Report: The Big PCa game-changers for 2025!

In an auditorium packed to capacity, the ‘Game-changing’ session today offered a concise wrap-up of an exceptional year in oncology research, particularly for prostate cancer patients. Read this report summarising the presentations on PSMAddition, AMPLITUDE, CAPItello-281, and EMBARK results.

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Webcasts of the day

CREST
T. Powles, London (GB)

CC Case: Systemic treatment for RCC – What to do with the primary tumour? Take it out or let the drug do the work?
U.  Vogl, Bellinzona (CH), G.  Pignot, Marseille (FR), and Y.  Ürün, Ankara (TR)

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Report: Hereditary GU cancers session examines BRCA and PRS

Is prostate cancer (PCa) risk elevated in individuals with BRCA mutations? What is the potential of polygenic risk score (PRS) in PCa screening? Experts explored these topics during “Plenary Session 8: Hereditary genito-urinary cancers” held on day 3 of EMUC25.

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Photos from the congress floor in Prague

Check out our photo albums of Day 3 of EMUC25 and Abstract Award winners on Facebook. Share your photos and stories on Instagram, LinkedIn, and X as well.

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Best EMUC25 Abstracts

O04: Real world evidence of adjuvant pembrolizumab in renal cell carcinoma (RCC) from a Spanish registry: The ARENAL trial from the GUARD consortium.
M.I. Galante Romo, Madrid (ES)

O01: ONE SHOT – single shot radiotherapy for localized prostate cancer: primary endpoint results of a single arm, multicenter, prospective phase I/II trial
T. Zilli, Bellinzona (CH)

O03: Secondary outcomes by prior definitive treatment (tx) in patients (pts) with high-risk biochemically recurrent prostate cancer (hrBCR) treated with enzalutamide plus leuprolide (enza combo): EMBARK post hoc analysis
A.S. Rannikko, Espoo (FI)

The post Highlights from Day 3 appeared first on EMUC25.

For ctDNA-positive patients, adjuvant immunotherapy can be offered, with demonstrated treatment efficacy in a predominantly clinically high-risk population (IMvigor011), and a 50% ctDNA clearance in both low- and high-risk groups (TOMBOLA).

Prof. Dyrskjøt: “Overall, ctDNA-based molecular stratification outperforms clinical and histopathological risk assessment in identifying patients who benefit from adjuvant treatment, as shown in both IMvigor011 and TOMBOLA.”

In regard to the requirements for implementing ctDNA-guided care, Prof. Dyrskjøt stated that “Sensitive tumour-informed tests are required. Continued ctDNA analysis is needed, a single test post-RC is not enough, and assay availability and fast turnabout time are essential. We need to generate knowledge on how to bridge and use ctDNA in the peri-operative setting (NIAGARA, KEYNOTE-905/EV303, etc.).”

On his overall view on ctDNA use, he concluded, “Yes, it can be used for guiding adjuvant immunotherapy. But for guiding pre-cystectomy treatment – no, not yet; we need more studies first.”

Following this was a presentation on ‘Treating metastatic bladder cancer when money is an issue’, by Dr. Jorge Estaban Villarrubia (ES). “Back in October 2023, we were all excited about the enfortumab -vedotin + prembrolizunam (EV-P) data presented, and then the 2024 guidelines were updated and the EMA granted approval for the new combination.”

But according to Dr. Estaban Villarrubia, it is important to note that although the survival rates of this combination therapy are impressive, its high-cost limits broader use in many public health settings. In addition, some countries (including Spain) are still awaiting approval of EV-P, and there is also the issue of access to NGS (next-generation sequencing) which is not readily available in all hospitals.

“As oncologists, we must ask some important questions when we can’t get the best systemic therapy. What are the next best options for maximising treatment benefit, without increasing toxicity? Is there a role for radical treatment options?”

He reviewed treatments such as chemotherapy (cisplatin), split dose cisplatin for cisplatin-ineligible symptomatic patients, as well as strategies supported by evidence to reduce the number of cycles in order to minimise toxicity.

