Wow did this paper cause a fuss this week!! The ENACT trial was published online in JAMA Oncology last weekend and provoked a huge outcry on social media. Many people were  genuinely shocked at the study design, the conclusions, even the title of the study.
We've linked to the paper below, but in summary, this prospective multi centre study enrolled patients with with low-risk or favourable intermediate-risk prostate cancer, entirely suitable for active surveillance (ie no treatment/no side-effects), and randomised half of them to receive enzalutamide. Yes enzulautmide,  a super powerful AR pathway inhibitor that works very well in men with advanced prostate cancer. But with plenty of side-effects.
So we decided to invite study co-author, active surveillance advocate and friend of teh podcast, Dr Matt Cooperberg, to come on and help us understand the rationale. We also welcomed Dr Keith Kowalczyk, Georgetown Medical Centre, Washington DC, to help us figure it out.
What do you think? Comments welcome on our Youtube channel

Links:
ENACT paper 

GU Cast returns to one of our favourite topics - PSMA imaging and theranostics! We chat with Nuclear Medicine Physician Professor Michael Hofman, and GU Medical Oncologist, Associate Professor Arun Azad, about some PSMA highlights at the recent ASCO Annual Meeting. Michael presented the eagerly anticipated overall survival data from the TheraP trial in the oral abstract session, and discusses the findings with Arun, Renu and Declan.
They also discuss another important paper in the oral abstract session - an analysis of the quantitative parameters of PSMA PET/CT scans in the VISION study.

Also available of our Youtube channel here

Part 2 of Declan's visit to the Martini-Klinik in Hamburg. Today he chats with Professor Derya Tilki, Urologist and Clinician Researcher, about their ongoing  research activities, including the huge database of radical prostatectomy outcomes which now includes a staggering 35,000 patients.
Plus a fantastic trip to the operating room with Professor Tobias Maurer to perform PSMA-guided salvage pelvic lymph node dissection. Declan gets to scrub in and learn from Tobias about his huge experience in this evolving area.

Also cross-posted to our YouTube channel, featuring Declan's up close experience assisting Tobias perform PSMA radio guided surgery

Declan Murphy continues his sabbatical adventures in Europe by spending a few days at the famous Martini-Klinik in Hamburg. The Martini-Klinik is the world's largest radical prostatectomy centre, and is preparing to move to a new building to increase their capacity even more.
In this first part of a two-part podcast/videocast, Declan chats with Chief of Urology Professor Markus Graefen, and spends some time in the operating rooms with Markus and Professor Alexander Haese, looking at the Neurosafe frozen section technique which was developed at the Martini Klinik. Plus we discuss a new randomised trial of pelvic lymph node dissection. Part 2 follows next week.

GU Cast also cross posts on YouTube. This is a great one to watch on YouTube due to our trips to the operating rooms at Martini-Klinik

Links:
YouTube version of this episode
Martini-Klinik website 

In his third and final podcast from Lugano, Declan chats with Dr Axel Merseberger (Lubeck), Dr Jochen Walk (Marseille), Ms Jane Fisher (Melbourne), and Dr Chris Sweeney (Boston/Adelaide). Plus listen out for fantastic father and son act, Professor Joe and Oisin O'Sullivan, who played for the crowds outside the Villa Cian. 

Silke Gillessen and Aurelius Omlin were also pleased to announce the dates of the next APCCC which will take place from 25-27 April 2022 in spectacular Lugano. 

GU Cast is our regular podcast brought to you by Professor Declan Murphy and Dr Renu Eapen, Urologists at Peter MacCallum Cancer Centre in Melbourne. Available on all major podcasting platforms. Now also cross-posting on YouTube. https://gucast.buzzsprout.com/

Also cross-posted on Youtube

Links:
APCCC Website
SAGENCI 

Declan continues his three part podcast from the Advanced Prostate Cancer Consensus Conference (APCCC) 2022. Imaging played a very dominant (and disruptive) role at APCCC 2022, especially PSMA PET/CT with lots of “train has left the station analogies” and a healthy amount of panellists wanting to stay on the platform! 

Today Declan speaks with four imaging experts to hear their thoughts. Nuclear Medicine physicians Professor Michael Hofman (Melbourne), Professor Stefano Fanti (Bologna) and Dr Ken Herrmann (Essen), were joined by MRI guru Professor Anwar Padhani (London). Fair to say the prostate cancer world needs help figuring out what to do with PSMA PET/CT!! 

Dr Marcus Cumberbatch, Consultant Urologist at the University of Sheffield Hospital (Sheffield), and Melbourne alumnus, gives a great perspective of his experience as a delegate at APCCC.

