategy for overcoming chemoresistance in penile cancer. The first step is from the clinic to the bench which involves the following:

  • Identifying the mechanism and markers of chemo and immune response/resistance
  • Defining novel therapeutic targets for immune-based therapies, targeted therapies, antibody-drug conjugates (ADCs), and chimeric antigen receptor (CAR)-T cell therapy
  • Generating tissue for future TIL (tumour-infiltrating lymphocytes) experiments and trials

The next step is from the bench to the clinic which comprises dissecting the mechanism of chemo and immune resistance; validating therapeutic ADC targets and immune combination; and verifying the activity of cellular therapies.

The third step is from the clinic to the bench again which involves collaborative multicentre clinical trials with smart correlative work to bring back to the bench. “We need to optimise our knowledge and bridge knowledge gaps to assess and consider opening more trials with different drugs and therapies, and learn from these trials,” stated Dr. Chahoud.

In the subsequent presentation on germ-cell tumours, Prof. Nettersheim shared that common druggable mutations, which are mainly amplifications related to FGF (fibroblast growth factor) signalling molecules, have been identified. He added that putative epigenetic and liquid biomarkers were also specified, as well as common mechanisms of therapy resistance related to somatic-type malignancy (STM).

Prof. Nettersheim discussed putative tissue-of-origin. He stated that based on proteome data and DNA methylation, it has been found that the carcinoma-type STMs are more similar to yolk sac tumours, while sarcoma-type STMs are more similar to teratomas.

To (re)watch the full presentations during this Thematic Session, please visit EAU On Demand on the Virtual Platform.