The faculty discuss how androgen receptor pathway inhibitor–based strategies are reshaping the management of high-risk biochemical recurrence, with an emphasis on risk stratification, imaging, and patient selection for systemic therapy. The conversation also explores how long-term clinical evidence, treatment suspension, and emerging study designs are informing more individualized treatment decisions in practice.
“I always encourage urologists and physicians in general to keep up with the organizations that they're a part of, like the AUA, that often advocate on your behalf," says Ruchika Talwar, MD.
"I say with a lot of confidence, just continue using telehealth as you are," says Chad Ellimoottil, MD, MS.
A panelist discusses how benign prostatic hyperplasia (BPH) management involves a comprehensive patient journey that encompasses initial diagnostic evaluation, tailored pharmacological interventions including α-blockers and 5-α reductase inhibitors, and a progressive treatment approach ranging from conservative drug therapy to potential surgical options based on symptom severity and patient response.
"I'm all for this great effort by ImmunityBio to provide us with an alternative option,” says Suzanne B. Merrill, MD, FACS.
"Viral vectors are basically a blueprint of the virus that's used to carry the DNA payload into the target tissue, but the problem is they have some issues," says Katherine Chan, MD, MPH.
“I think we now have really robust data showing that earlier treatment intensification with combination regimens does lead to improved survival for patients with metastatic hormone-sensitive prostate cancer," says Dr Louise Kostos.
"For other health care professionals aiming to advocate for equitable changes within their system, it's really important to just start conversations about what you're noticing," says Hailey Frye.
John A. Taylor, III, MD, MS, discussed the new wealth of options in non–muscle invasive bladder cancer, specifically highlighting detalimogene voraplasmid.
"In a practice like mine, where approximately 30% of the practice is low testosterone, it'll have actually very little negative effect," says John P. Mulhall, MD.
“What's really cool about overactive bladder is that, it's not like high blood pressure. They do not have to leave this office with a pill in hand," says Anna Myers, CNP.
"The objective of this project [was] to clinically adjudicate the complications identified by that outpatient software," says Timothy D. Lyon, MD.
“One important aspect to get across…is that access to this EAP is pretty easy," says Suzanne B. Merrill, MD, FACS.
Panelists discuss how future trials in metastatic castration-resistant prostate cancer (mCRPC) should focus on developing reliable biomarker-driven treatment selection strategies to optimize sequencing decisions and identify which patients will benefit most from specific therapies or combinations, particularly as the treatment landscape becomes increasingly complex.
Experts discuss where they are using FDA-approved treatments for bacille Calmette-Guérin (BCG)–unresponsive patients in their practice, how they choose between these treatments, and how these advances have impacted the timing of radical cystectomy for patients.
Panelists discuss how the phase 3 DORA trial investigates the combination of standard of care darolutamide with radium-223 in patients with metastatic castration-resistant prostate cancer (mCRPC), building upon the positive safety profile of novel hormone therapy combinations with radiopharmaceuticals seen in PEACE-3.
Experts briefly discuss 3 new FDA-approved treatments for patients who are unresponsive to bacille Calmette-Guérin (BCG) in the last 5 years—pembrolizumab, nogapendekin alfa inbakicept-pmln, and nadofaragene firadenovec—highlighting how each is administered, and share their impressions of the safety and efficacy of these agents.
"We found that the location that prescribers were registered in, as well as their fellowship training, was significantly associated with higher vibegron prescription rates,” says Grace Khaner.
“High risk, non–muscle invasive bladder cancer carries a significant risk of recurrence and progression. This emphasizes the need for careful patient selection, especially when we are considering bladder-sparing approaches," says Neeraja Tillu, MD.
"This now clarifies and substantiates the fact that there are not increased risks from a cardiovascular standpoint with [testosterone] therapy, at least at the doses studied," says Landon Trost, MD.
"There is evidence for a direct link between the exposures you get by doing your job as a firefighter and then developing cancer down the road," says Sima P. Porten, MD, MPH.
"A lot of times…decreased desire is affected by everything else: pain with sex, orgasm, arousal. Because if none of that is good, then desire isn't going to be good either," says Anna Myers, CNP.
“The impact on bone health is really significant with long-term androgen suppression," says Dr Louise Kostos.
An expert discusses how TAR-200 shows promise for non–muscle invasive bladder cancer (NMIBC) treatment, with medical professionals optimistic about its targeted delivery, potentially improved outcomes, and transformative approach to bladder cancer management.
The phase 2 STARLITE 2 trial is assessing 177Lu-girentuximab plus nivolumab in advanced clear cell renal cell carcinoma.
“I think we can really use AI in several different facets of endourology," says Perry Xu, MD.
“For all intents and purposes, how you've been practicing telehealth currently is exactly how you'll be able to practice it until September 30," says Chad Ellimoottil, MD, MS.
"I hope that these new guidelines and the removal of the black box warning on testosterone therapy will help more physicians feel comfortable providing testosterone therapy to men," says Helen L. Bernie, DO, MPH.
"Radium-223 continues to have a very significant role for patients with advanced castration-resistant prostate cancer," says Rana R. McKay, MD, FASCO.
"When we compared the 2 groups, those that received tamsulosin and those that did not, we did find a significant difference with regard to success rates," says Kate H. Kraft, MD, MHPE, FACS, FAAP. .
