Videos

Amar U. Kishan, MD, establishes why individualized ADT decision-making remains an unsolved problem in intermediate-risk prostate cancer.

Welcome back to another Urology Times Virtual Tumor Board series. In this episode titled “Navigating Comorbidities and Treatment Decisions in Metastatic Castration-Sensitive Prostate Cancer,” expert faculty discuss a patient with advanced prostate cancer whose management highlights the importance of individualized treatment decisions that extend beyond tumor characteristics alone.

In this segment, Rana R. McKay, MD, FASCO, and Neal D. Shore, MD, FACS, detail the 6 prognostic variables used for propensity score matching, the mechanics of 1:1 patient pairing, and the practical advantages of the ARASEC design over a large randomized phase 3 trial.

Through a methodical, patient-driven evolution from 20 injection sites to a single posterior bladder wall injection, Steven Bernstein, MD, maintained onabotulinumtoxinA (Botox) efficacy—with a greater than 93% response rate and a mean retreatment interval of 7.5 months—while substantially improving patient comfort and persistence on therapy.

OAB is a chronic, potentially debilitating condition affecting a substantial proportion of patients in urologic practice, and effective long-term management depends on systematic escalation from behavioral modification through pharmacotherapy to third-line procedural options—including onabotulinumtoxinA (Botox)—when treatment objectives are not met.

Kevin C. Zorn, MD, FRCSC, FACS, discusses the factors that clinicians should consider when selecting among different MIST options for BPH.

New bladder cancer trials test perioperative immunotherapy combos, weighing added enfortumab vedotin vs adjuvant de-escalation to boost durable cures.

EV/pembrolizumab in EV-304 delivers strong pathologic response, event-free and overall survival gains versus standard chemo, reshaping neoadjuvant bladder cancer choices.

In this video, R. Jeffrey Karnes, MD, translates MMAI scoring into practical clinical guidance, discussing how MMAI High and MMAI Low results can inform surveillance intensity, early salvage radiation consideration, and adjuvant therapy planning, and outlining the shared decision-making framework he uses when ordering the test.

In this video, Nicole L. Miller, MD, FACS, discusses her approach to assessing patients after prior treatment failure for benign prostatic hyperplasia.

Abigail Keller shares findings showing that nadofaragene firadenovec is associated with increased urine production during instillation compared with gemcitabine/docetaxel.

Praful Ravi, MB, BChir, MRCP, discusses results from PSMAtrack, which assessed changes in PSMA-PET during initial systemic therapy for metastatic hormone-sensitive prostate cancer.

Rana R. McKay, MD, FASCO, and Neal D. Shore, MD, FACS, explain ARASEC's use of a synthetic historical control arm derived from the CHAARTED trial, a design approach they describe as both ethically necessary and methodologically efficient.

This episode, titled “Comparing Perioperative Strategies in Cisplatin-Eligible MIBC,” features panelists discussing how the KEYNOTE-B15/EV-304 trial is reshaping perioperative treatment considerations for patients with muscle-invasive bladder cancer (MIBC). The expert faculty review the study design evaluating perioperative enfortumab vedotin plus pembrolizumab (EVP) compared with standard neoadjuvant gemcitabine-cisplatin (Gem-CIS), and discuss how these findings may influence treatment selection in cisplatin-eligible patients.

In “Perioperative Therapy Expansion in Cisplatin-Ineligible MIBC,” our panel explores how the treatment paradigm for muscle-invasive bladder cancer (MIBC) is rapidly evolving with the emergence of effective perioperative therapies for cisplatin-ineligible patients. The expert faculty discuss how traditional approaches that relied heavily on determining cisplatin eligibility are changing in light of recent clinical trial data supporting enfortumab vedotin plus pembrolizumab (EVP) in patients who historically would have proceeded directly to surgery.

R. Jeffrey Karnes, MD, presents the performance results of the MMAI model in the Mayo Clinic long-term survivor cohort, including its ability to outperform CAPRA-S in multivariable analysis, its sustained discrimination at 15 years of follow-up, and its prognostic value in patients with biochemical recurrence, salvage radiotherapy receipt, and persistent postoperative PSA.

Pedro C. Barata, MD, MSc, FACP, discusses preliminary findings from the phase 3 ProstACT Global study evaluating 177Lu-rosopatamab plus standard of care for patients with mCRPC.

Tanya B. Dorff, MD, FASCO, shares phase 1 data on ABBV-969, an investigational antibody-drug conjugate being explored for metastatic castration-resistant prostate cancer.

Kim Chi, MD, highlights findings from a pre-planned analysis of the PLUDO trial examining the impact of crossover on survival outcomes between 177Lu-PSMA-617 vs docetaxel in mCRPC.

This episode reviews treatment intensification in metastatic castration-sensitive prostate cancer, focusing on why ADT plus an ARPI is the current backbone of care, what barriers still limit its use, and how clinicians think about triplet therapy, de-intensification, frail patients, and emerging biomarker-driven options such as PARP inhibitors.

This episode examines how indirect trial comparisons can help guide ARPI selection in metastatic castration-sensitive prostate cancer when head-to-head studies are unavailable, while emphasizing the importance of patient-specific factors, tolerability, and clinical judgment.

Lucia Nappi, MD, PhD, FRCPC, highlights key findings from an interim analysis of SWOG S1823, evaluating miR371 for predicting active germ cell malignancy in patients with early-stage testicular cancer.

Alicia K. Morgans, MD, MPH, discusses key findings from the ARACOG study, assessing cognitive outcomes between patients who received darolutamide vs those who received enzalutamide for advanced prostate cancer.

Rana R. McKay, MD, FASCO, highlights phase 2 data on radium-223 dichloride plus cabozantinib for patients with renal cell carcinoma with bone metastases.

Mark Fleming, MD, and Manoj Bupathi, MD, MS, highlight the key studies and sessions in GU oncology that they're most anticipating at ASCO 2026.

Objective performance indicators in robotic surgery are providing the first quantitative framework for evaluating surgical technique, according to Michael Stifelman, MD, professor and chair of urology at Hackensack Meridian Health, whose early prostatectomy data link specific intraoperative metrics to functional outcomes—while governance frameworks, cultural adoption, and the prospect of real-time intraoperative guidance define the near-term challenges and long-term trajectory.

Break Wave lithotripsy met all pivotal noninferiority end points vs shock wave lithotripsy.

Bilal I. Chughtai, MD, highlights 12-month cystoscopic data from the pivotal IDE trial of the Zenflow Spring System.

In this episode, “The Emerging Perioperative Era in MIBC with the NIAGARA Trial,” the expert faculty explore how the NIAGARA trial is reshaping the treatment landscape for muscle-invasive bladder cancer (MIBC). The panel reviews the clinical data supporting perioperative durvalumab plus gemcitabine-cisplatin (GC) in cisplatin-eligible patients, including findings related to pathologic complete response, event-free survival, overall survival, and safety, and discusses how these outcomes are influencing treatment strategies in clinical practice.

Welcome back to another Urology Times Peer Exchange series. In this episode titled, “The Evolving Treatment Landscape in MIBC,” the expert faculty discuss how the treatment landscape for muscle-invasive bladder cancer (MIBC) is evolving with the emergence of perioperative treatment strategies that integrate systemic therapy before and after surgery.