In his take-home messages, he concluded, “When money is an issue, we still have therapeutic options with proven efficacy. Collaboration between institutions is key to providing access to precision medicine, clinical trials and best available care. Multidisciplinary management of the patient leads to better outcomes, not only in survival, but quality of life, too. We must not forget that palliation is an important target of our treatment.”

For more information, you can (re)watch the presentations via the EMUC25 Resource Centre.

The post Treatment challenges in MIBC: ctDNA, EV-P cost and access appeared first on EMUC25.

On BRCA mutations

In her presentation on BRCA, medical oncologist and EMUC25 Steering Committee member Dr. Elena Castro (ES) stated that lifetime prostate cancer (PCa) risk is significantly elevated in individuals with BRCA mutations, with estimates of approximately 17% for BRCA1 carriers and up to 40% for those with BRCA2. Due to this higher risk, annual PSA screening beginning at age 40–45 is recommended for BRCA2 mutation carriers. In contrast, there is currently no clearly established screening ESMO guideline for individuals with BRCA1 mutations.

Germline BRCA2 is considered an adverse prognostic factor in PCa, while the impact of BRCA1 is less well defined. Patients with PCa who harbour BRCA1 or BRCA2 mutations benefit from close clinical monitoring. Importantly, germline BRCA1 and BRCA2 alterations sensitise tumours to PARP inhibitors.

Men with high-risk localised, locally advanced, or metastatic PCa should be offered germline genetic testing. Currently, there are no clinical characteristics to identify mutation carriers. Dr. Castro added that when a BRCA1 or BRCA2 mutation is detected in tumour tissue, germline origin should be excluded.

PRS for PCa screening

In her presentation “Polygenic risk to guide prostate cancer screening”, oncogenetics research nurse consultant Dr. Elizabeth Bancroft (GB) discussed the potential of using PRS in PCa screening.

PRS is used to estimate an individual’s genetic predisposition to developing a certain disease. However, it only provides the probability, not a prediction. A higher PRS means a higher genetic predisposition to the disease relative to others in the population, and it can be used to risk-stratify populations.

PRS is calculated by summing the effects of single nucleotide polymorphisms (SNPs), which are the most common type of genetic variation among people. There are 451 SNPs identified that are associated with PCa.

Dr. Bancroft discussed the BARCODE1 study, which evaluated the use of PRS (~130 SNPs) to identify those at the highest risk. Those participants in the top 10% were offered PSA, MRI, and prostate biopsy. The BARCODE1 study concluded that PRS found a high proportion of clinically significant PCa in men at higher genetic risk. PSA and MRI missed some significant cancers in this high-risk group.

“PRS is a one-time test using germline DNA, which is constant, unlike other tools such as PSA, which can fluctuate,” stated Dr. Bancroft.

Furthermore, the PRODICT study, which will replicate BARCODE1, was recently launched with an enriched recruitment in Black African, Black Caribbean, East Asian and South Asian populations.

Pathologist Prof. Markus Eckstein (DE), urologist Prof. Juan Gómez Rivas (ES), oncologist Dr. Pasquale Rescigno (GB), radiation oncologist Dr. Noelia Sanmamed (ES), and radiologist Prof. Harriet Thoeny (CH) spearheaded the session.

For more information, you can (re)watch the presentations via the EMUC25 Resource Centre.

The post EMUC25 examines BRCA and PRS in hereditary GU cancers session appeared first on EMUC25.

PSMAddition

Medical oncologist Prof. Scott Tagawa (US) presented the interim analysis of PSMAddition, a phase III trial of ¹⁷⁷Lu-PSMA-617 combined with androgen deprivation therapy (ADT) plus an androgen receptor pathway inhibitor (ARPI) in patients with PSMA-positive metastatic hormone-sensitive prostate cancer (mHSPC).

