
Experts unpack evolving mCSPC care, from ARPIs and chemo to PARP and PSMA advances, plus guideline-driven, personalized therapy choices.

Experts unpack evolving mCSPC care, from ARPIs and chemo to PARP and PSMA advances, plus guideline-driven, personalized therapy choices.

Atish D. Choudhury, MD, PhD, discusses findings from the A-DREAM / Alliance A032101 trial evaluating treatment interruption following favorable response to combination ADT and ARPI therapy in mHSPC.

In “Managing High-Risk Biochemical Recurrence in Advanced Prostate Cancer,” our panel explores the evolving treatment landscape for patients experiencing biochemical recurrence following definitive therapy. Through the case of a 75-year-old man with a rising PSA after radical prostatectomy, a rapid PSA doubling time, and multiple cardiovascular and metabolic comorbidities, the expert faculty discuss how risk stratification and patient-specific factors influence treatment selection.

Kevin Koo, MD, MPH, highlights findings from a study evaluating automated kidney stone detection and measurement on CT.

In this video, Isaac Y. Kim, MD, PhD, MBA, discusses why immunotherapy may ultimately represent the next major advance in prostate cancer treatment.

Amar U. Kishan, MD, walks through the design and results of the Markov model-based cost-effectiveness analysis, explaining what it means for the ArteraAI-guided strategy to dominate both comparators and why that finding held up across a wide range of sensitivity analyses.

In this video, Neal D. Shore, MD, FACS, and Rana R. McKay, MD, FASCO, address the clinical positioning of darolutamide (Nubeqa) plus ADT in mHSPC, the favorable safety profile of darolutamide, and the importance of multidisciplinary involvement in prostate cancer management.

Break Wave lithotripsy's real-time ultrasound visualization of cavitation and its low-energy resonant frequency delivery mechanistically reduce the risk of renal hematoma and arrhythmia seen with conventional shock wave lithotripsy, while the boundaries of stone size, Hounsfield unit thresholds, and patient anatomy eligible for treatment remain to be defined in commercial practice, according to Ben H. Chew, MD, MSc, FRCSC.

Fred Saad, MD, CQ, FRCS, FCAHS, discusses additional efficacy data from the phase 3 PSMAddition trial, evaluating the addition of 177Lu-PSMA-617 to standard of care ADT plus an ARPI in PMSA+ mHSPC.

Aleece Fosnight, MSPAS, PA-C, identifies the 3 most consequential gaps between the 2024 AUA/SUFU OAB guideline and real-world clinical practice—clinician awareness, prescribing mindset, and payer alignment—and offers her single most important takeaway for clinicians applying this framework at the point of care.

In this video, Aleece Fosnight, MSPAS, PA-C, provides a comprehensive review of intradetrusor onabotulinumtoxinA in OAB practice, covering preprocedural counseling, dose individualization including the evidence for escalation to 200 U in refractory patients, post-void residual evaluation, catheterization risk, and the systems-level strategies she uses to sustain long-term patient adherence to retreatment schedules.

Aleece Fosnight, MSPAS, PA-C, explains how she translates the guideline's Grade A evidence for sacral neuromodulation, posterior tibial nerve stimulation, and intradetrusor onabotulinumtoxinA into individualized treatment recommendations, and describes the shared decision-making process she uses when a patient is a candidate for all 3 options.

In this video, Aleece Fosnight, MSPAS, PA-C, reviews the evidence and practical application of behavioral interventions and pharmacologic therapy for OAB, including the clinical and safety rationale for leading with beta-3 agonists over anticholinergics, and outlines how she frames the transition to minimally invasive therapy for patients who have not responded to prior treatments.

EV+pembrolizumab drives deep nodal responses in bladder cancer, shifting decisions on cystectomy and retroperitoneal node dissection.

See how cystectomy after immunotherapy looks surprisingly routine, with insights on pelvic node dissection and post-op treatment decisions.

Aleece Fosnight, MSPAS, PA-C, introduces her practice philosophy and credentials, characterizes the full scope of OAB's impact on patients who go undiagnosed or undertreated, and explains what the 2024 AUA/SUFU guideline's shift away from mandatory step therapy means for patient-centered care.

Mina M. Fam, MD, discusses the significance of the FDA's recent approval of tebipenem pivoxil for patients with complicated urinary tract infections.

Rahul Winayak, MD, discusses the prognostic and predictive value of microbial dysbiosis in patients receiving CBM588 plus first-line immune checkpoint inhibitor-based regimens for metastatic renal cell carcinoma.

Eugene Pietzak, MD, highlights results from a phase 2 study of pembrolizumab plus BCG for patients with very high-risk, BCG-naive high-grade T1 NMIBC who declined upfront radical cystectomy.

Unwanaobong Nseyo, MD, MHS, discusses a retrospective analysis comparing treatment continuation outcomes with minimally invasive therapies for idiopathic overactive bladder.

Sandip Prasad, MD, discusses 3-year data from the phase 3 ENVISION trial evaluating mitomycin for intravesical solution for recurrent low-grade intermediate-risk non–muscle-invasive bladder cancer.

Andrew J. Armstrong, MD, MSc, discusses efficacy results from a phase 2 study evaluating a chemoimmunotherapy regimen for patients with neuroendocrine or aggressive-variant metastatic prostate cancer.

Amar U. Kishan, MD, describes how the ArteraAI Prostate Test was built and validated, with particular attention to the RTOG 9408 data showing that more than 60% of intermediate-risk patients are biomarker-negative.

In this episode, “Preserving Quality of Life in Metastatic Castration-Sensitive Prostate Cancer,” the expert faculty explores how cognitive function, independence, and patient priorities influence treatment selection for metastatic castration-sensitive prostate cancer (mCSPC). Through the case of a 74-year-old man with low-volume metastatic disease, mild cognitive impairment, and a strong desire to maintain an active lifestyle, the panel examines the importance of treating the whole patient, rather than focusing solely on disease characteristics.

Neal D. Shore, MD, FACS, and Rana R. McKay, MD, FASCO, present the primary rPFS and key secondary OS results from ARASEC and contextualize the findings within the broader darolutamide (Nubeqa) evidence base.

Watch surgeons review cystectomy after immunotherapy—tissue planes stay familiar, lymph node dissection matters, and adjuvant choices remain unclear.

Proactive scheduling of the next onabotulinumtoxinA (Botox) treatment before the patient leaves the office—combined with a streamlined, reduced-site injection protocol—is a central strategy in Steven Bernstein, MD's practice for sustaining long-term persistence on therapy in patients with OAB.

In more than 1000 onabotulinumtoxinA (Botox) treatments using a reduced-site protocol, Steven Bernstein, MD, observed a UTI rate of approximately 4.9% per treatment, a single clinically significant post-procedural bleed (early in experience with 20-site injection), and only 1 patient advised to undergo post-procedural catheterization—findings that support a streamlined, symptom-guided approach to complication management.

R. Jeffrey Karnes, MD, addresses the limitations of the retrospective validation study design, outlines the future research he considers necessary for broad clinical adoption of MMAI, and offers his perspective on the trajectory of digital pathology and multimodal AI across urologic oncology over the next 5 years.

EV-pembro and immunotherapy may shorten time to cystectomy, with fewer chemo-era blood issues but new immune toxicities to manage.