LUGPA 2025 Global Prostate Cancer Congress Enduring Program-2025 GPCC Session 2

Video Transcription

Video Summary

This session focused on advanced approaches in prostate cancer diagnosis, risk stratification, and management, involving expert talks and interactive case discussions.<br /><br />Dr. Michael Liss moderated presentations emphasizing integration of clinical, genomic, imaging, and microbiome biomarkers. Prostate-specific antigen (PSA) density was highlighted as a strong predictor of prostate cancer progression during active surveillance, where values above 0.15 correlate with higher grade progression. Genomic classifiers like Decipher and AI-based tools such as Artera AI help reclassify patients’ risk beyond traditional staging, influencing treatment decisions particularly regarding active surveillance versus intervention. Imaging modalities, notably multiparametric MRI with PIRADS scoring and PSMA PET scans, serve as biological markers; higher PIRADS and PSMA SUV correlate with more aggressive tumors and biochemical recurrence risk. Concordance among imaging and genomic markers enhances prognostic accuracy.<br /><br />Microbiome research revealed specific urinary bacteria linked to prostate cancer progression and therapy response, opening avenues for novel biomarkers and personalized treatment.<br /><br />Screening discussions covered the new AUA guidelines recommending baseline PSA testing from age 40-45 (higher risk) or 45-50 (average risk), utilizing shared decision-making incorporating risk calculators, advanced urinary biomarkers, and MRI to refine biopsy necessity and reduce overdiagnosis.<br /><br />Clinical cases illustrated challenges in managing discordant biomarker findings and the utility of combining urine tests, MRI, and genomic data.<br /><br />Radiation oncology sessions outlined genomic and AI biomarkers guiding hormonal therapy use alongside radiation, with trials like NRG-GU-010 tailoring ADT duration based on Decipher scores.<br /><br />The PC Markers website was introduced as an educational resource for clinicians and patients to navigate the complex biomarker landscape.<br /><br />Finally, genetic counseling referral patterns improved post-2018 NCCN guideline expansion, with ongoing efforts needed to enhance germline testing in high-risk prostate cancer.<br /><br />Overall, integrating multi-modal biomarkers promises personalized, less invasive, and more precise prostate cancer management.

Keywords

prostate cancer

risk stratification

PSA density

genomic classifiers

Decipher

AI tools

Artera AI

multiparametric MRI

PIRADS scoring

PSMA PET scans

microbiome biomarkers

AUA screening guidelines