Advances in the Treatment of Genitourinary Cancer

Highlights from the 3rd Annual Meeting of the Society of Urologic Oncology

MEETING REVIEW Advances in the Treatment of Genitourinary Cancer Highlights from the 3rd Annual Meeting of the Society of Urologic Oncology, December 13-14, 2002, Washington, DC [Rev Urol. 2003;5(4):232–234] © 2003 MedReviews, LLC Key words: Genitourinary oncology • Bladder cancer • Kidney cancer • Prostate cancer • Testicular cancer ecember 13-14, 2002, members of the Society of Urologic Oncology (SUO) convened at the National Institutes of Health in Washington, DC, for their third annual meeting, entitled “Extraordinary Opportunities for Discovery.” The 2-day meeting was attended by more than 100 scientists and physicians representing all areas of genitourinary oncology. D Reviewed by Ganesh S. Palapattu, MD, Hyung L. Kim, MD, and Arie S. Belldegrun, MD, FACS, Department of Urology, The David Geffen School of Medicine at UCLA, Los Angeles, CA 232 VOL. 5 NO. 4 2003 Selected Feature Presentations Several interesting presentations were made by noted leaders in the field of bladder cancer. For example, Michael O’Donnell, MD, from the University of Iowa, discussed promising results regarding the use of interferon plus low-dose bacillus Calmette-Guérin (BCG) for the treatment of BCGrefractory disease. Donald Lamm, MD, from the Mayo Clinic Scottsdale, detailed the importance of a clinically valid definition of BCG failure in patients with bladder cancer. John Stein, MD, from the University of Southern California described the use of lymph node density (ie, the num- REVIEWS IN UROLOGY ber of positive lymph nodes divided by the number of total lymph nodes sampled) as a prognostic marker for patients with bladder cancer treated with radical cystectomy. In the field of kidney cancer, Robert Flanigan, MD, from Loyola University, and Robert Dreicer, MD, from The Cleveland Clinic, discussed the merits of radical nephrectomy in patients with metastatic disease, emphasizing the importance of patient selection if cytoreductive nephrectomy is planned. Arie Belldegrun, MD, from UCLA, presented exciting new data on novel pathologic and molecular prognostic 3rd Meeting of the SUO markers for renal cell carcinoma and results of the treatment of advanced disease with interleukin (IL)-2. Numerous presentations were made on the topic of prostate cancer. Notably, a point-counterpoint discussion on early versus delayed hormonal therapy was led by Edward Messing, MD, from the University of Rochester, who argued for late hor- node dissection for clinical stage I disease. Selected Poster Presentations Ashish Kamat, MD, and colleagues, from MD Anderson Cancer Center, presented interesting work on the effects of a pan-erb-B tyrosine kinase inhibitor, CI-1033, on the growth of transitional cell carcinoma in a These results suggest that FISH may be performed and safely interpreted in patients who are receiving BCG therapy. monal therapy, and Martin Gleave, MD, from the University of British Columbia, who argued the merits of early hormonal ablation for biochemical failure following radical prostatectomy. The technique and results of robotic-assisted laparoscopic prostatectomy were elegantly illustrated with a 3-dimensional presentation by Mani Menon, MD, from Henry Ford Hospital. The early results presented by Dr Menon appear to compare favorably with the established open technique. In the area of testicular cancer, Mark H. Greene, MD, from the National Cancer Institute, discussed the clinical implications of hereditary testicular cancer. Georg Bartsch, MD, from the University of Innsbruck, discussed the technique and promise of laparoscopic retroperitoneal lymph mouse model. After in vivo therapy, treated animals displayed significantly smaller tumors compared with controls, as well as reduced levels of vascular endothelial growth factor and IL-8 and diminished rates of tumor cell proliferation. These find- samples in patients being treated for bladder cancer. These results suggest that FISH may be performed and safely interpreted in patients who are receiving BCG therapy. Matthew Bui, MD, PhD, and colleagues, from UCLA, discussed findings from their analysis of the hypoxia marker carbonic anhydrase IX (CAIX) in kidney cancer. They found that decreased CAIX levels were an independent factor associated with poor survival, even in patients with metastatic disease. Moreover, low CAIX levels may correlate with immunotherapy failure. These compelling data establish CAIX as the most significant molecular marker of kidney cancer uncovered to date and provide a new potential target for therapy. In the prostate cancer section, Shahrokh F. Shariat, MD, and colleagues, from Baylor College of Low CAIX levels may correlate with immunotherapy failure. ings may have important implications for the future treatment of advanced bladder cancer. In another study, Robert Jeffrey Karnes, MD, and colleagues, from the Mayo Clinic, showed that BCG therapy did not affect the ability to interpret fluorescence in situ hybridization (FISH) analysis of collected urine Medicine, presented data on the ability of pretreatment (radical prostatectomy) IL-6 soluble receptors and transforming growth factor 1 serum levels to predict posttreatment biochemical recurrence. These investigators found that levels of these specific markers were significantly associated with recurrent increases in prostate-spe- Main Points • Recent research suggests that the pan-erb-B tyrosine kinase inhibitor CI-1033 holds promise as a potential therapy for bladder cancer. • In patients with kidney cancer, decreased levels of carbonic anhydrase IX (CAIX) were found to be an independent factor associated with poor survival, even in patients with metastatic disease. Moreover, low CAIX levels may correlate with immunotherapy failure. • New data suggest that bacillus Calmette-Guérin therapy does not affect the interpretation of fluorescence in situ hybridizationanalyzed urine samples in patients being treated for bladder cancer. • Interleukin-6 soluble receptors and transforming growth factor 1 serum levels prior to radical prostatectomy have been significantly associated with recurrent increases of prostate-specific antigen. VOL. 5 NO. 4 2003 REVIEWS IN UROLOGY 233 3rd Meeting of the SUO continued cific antigen on multivariate analysis and, furthermore, enhanced the ability of nomograms to predict biochemical recurrence. Incorporation of such serum markers may improve the predictive value of the currently used prostate cancer nomograms. Another study, by Debra L. Bemis, PhD, and colleagues, from Columbia University, found that the herbal preparation and cyclooxygenase-2 inhibitor Zyflamend had a pro-apoptotic effect on the LNCaP prostate cancer cell line in vitro. Further studies of this substance and similar compounds 234 VOL. 5 NO. 4 2003 may uncover new agents for prostate cancer chemoprevention. In addition to the many high-quality plenary and poster presentations made at the SUO meeting, 2 specific moments stand out. One was the Honorary Huggins lecture, given by an individual selected by the SUO as a distinguished leader in the field. This year, the honor was bestowed upon John Grayhack, MD, from Northwestern University. Dr Grayhack delivered an extremely insightful portrait of the past halfcentury in urologic oncology, high- REVIEWS IN UROLOGY lighting many of his personal experiences. The second memorable address was given by Andrew von Eschenbach, MD, director of the National Cancer Institute. His talk underscored the importance of bringing continuity to the different aspects of urologic oncology research. In summary, the third annual SUO meeting was a resounding success. The active participation of known leaders in the field, along with that of more junior scientists, physicians, and trainees, makes this meeting essential for the urologic oncologist.