Dr. Tagawa: “The addition of ¹⁷⁷Lu-PSMA-617 with ADT and ARPI led to a statistically significant improvement in radiographic progression-free survival (rPFS) in patients with PSMA-positive mHSPC, compared to ADT + ARPI. This benefit was consistent across subgroups. There was a positive trend in overall survival (OS), with follow-up for mature data ongoing. The results of the PSA response, PFS, mCRPC, and symptomatic skeletal events (SSE) favoured the ¹⁷⁷Lu-PSMA-617 combination arm.”

In regard to safety, Dr. Tagawa said that findings where consistent with the known profile of ¹⁷⁷Lu-PSMA-617, with no unexpected concerns about the combination with ADT + ARPI. “Adverse events were more frequent in the ¹⁷⁷Lu-PSMA-617 combination arm, most commonly dry mouth, fatigue, and nausea. There were no clinically significant differences in time worsening in health-related quality of life.”

He concluded that the PSMAddition trial findings indicate that combining ¹⁷⁷Lu-PSMA-617 with ADT and ARPI provides a clinically meaningful benefit in patients with PSMA-positive mHSPC.

AMPLITUDE

“This trial is a good example of molecular precision medicine.” Began Dr. Gerhardt Attard (GB) in his presentation on the phase 3 AMPLITUDE trial results: niraparib + abiraterone acetate + prednisone for metastatic castration-sensitive prostate cancer (mCSPC) patients with alterations in homologous recombination repair genes.

Dr. Attard: “The AMPLITUDE trial met its primary endpoint of improved rPFS, with the likely greatest benefit of the combination treatment in patients with BRCA alterations (HR: 0.52). Improvements in rPFS were supported by a statistically significant delay in time to symptomatic progression and a trend toward improved overall survival. There was less than 5% increase in patients discontinuing treatment due to toxicity compared to the placebo.”

He also noted that treatment intensification requires careful patient selection due to the associated increase in toxicity.

He concluded that the AMPLITUDE results support early genomic testing, and niraparib + abiraterone acetate + prednisone as a new treatment option for patients with mHSPC and HRR gene alterations.

CAPItello-281

Dr. Gerhardt Attard (GB) also presented the phase III study of capivasertib + abiraterone versus placebo + abiraterone in patients with PTEN-deficient de novo mHSPC, an important advancement given that these patients typically have a poor prognosis and limited benefit from the current standard-of-care therapy.

From the results he presented, the CAPItello-281 trial met its primary objective, showing statistically significant PFS benefit with capivasertib + abiraterone versus placebo + abiraterone. “The median rPFS of capivasertib + abiraterone was 33.2 months versus the placebo + abiraterone of 25.7 months (HR: 0.81, 95% CI: 0.66-0.98; p=0.034). Consistent benefits were also observed in secondary endpoints and clinically relevant pre-defined subgroups, but overall data were immature, and further follow-up is planned”.

Dr. Attard concluded with, “Capivasertib + abiraterone represents a potential first-in-class targeted treatment for patients with PTEN-deficient mHSPC.”

EMBARK

Dr. Murilo De Almeida Luz (US) presented the overall survival (OS) results from EMBARK, a randomised phase III trial of enzalutamide (enza) or placebo + leuprolide acetate and enzalutamide monotherapy in high-risk biochemically recurrent prostate cancer (HRBCR PCa). This trial began in 2014.

According to the trial results Dr. De Almeida Luz presented, the combination of enza + leuprolide reduced the risk of death by more than 40% versus leuprolide alone in patients with HRBCR PCa, and there was no evidence of metastasis on conventional imaging.

“Enza monotherapy led to numerically lower risk of death versus leuprolide alone, although the difference did not reach statistical significance. The trial results show that significant improvements in time to first use of the new antineoplastic therapy, time to symptomatic skeletal events, and PFS further highlight the benefit of both combining enza and monotherapy. The results show no new safety signals in the long-term safety analysis.”

