Democracy in action! This month's GU Cast Journal Club papers were chosen by an audience vote at our GU Cast Live Event at EAU in London.
Therefore today we focus on first, the landmark proPSMA paper which established the superior accuracy of PSMA PET/CT for staging unfavourable intermediate and high-risk prostate cancer (Lancet 2020). Then for something completely different, we dig out a paper called "Penile fractures - the merry price of Christmas", published in BJUI 2020. Thanks very much to our live audience for this one!

We are delighted to welcome back our GU Cast Journal Club Editors, Dr Carlos Delgado and Dr Elena Berg who joins us in studio for the first time. Elena has just moved to Melbourne to join Carlos doing a Fellowship with GU Cast hosts, Renu Eapen and Declan Murphy.

Links to papers below:
1. Prostate-specific membrane antigen PET-CT in patients with high-risk prostate cancer before curative-intent surgery or radiotherapy (proPSMA): a prospective, randomised, multicentre study. Lancet 2020

2. Penile fractures: the price of a Merry Christmas BJUI 2023

GU Cast Journal Club is supported by our Partner, MSD, through an unrestricted educational grant.

Even better on our YouTube channel

About GU Cast Journal Club:
Each month, two papers are discussed, each of which are of importance to the GU Oncology community. These may be recent papers, or occasionally we will chose a classic landmark paper in GU Oncology
. The objective is to draw attention to important papers in GU Oncology, and critique these in a robust manner
. The key target audience is trainees working in Urology, Medical Oncology, Radiation Oncology, Nuclear Medicine, and diagnostic specialties such as Radiology and Pathology. But any of our regular audience are likely to enjoy this Journal Club series.

The trial they said would never be done! Huge congrats to the Alliance for Clinical Trials in Oncology who have recently opened the ASPIRE trial, a phase III randomised trial of ADT + apalutamide (doublet), vs ADT + apalutamide + docetaxel chemotherapy (triplet) for men with mHSPC. 1200 men will be recruited from more than 300 sites across the US with many sites already open and recruiting. This is the key trial which will answer the question of whether there is an overall survival benefit of adding chemo to the ADT/ARPI doublet which we all agree is standard of care.
We chat with study chair Dr Deepak Kilari (Medical College of Wisconsin) and Dr Rana McKay (University of California San Diego), and learn all about the rationale for ASPIRE, the study design, and the novel genomic stratification factors.
Your usual hosts are Renu Eapen and (chemo-sceptic) Declan Murphy!

This is a Themed Podcast supported by our Gold Partners, Johnson & Johnson Pharmaceuticals.

Links:
Alliance website with study details
Urology Times coverage
Clinical Trials registration

Our biggest live show to date! Taking to the huge eUro 2 auditorium at this month's EAU Annual Meeting in London, Declan and Renu bring you a fast-paced, high-energy session packed with favourite guests, controversial topics, behind-the-scenes stories, and lots of great giveaways, all boosted by having hundreds of our loyal supporters there in the audience with us.

Huge thanks to Maarten Albersen and all at the EAU Scientific Office for this invitation, and to everyone at MediAVentures, M-Events, Congress Consultants, Soma Studios and CMDM Media for helping us put it together. And to our own team including David Chen, Carlos Delgado, and Elena Berg for their help and for being with us in London.

This one for sure best enjoyed on our YouTube channel

Big day at the EAU Annual Meeting n London today, as our colleague Dr James Buteau (Nuclear Medicine Physician, Peter MacCallum Cancer Centre, Melbourne), reads out the PRIMARY 2 RCT at the Practice-Changing Plenary in London. Plus a simultaneous publication in Lancet Oncology. Big news for the early detection of prostate cancer, especially for patients with normal or equivocal MRI scans.

Declan Murphy and Renu Eapen are joined by James and senior author, Prof Louise Emmett (St Vincent's Hospital, Sydney), to discuss the journey from our first PSMA PET/CT scans in 2014, to the proPSMA trial, the PRIMARY trial, and now the PRIMARY 2 RCT. We discuss why this should now mean that patients with a PIRADS 2 or 3 prostate MRI, and a persisting suspicion such as high PSA density, should be considered for a PSMA PET/CT, rather than a systematic biopsy.

Huge congratulations to all the investigators across Australia for seeing this trial through to successful completion, and to all the patients who participated.

