Precystectomy ctDNA burden is predictive of poor oncological outcomes. Presentation by @ahmederaky @MountSinaiNYC. #SUO25 written coverage by @RKSayyid @UAUrology > https://t.co/9dU6ooQrzO @Uroweb #SUO2025

Honored to receive the SUO ‘Paper of the Year.’ I am sincerely grateful to my mentors at Mount Sinai for their constant guidance, high standards, and generosity with their time,this recognition reflects their mentorship as much as the science. #SUO2025

The whole medical publishing ecosystem (free content, free peer review, but $$ to publish/read) is a bizarre, exploitative business model. Even if one believes clinicians owe some degree of unpaid "academic service," it’s absurd publishers profit so massively off our free labor.

1/5 Just out 👉@NatRevClinOncol "Biomarkers in UC". HER2, FGFR3, PD-L1 are approved and ctDNA is becoming a reality. We address methodological inconsistencies, need for standardization & AI integration 🔗Open access – https://t.co/15VURJXPiu @OncoAlert @tompowles1 @b_szabados

More importantly descaltion could be possible for presistanlty ctDNA-negative patients with 95% DFS at 1 year 88% at 2 years

1/2 KN905 Enfortumab Vedotin + Pembro continues to transform bladder cancer in spectacle fashion. In cisplatin ineligible operable disease it beats cystectomy with EFS HR 0.4, OS HR 0.5. pCR of 57% is much ⬆️ than anything before #ESMO25 pCR> 50% questions unselected surgery

📢📢 ctDNA and testicular cancer! https://t.co/wxJcMZT7qv We are not there yet ‼️—> but with further investigation, I believe that ctDNA will ultimately demonstrate its merits in guiding decision-making and optimizing the management of testicular cancer. In our study, we

The October 2025 issue of The Journal of Urology® is here! Stay current with cutting-edge research, clinical insights and global literature in the most cited journal in the field. Read here! ➡️ https://t.co/nQlkBDmINl #TheVoiceOfUrology #Urology #AUA

Grateful to work with world giant Dr. @AshTewariMD & my mentor @MehrazinMD — their leadership and vision made this possible. Excited to see how PSMA PET/CT shapes the future of prostate cancer care. 🙏

Takeaway: PSMA PET/CT outperforms MRI & established risk models for nodal staging in intermediate-risk PCa. It may redefine PLND decision-making & improve patient outcomes.

Most striking: 💡 99% of PLNDs could have been safely avoided in PSMA-negative pts. That means fewer complications, shorter recovery — without sacrificing oncologic safety.

PSMA PET/CT results: 📌 Sensitivity 80% 📌 Specificity 87% 📌 NPV 99% 📌 AUC 0.83 ➡️ Superior to MRI (sens 0%, AUC 0.47) & nomograms (AUC ≤0.69).

We studied 189 men w/ intermediate-risk PCa who underwent: ✅ Radical prostatectomy ✅ Bilateral PLND ✅ Pre-op [18F]-DCFPyL PSMA PET/CT Performance compared vs MRI & nomograms (Briganti 2012, Briganti 2023, MSKCC).

PLND has been standard in radical prostatectomy, but: ⚠️ Most intermediate-risk pts have no nodal mets ⚠️ PLND adds morbidity (lymphocele, lymphedema, VTE) ⚠️ MRI & nomograms lack accuracy We need safer, more precise staging.

🚨 New in J Urol: Our team @MountsinaiUro evaluated [18F]-DCFPyL PSMA PET/CT for nodal staging in intermediate-risk #ProstateCancer. Could this imaging tool spare men unnecessary pelvic lymph node dissection (PLND)? 🧵👇 🔗

From surveillance (our work) ➡️ to treatment selection (IMvigor011), ctDNA is reshaping #BladderCancer care. 👉 Avoid overtreatment in ctDNA− pts 👉 Intensify therapy in ctDNA+ pts A clear step toward personalized, biology-driven pathways in uro-oncology.

Now, Phase III IMvigor011 proves that ctDNA signal can also guide adjuvant therapy: 📈 ctDNA+ pts treated with atezolizumab had significant DFS & OS benefit 📉 ctDNA− pts did well without adjuvant treatment This is the first prospective phase III validation of ctDNA in #MIBC.

🔑 We recently showed @EurUrolOncol that ctDNA can safely guide surveillance after cystectomy: ✔️ Sensitivity & NPV = 100% ✔️ Median ~3-mo lead time vs imaging ✔️ No recurrences in persistently ctDNA negative pts

JUST IN: IMvigor011 in muscle-invasive bladder cancer (MIBC) hits both DFS & OS with PD-L1 inhibitor Atezolizumab in ctDNA+ population. Major news for Precision Oncology in adjuvant Solid Cancers! @NateraGenetics @tompowles1 @Roche https://t.co/OlOirNfWHo

I was lucky to attend the SP symposium and learn from SP experts. To stay ahead of the curve, it’s crucial to embrace innovation and leverage technology to maximize the benefits for our patients.