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You can watch the full presentations, including the other ‘game-changing’ trials presented (CREST, ARASAFE, PACE B+C, and POTOMAC) via webcast recordings at the EMUC25 Resource Centre.

The post The big PCa game-changers for 2025 appeared first on EMUC25.

Session report: EMUC25 invokes mindset shift toward sustainability

“Healthcare is the fifth largest producer of greenhouse gases in the world” was a recurring claim in Plenary Session 1: Innovating for a sustainable future in genito-urinary cancer care: The road to 2050. The session featured sustainability in diagnosis and staging, as well as in treatments for radiation therapy, surgery, and medical oncology.

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Webcasts of the day

Kidney cancer – localised and locally advanced
RCC with venous thrombosis: optimal imaging for surgical planning and imaging-guided surgery
L. Bianchi, Bologna (IT)

Multidisciplinary case discussion: A stromal tumour in an unexpected location: Prostate
S.  Spohn, Freiburg (DE), R.  Flippot, Villejuif (FR), J.  Gómez Rivas, Madrid (ES), R.  Montironi, Ancona (IT), H.  Thoeny, Fribourg (CH)

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Session report on NMIBC: BCG failure, biomarkers and cost-effective treatments

Non-muscle invasive bladder cancer was featured in Plenary Session 4 today, with an insightful lecture from Dr. Chiara Mercinelli (IT) on ‘Failure after BCG systemic treatment”, Prof. Carmen Jeronimo (PT) presenting on “Urinary biomarkers for monitoring of NMIBC”, and Prof. Ashish Kamat (US) sharing the latest data review of the most cost-effective treatments for NMIBC failure.

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Photo impressions of the day

Check out our photo albums of Day 2 of EMUC25 and Abstract Award winners on Facebook. Share your photos and stories on Instagram, LinkedIn, and X as well.

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Best EMUC25 Abstracts

O07: Sasanlimab in combination with Bacillus Calmette-Guérin (BCG) in BCG-naive, high-risk non-muscle-invasive bladder cancer (HR NMIBC): Exploratory analysis of patients with very HR (VHR) disease from the phase 3 CREST trial
E.N. Xylinas, Paris (FR)

O05: Treatment with Oxaliplatin or Cisplatin in Combination with Gemcitabine ± Paclitaxel for Platinum-resistant Germ Cell Cancer: Results from a Multi-institutional Retrospective Study
C. Oing, Newcastle upon Tyne (GB)

O06: Association of Pathologic Response and Survival Outcomes in Muscle-Invasive Urothelial Cancer Following Different Neoadjuvant Therapies
Z. Myint, Lexington (US)

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EMUC25 Resource Centre

Missed a session? All webcasts, videos, posters and full-text abstracts EMUC25 are available via the Resource Centre.

For participants, viewing EMUC25 webcasts will also earn you CME accreditation. Webcasts are accredited up until Monday, 17 November 2025 (13:00 CET).

The post EMUC25: Day 2 highlights appeared first on EMUC25.

“BCG failure is defined as any high-grade disease occurring during or after BCG therapy” said Dr. Chiara Mercinelli (IT) in her lecture on ‘Failure after BCG systemic treatment”. How does this happen? According to Dr. Mercinelli, BCG treatment increases the expression of PD-L1, Tregs, and tumour-associated macrophages, creating an immunosuppressive microenvironment over time. “This PD-L1 upregulation is one of the key mechanisms of immune escape and ultimately explains why some patients become BCG-unresponsive.”

What are the options? Dr. Mercinelli shared the key results of several novel therapies, before summarising these key take-home messages:

• Systemic checkpoint inhibitors restore T-cell function and can enhance or complement the anti-tumour activity of intravesical agents.
• Pembrolizumab is already FDA-approved for CIS BCG-unresponsive, confirming a clinical role for systemic therapy (complete clinical response at 6 months: 36%).
• Trials combining local and systemic therapy (CG0070 + pembrolizumab) show the highest clinical response rates in early-phase trials. Targeted therapy is a valid approach in the NMIBC population.
• Robust randomised trials to compare intravesical and systemic versus intravesical alone are urgently needed to define optimal sequencing and combination strategies.

