H. Van Poppel MD, PhD

Update in prostate cancer 2019

SUMMARY

The prostate cancer (PCa) landscape has changed dramatically over the past few years. New paradigm-shifting data are published nearly every month. This review aims to give a brief overview of the most important publications of 2018–2019. From the ever-lasting discussion about PSA screening, with the recent publication of the CAP trial, over diagnostics where multi-parametric MRI has caused a true revolution, to hypofractionation in radiotherapy and the dramatic treatment shifts in metastatic hormone sensitive and non-metastatic castrate resistant PCa. All exciting data that will change clinical practice.

(BELG J MED ONCOL 2020;14(1):13–21)

Case report of a patient treated locally for bone metastatic renal cell carcinoma

SUMMARY

Based on a case report of a 47-year old male with primary bone metastatic renal cell carcinoma, the current treatment options are reviewed in this article.

(BELG J MED ONCOL 2019;13(7):305–8)

EAU19: New developments in PCa imaging and trials

SUMMARY

The European Association of Urology (EAU) held its 34th Annual Congress in Barcelona from the 15–19th of March, a recurring highlight for the Association and for urology in general. While the presenting of the latest EAU Guidelines, holding meetings for its Board and Sections and setting agendas for the coming year are essential to the running of the Association, it is the latest scientific developments in urology that took centre stage in Barcelona.

Scientific Congress Office Chairman Prof Arnulf Stenzl (DE) presided over the scientific programme one last time, stepping down to join the EAU Executive as Adjunct Secretary General (Science). He was congratulated on his track record and particularly the comprehensive and diverse five-day programme that greeted the nearly 12,000 participants from 127 countries in Barcelona.

This article provides some uro-oncological highlights from the 263 different scientific sessions at EAU19. For the most complete coverage, see the on-site news reports on www.eau19.org/news.

(BELG J MED ONCOL 2019;13(7):314–6)

EMUC18: Synergy of disciplines for optimal genitourinary cancer care

SUMMARY

Marking its decade-long dedication to the goal of pursuing multidisciplinary collaboration, the 10^th European Multidisciplinary Congress on Urological Cancers (EMUC18) examined the best practices, advances and future prospects in managing genitourinary malignancies. The congress also identified current dilemmas and addressed gaps in clinical practice.

(BELG J MED ONCOL 2019;13(2):63–65)

Oncological topics presented at EAU 2018

At the occasion of the Annual Congress of the European Association of Urology (EAU), a number of new trial protocols with new immuno-oncology drugs were presented for bladder and renal cancer next to the results of studies on adjuvant and neo-adjuvant chemotherapy for upper tract transitional cell carcinoma. In prostate cancer, the value of prostate-specific antigen screening and multiparametric MRI at first diagnosis was investigated, and the results of clinical trials with enzalutamide and apalutamide were reported.

(BELG J MED ONCOL 2018;12(7):339–341)

Multimodality treatment for high-risk prostate cancer: New perspectives

High-risk prostate cancer represents the most aggressive form of the disease worldwide. In the past it was largely treated without curative intent but during the last years there has been a paradigm shift with an increase of curative procedures (particularly radical prostatectomy) for high-risk patients and, vice versa, active surveillance for low-risk disease. For this reason the high-risk group represents the novel target for contemporary research. The pre-operative risk groups are considered homogeneous in terms of prognosis and therapeutic response but there are grey zones within each group that have not been adequately studied. The main hypothesis of this PhD thesis (ISBN-NUMBER: 9789082757606 for the printed version and 9789082757613 for the e-version) is that not all high-risk prostate cancer patients have the same outcomes after surgery and also not the same response to multimodality therapies. In this context, novel treatments or their combinations should be tested. We analysed the largest high-risk database in the world demonstrating that not all high-risk patients after surgery have the same outcome according to their postoperative pathologic features. The European Multicentre Prostate Cancer Clinical and Translational Research group classifier was then defined as three different prognostic groups to predict cancer specific death. Interestingly, patients in these groups did not respond homogenously to adjuvant radiotherapy and/or androgen deprivation therapy. We also analysed the survival impact of neoadjuvant hormonal therapy before surgery, showing that patients who need adjuvant radiotherapy and were exposed to neoadjuvant hormonal therapy have the best prognosis. This outcome opens new perspectives for neoadjuvant treatment with or without other treatment combinations. The ARNEO trial is a phase II randomised, double blind, placebo controlled trial to study the association of apalutamide and degarelix before surgery for intermediate and high-risk disease.

(BELG J MED ONCOL 2018:12(3):130–132)

Risk factors associated with bladder cancer occurrence and recurrence: an epidemiological and clinical approach

SUMMARY

Age, gender and smoking habits are the most important risk factors for bladder cancer. Selenium supplement, in addition to standard care, does not diminish recurrence in bladder cancer patients compared to placebo and increases the risk of bladder cancer with 6% for each increase of 10 mcg/L of blood selenium level. Each extra daily portion of vegetables decreases the risk of bladder cancer with 6%. Neither diabetes nor metformin was associated with bladder cancer risk in the Clinical Practice Research Datalink.

(BELG J MED ONCOL 2017;11(8):393-395)