Acknowledgements:

Sponsored by Peter MacCallum Cancer Centre, with financial support from the Prostate Cancer Foundation (PCF), St Vincent’s Curran Foundation, ProsTIC, Peter Mac Foundation, NHMRC and ANZUP

Links:
PRIMARY 2 trial in Lancet Oncology

We bring you highlights from a fantastic two day meeting at the ORSI Academy in Belgium, focussing on the hot topic of intra-operative margin assessment (IOMA), especially during prostate cancer surgery. Following on from the publication of the Neurosafe Proof RCT last year, there has been a surge in interest in new technologies to facilitate IOMA, in particular the Histolog confocal laser microscope (Samantree Medical).
Day one consisted of a Delphi consensus meeting with a gathering of world-leading experts in IOMA, discussing how novel technologies like Histolog can be used to assess surgical margins in real time, and thereby improve nerve-sparing surgery. Day 2 consisted of a 12 hour World Robotic Surgery Event (WRSE) run by Surgquest, the digital arm of ORSI Academy, during which very many surgeries used Histolog to assess surgical margins. Just outstanding!
Your usual hosts Declan Murphy and Renu Eapen participated in the Delphi and caught up with many experts to discuss IOMA. A wonderful overview of this hot topic - enjoy!

This one definitely best appreciated on our YouTube channel.

Links:
ORSI Academy
Surgquest
Histolog website

Yes that's right, our great APCCC giveaway is back! We are sending three lucky winners to Lugano to attend the world's best prostate cancer meeting - the Advanced Prostate Cancer Consensus Conference. Just send us a 60 second video to enter.
Closing date Fri 13th June 9pm GMT. Winners will be announced at the GU Cast Live Event at the EAU in London on Sun 15th March 2026.
Full details at gucast.org

Check out APCCC at apccc.org

Welcome to Episode 6 of our monthly GU Cast Journal Club! Two important papers in upper tract urothelial cancer (the POUT trial of adjuvant chemo post nephro-ureterectomy), and metastatic testicular cancer (the SEMS trial of surgery for early metastatic seminoma).

We are delighted to welcome back our GU Cast Journal Club Editors, Dr Carlos Delgado (Melbourne, AUS), and Dr Elena Berg (Munich, GER), along with main GU Cast Hosts, Renu Eapen and Declan Murphy. No prostate cancer today, and go easy on Declan he is struggling with man flu!

Links to papers below:
1. Adjuvant chemotherapy in upper tract urothelial carcinoma (the POUT trial): a phase 3, open-label, randomised controlled trial Lancet 2020


2. Surgery in Early Metastatic Seminoma: A Phase II Trial of Retroperitoneal Lymph Node Dissection for Testicular Seminoma With Limited Retroperitoneal Lymphadenopathy J Clin Oncol 2023

GU Cast Journal Club is supported by our Partner, MSD, through an unrestricted educational grant.

Even better on our YouTube channel

About GU Cast Journal Club:
Each month, two papers are discussed, each of which are of importance to the GU Oncology community. These may be recent papers, or occasionally we will chose a classic landmark paper in GU Oncology
. The objective is to draw attention to important papers in GU Oncology, and critique these in a robust manner
. The key target audience is trainees working in Urology, Medical Oncology, Radiation Oncology, Nuclear Medicine, and diagnostic specialties such as Radiology and Pathology. But any of our regular audience are likely to enjoy this Journal Club series.

It is the eve of the USANZ ASM here in Melbourne (which Renu is Convening!), and some of the 27 International guests are already into town. So we grabbed Anders Bjartell (Lund University/University Hospital Malmo, SWE), for a sit down chat in studio. Anders has been a huge name in prostate cancer research in Europe for the past couple of decades, including as a senior investigator on TITAN. so we decided to pick his brain on three topical areas in prostate cancer:
1. ADT/ARPI doublets in mHSPC - can we adopt an intermittent approach before the trials read out? What about docetaxel triplet therapy?
2. The SPARC consensus on PSMA PET/CT reporting - Anders led this initiative which recently publihsed in Eur Urol. What is this and why does it matter?
3. Organised Prostate Testing - what is the difference between screening and organised prostate testing?

With usual hosts Renu Eapen and Declan Murphy

This is a Themed Podcast supported by our Gold Partners, Johnson & Johnson.

Links:
SPARC consensus paper in European Urology