Prof. Carmen Jeronimo (PT) presented on “Urinary biomarkers for monitoring of NMIBC”. She noted that NMIBC represent the majority of all bladder cancers and have a high recurrence (up to 70%) and variable progression (up to 20%), necessitating life-long surveillance. In her opinion, biomarkers offer the potential to reduce unnecessary cystoscopies and anticipate the identification of high-risk patients in NMIBC. “Urinary biomarkers are ideal for risk-adaptive surveillance – balancing patient burden and recurrence detection.”

She emphasised the need for further validation of the best-performing biomarkers in diverse real-world settings (different populations, different hospitals) and their implementation in clinical practice. She also highlighted that combing biomarker panels with AI driven multimodal surveillance could help individualise NMIBC follow-up.

What is the most cost-effective treatment in NMIBC failure?

According to Prof. Ashish Kamat (US), current options for patients in NMIBC failure are extensive and include immunotherapies, chemotherapy, a combination of both, gene therapies, targeted therapies, device-assisted therapies, and radiotherapy plus immunotherapy. But patients face many treatment considerations, including short-term cure versus short-term gain, quality of life, logistical challenges, anxiety, potential long-term side effects from drugs, and financial toxicity.

Prof. Kamat shared new research (Myers, Talwar et al. 2025) assessing the financial toxicity of five treatments: radical cystectomy, nadofaragene, nogapendekin/BCG, pembrolizumab and gemcitabine/docetaxel, as well as the study CISTO (Gore J, et. al 2025) on the financial impact of bladder-sparing therapy versus radical cystectomy.

He concluded that cost-effectiveness varies by treatment strategy and patient goals, but radical cystectomy remains the most cost-effective overall. Among bladder-sparing therapies, gemcitabine/docetaxel is the most-cost effective single-line option. He noted that multiple sequential therapies offer limited (financial) value, and in his final in comment he stressed that shared decision making is as important as ever.

Visit the EMUC25 Resource Centre to see their full presentations.

The post Strategies in NMIBC: BCG failure, biomarkers and cost-effective treatments appeared first on EMUC25.

Session report: The future of finding cancer

“Without the right clinical question, even the best technology is useless,” said Prof. Konrad Stock (DE), opening a discussion on whole-body MRI (WB-MRI) as a screening tool in healthy individuals. Read this report featuring lectures by Profs. Grant Stewart (GB), Laurence Klotz (CA), and Giuseppe Petralia (IT) on the future directions in early cancer detection.

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Webcasts of the day

Watch the introduction of the patient case here by A. Van Der Heijden, Nijmegen (NL).

Imaging Plenary Session 3
Rapid case debate: Cystectomy without TURBT
Yes, we can
J. D. Kelly (GB)

Imaging Plenary Session 3
Rapid case debate: Cystectomy without TURBT
No, it’s madness
M. Rouprêt, Paris (FR)

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Session report: SPARC, APCCC, and a new RCC tracer

What are the conclusions of the Standardised PSMA PET Reporting Concensus (SPARC)? Are there disparities in the Advanced Prostate Cancer Consensus Conference (APCCC) diagnostics? What is the latest tracer in the diagnosis of kidney cancer? Led by the Chair of the EAU Section of Urological Imaging, Prof. Francesco Sanguedolce (ES), together with nuclear medicine physician, Prof. Karolien Goffin (BE), the “Joint Session of the EAU Section of Urological Imaging and European Association of Nuclear Medicine” provided insights into these questions.

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Photos and Imaging Abstract Award Winners

Check out our photo albums of Day 1 of EMUC25 and Abstract Award winners on Facebook. Share your photos and stories on Instagram, LinkedIn, and X as well.