Finally (for this episode), Declan speaks with top prostate cancer specialists Dr Neha Vapiwala, Radiation Oncologist at the University of Pennsylvania (Philadephia), and Dr Elena Castro, Medical Oncologist at the Virgen de la Victoria University Hospital (Malaga). 

Also cross-posted including some great video on our YouTube channel.

Links:
APCCC Website 

Declan Murphy stops off at the world-famous Netherlands Cancer Institute (NKI) in Amsterdam for a couple of days to visit his old friend, Professor Henk van der Poel. Henk is Consultant Urologist and Chief of Urology at the NKI, and leads a fantastic team with world-renowned expertise in GU oncology. 

Declan spends a day in the operating room to watch Henk perform robotic radical prostatectomy and extended pelvic lymph node dissection using a fluorescence-guided approach to detect sentinel lymph nodes, and hears the latest about Henk’s ongoing trials in this area. 

He then spends a day engaging with some of Henk’s collaborators and PhD students, and has a sit-down chat with Henk and Dr Hilda de Barros who recently published a very nice manuscript in European Urology on PSMA radio-guided surgery.

 GU Cast also cross-posts on Youtube - check out Declan's visit to NKI here. 

Links:

Netherlands Cancer Institute
de Borras et al European Urology paper
Youtube version  

To celebrate the return of the world’s premiere prostate cancer meeting, GU Cast is very pleased to bring you the first of three special editions from the Advanced Prostate Cancer Consensus Conference 2022. GU Cast co-host Professor Declan Murphy joined other panellists and delegates in beautiful Lugano, and recorded interviews with many other speakers and attendees, and captured some fantastic footage by Lake Lugano (check out our YouTube version). In this episode, Declan chats with APCCC Convenors, Dr Silke Gillessen and Dr Aurelius Omlin, and panellists Dr Pierre Blanchard, Dr Jochen Walz, and Dr Bertrand Tombal, along with patient representative David Mathesen. Plus Dr Derya Tilki rather cheekily turns the microphone on Declan! Of course APCCC is now a hybrid meeting, so you can still register and enjoy the full presentations and discussion (link below). 

You can also watch this podcast on YouTube and enjoy some great scenery in Lugano.

Links:
APCCC Website 

Another GU Cast special from the ProsTIC Preceptorship in Melbourne. Today Dr Renu Eapen welcomes back guest co-host Associate Professor Arun Azad, Medical Oncologist at Peter MacCallum Cancer Centre, to discuss some fantastic translational work going on in his Centre based on our Lutetium PSMA experience.
We welcome three great guests to talk about their work. Dr Luc Furic is Head of Translational Prostate Cancer Research at Mac; Dr Louise Kostos is a Medical Oncologist doing a PhD looking at mechanisms of resistance with LuPSMA, and Dr Heidi Fettke is a Post-Docotoral researcher focussing on circulating tumour cells in LuPSMA patients. Plus of course co-host Dr Eapen is also doing a PhD focussing on the immunology of patients receiving LuPSA on the LuTectomy trial.

Amazing discussion about the very exciting translational opportunities which LuPSMA presents.

Also posted on YouTube if you want to see us in studio

Links
ProsTIC Preceptorship 
ProsTIC Twitter
Dr Louise Kostos Twitter

GU Cast moved on-site this week to the ProsTIC Preceptorship in Melbourne, a state-of-the-art meeting focusing on PSMA Theransotics, led by the PCF-funded ProsTIC Centre of Excellence at Peter MacCallum Cancer Centre. What a great meeting! In-person and virtual with on-demand available for two years (links below).
We invited international guest Dr Tom Hope, Nuclear Medicine Physician and Radiologist at the University of California San Francisco, to join us for a late-night drink in our GU Cast studio at the Sofitel in Melbourne, to have a chat about all things PSMA. Along with Australian PSMA pioneers Professor Michael Hofman (Peter MacCallum Cancer Centre) and Professor Louise Emmett (St Vincent's/Garvan in Sydney).
A truly relaxed chat about where it all began, where we are now, and where it is all going. No holds barred, very entertaining.
Hosted as ever by Dr Renu Eapen and Professor Declan Murphy.

You can also watch this podcast on YouTube and see our nice late-night set-up on Level 48 of the Sofitel in Melbourne.

Links:
ProsTIC Preceptorship
ProsTIC Twitter
Dr Tom Hope Twitter
Professor Michael Hofman Twitter
Professor Louise Emmett Twitter