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Best imaging abstracts

LBO01: Impact of Initial PSMA-PET/CT Staging and PSMA-Targeted Biopsies on Treatment Decisions in Prostate Cancer: Results from the Phase II DEPROMP Trial
P. Krausewitz, Bonn (DE)

O08: The RING study: A European registry of next-generation imaging in advanced prostate cancer – protocol and preliminary findings
D. Chernysheva, Tashkent (UZ)

O12: A retrospective study of the diagnostic performance of CT urography vs. ureterorenoscopy in the follow-up setting of kidney-sparing surgery for upper tract urothelial carcinoma
O. Figaroa, Amsterdam (NL)

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EMUC25 Resource Centre

Missed a session? All webcasts, videos, posters and full-text abstracts EMUC25 are available via the Resource Centre.

For participants, viewing EMUC25 webcasts will also earn you CME accreditation. Webcasts are accredited up until Monday, 17 November 2025 (13:00 CET).

The post Highlights from Day 1 at EMUC25 appeared first on EMUC25.

AI: New horizons in urological practice

In his presentation “AI for pathology reporting”, Prof. Geert Litjens (NL) reviewed diagnostic, prognostic and predictive applications of AI in urological cancers, highlighting that AI can support cancer detection and Gleason grading at expert level.  However, he stresses the continued need for more transparent systems, as seen in the work by Sun et al. in Medical image computing and computer assisted interventions (2025).

Prof. Litjens also emphasised the need for better multimodal integration in AI. “The current AI models lack multimodal integration for accurate biochemical prediction occurrence (BCR)”. He highlights the recent CHIMERA (Combining Histology, medical (radiology) and molecular data for medical pRognosis and diagnosis) Challenge, which aims to advance precision medicine through its uniquely composed multimodal dataset. CHIMERA is a multimodal AI model combining transcriptomics, histopathology and radiology. Tasks include pairing MRI plus pathology of the prostate to predict biochemical recurrence (BCR), and pairing H & E (haematoxylin and eosin staining) plus RNA (ribonucleic acid) data of bladder cancer to predict overall survival. He expects this to have a big impact on AI-driven PCa research.

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“The future is not man versus machine but man with machine”, stated Ass. Prof. Giuseppe Fanelli (IT) in his presentation on ‘prostate cancer pathology in the AI era: Impact and horizons’, where he highlighted that AI tools are powerful assistants, but accountability remains with the pathologists. “Vendors and institutions share responsibility through proper validation, monitoring, and compliance with regulatory frameworks.”

He illustrates how AI is being used for computational pathology with its ability to extract clinically actionable knowledge using computational methods from complex, high-dimensional laboratory and clinical data, thereby yielding more precise diagnosis, disease stratification, and selection of patient-specific treatments.

Ass. Prof. Fanelli stresses that data alone is not enough, analysis tools are required. “There are many vendor solutions and general-purpose machine learning tools, but none satisfied all our requirements, so we built our own.” He shares details of the PathML, which is a fully open-source research toolkit able to support the entire digital pathology research workflow.

The next step to advancing pathology digitalisation according to Ass. Prof. Fanelli is the integration of digital slides data with clinical, radiological and genomic information.

You can watch the full presentations via webcast recordings at the EMUC25 Resource Centre.

The post Controversial issues in urological pathology: a multidisciplinary approach appeared first on EMUC25.

Update on kidney cancer screening

How can we improve survival from kidney cancer? “In my opinion, we need to treat high-risk localised diseased better with drugs around the time of surgery, and critically, to detect it earlier,” said Prof. Grant Stewart (GB) while presenting results from the Yorkshire Kidney Screening Trial, as well as future research plans. The latter explored the feasibility of adding abdominal non-contrast CT to screen for kidney cancer and other abdominal pathology to the chest CT offered within lung cancer screening.”

His results illustrated that from the 4,019 who accepted the scan, 5.3% of participants were found to have serious findings involving one or more organ systems. Only 18 participants needed to be screened to detect one serious finding, showcasing the efficiency of this programme. Ninety-three to identify a suspicious renal lesion, and 402 to confirm one case of renal cancer histologically. (Stewart G et al. European Urology, May 2025)

According to Prof. Stewart, the next step is to test whether abdomen screening can stage shift disease and/or improve disease specific survival. Starting this week, this will be evaluated in a randomised trial, piloted first in the ‘live’ Lung Cancer Screening Programme – TACTICAL1 (Targeted Abdominal CT in Conjunction with Lung screen). This feasibility study adds a non-contrast abdominal CT scan to the Targeted Lung Health Check thorax CT in high lung cancer risk ever-smokers aged 55-60 years.

Rehabilitating PSA screening in North America

According to Prof. Laurence Klotz (CA), “The US and Canadian national guidelines are a mess”, both being inconsistent, as well as outdated, with conflicting interests between methodologists and clinicians. In his lecture, he shared details of his work with the ‘Canadian Coalition for Responsible Health Care Guidelines’, a group formed in 2022 to improve guidelines in Canada.

As a result, the Canadian Task Force responsible for writing the guidelines was ‘paused’ by the Ministry of Health this year, with plans to move towards a more agile ‘living guidelines’ approach. Prof. Klotz stressed the importance of involving colleagues from other specialities to ensure expert representation on guidelines panels.

In his opinion, future PCa screening considerations include how to use PSA optimally – specifically, what upper threshold should prompt further testing and what lower threshold to stop testing, including intervals. He recommends a national screening programme for men at risk, restricting testing to only men who will benefit. The outcome will result in less overdiagnosis and morbidity from treatment, as well as fewer biopsies and missed significant cancers.

Whole body-MRI screening for healthy people: A tool for the future?

“Without the right clinical question, even the best technology is useless,” stated Prof. Konrad Stock (DE) as he opened the discussion on the innovative use of whole body MRI (WB-MRI) as a screening tool in healthy people. He emphasised that different cancer types need different strategies for effective detection.

Prof. Giuseppe Petralia (IT) presented on the pros and cons of using WB-MRI as a cancer screening tool in healthy individuals, detailing both its clinical effectiveness and the ethical considerations. He cited findings from his paper on “Oncology relevant findings reporting and data systems (ONCO-RAD): Guidelines for the acquisition, interpretation, and reporting of whole-body MRI for cancer screening.

According to Prof. Petralia, there is no evidence of its cost-effectiveness, raising questions about who pays for it, and who ultimately benefits – such as high-risk groups for cancers that do not currently have screening programmes (e.g., urinary bladder, kidney, pancreas, liver, non-Hodgkin Lymphoma [NHL]).

“The survival benefit of WB-MRI has not yet been measured, but its use is increasing. Studies report up to 99% abnormal findings, with cancer detected in 1-2% of cases. The main challenge is to minimise harm and avoid over-investigation for the majority, while ensuring optimal management for those with confirmed cancer through expert, multi-organ evaluations”.

Prof. Petralia also elaborated on ethical concerns, particularly around the growing direct-to-consumer WB-MRI market, which bypass traditional physician gatekeeping. Their marketing often emphasises potential benefits and minimises limitations. “It is an unregulated industry with no centralised registry or data on companies operating in this space.” He also stated that there are concerns around a truly informed consent from patients.

You can watch the full presentation at the EMUC25 Resource Centre

The post The future of finding cancer: Detecting earlier appeared first on EMUC25.

Leading voices such as radiation oncologist and one of the session chairs, Prof. Thomas Zilli (CH), together with some of the presenters epidemiologist Prof. Monique Roobol (NL), medical oncologist Prof. Yüksel Ürün (TR), and urologist Prof. Veeru Kasivisvanathan (GB) will provide crucial insights during Plenary Session 1: Innovating for a Sustainable Future in Genito-Urinary Cancer Care: The Road to 2050.

Why the focus on sustainability?

“This session was inspired by a growing awareness that sustainability in healthcare must extend beyond environmental concerns to include economic viability, resource optimisation, and equitable patient access—especially in a field as complex and evolving as GU cancer care where technology and new systemic therapies are growing exponentially,” said Prof. Zilli.

From the perspective of radiation oncology, he noted both the progress and the tension: “We’ve seen remarkable advances in the last decades in imaging, planning, and delivery, but these innovations often come with increased costs, energy demands, and disparities in access. As we look toward 2050, how can radiation oncology continue to evolve in a way that is environmentally responsible, economically feasible, and equitable across diverse patient populations?”

Provoking a mindset shift

Prof. Zilli emphasised that Plenary Session 1 is designed to provide both inspiration and practical tools. “We want to provoke a mindset shift where sustainability can become an integrating part and principle of clinical decision-making, policy planning, and innovation. In addition, we also want delegates to leave with actionable insights such as sustainable technology adoption, frameworks for reducing the environmental footprint of care, or collaborative strategies to address disparities in access.”

The examples he provided included hypofractionation in radiotherapy, artificial intelligence (AI)-driven planning, and cloud-based systems to improve access in underserved regions.

New frontiers

Prof. Zilli highlighted one of the most provocative themes of the session: the intersection of precision medicine and sustainability to provide personalised treatment by means of imaging, biomarkers, AI-driven tools; prevent overtreatment; and reduce waste and costs.

The session will also address ethical and global questions, from equitable access to cutting-edge treatments to the environmental implications of diagnostic and therapeutic pathways.

A sneak peek and dispelling myths

In her lecture, Prostate cancer screening at its best, Prof. Roobol will discuss how prostate cancer screening has evolved from an era of evidence-gathering through randomised trials to one focused on applying these results in healthcare, as Europe prepares to address a disease affecting so many men.

Prof. Roobol also revealed a sustainability myth in her field: “A common myth is that organised prostate cancer screening does not reduce unnecessary healthcare costs, when in reality, it is the only way to sustainably reduce the burden of this disease.”

“In genitourinary cancers, sustainability means integrating evidence-based innovations with rational use of resources,” said Prof. Ürün. In his lecture, Sustainable treatments: Medical oncology, he will provide strategies to optimise treatment duration; select therapies using validated biomarkers; and design sequencing that preserves future options.

He also addressed misconceptions: “Many assume that sustainability conflicts with optimal cancer care, but the opposite is often true. Avoiding low-value interventions, limiting overtreatment, and tailoring intensity to disease biology can improve outcomes and reduce toxicity. From my perspective, sustainable oncology is not a compromise, it is the foundation of long-term quality care.”

“My lecture, Sustainable diagnosis and staging, will discuss delivering the right investigations to the right patient at the right time, whilst minimising harm, cost, and environmental impact. With an ageing population, a surge anticipated in prostate cancer cases, and the introduction of novel imaging techniques, this is an increasingly important topic,” stated Prof. Kasivisvanathan.

When asked about sustainability myths in urology, he said, “A common misconception is that sustainability is not the urologist’s direct problem. However, I believe that urologists need to play an active role in ensuring sustainable care, as we are the ones making key decisions about who to biopsy, which imaging to order, and how to stage patients, which in turn influence the sustainability of the services that we provide.”

Not less, but smarter

Whether in screening, diagnosis, treatment, or long-term planning, the experts highlighted how sustainable practices can reduce waste, lower costs, expand access, and ultimately improve outcomes.

As Prof. Zilli put it, “The goal is to equip delegates not only to think differently but to act decisively in shaping a more sustainable future for GU cancer care.”

EMUC25 awaits you

The congress scientific programme blends the latest developments, actionable insights, and hands-on activities—all designed to make a real impact on your clinical practice and patient care. Join us at EMUC25 and register here.

Have insights, research, or innovations to share as late-breaking abstracts? Be heard, be seen, make an impact—submit your abstract before 1 October 2025 and contribute to the dialogue on optimal GU cancer care.

The post No compromises: GU-cancer care can be effective, equitable, accessible, and sustainable by 2050 appeared first on EMUC25.