Declan Murphy
@declangmurphy
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Urologist & Director of GU Oncology, Peter MacCallum Cancer Centre | Professor, University of Melbourne | Podcasting at GU Cast. Views my own. RT = endorsement
Melbourne, Australia
Joined March 2011
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Prostate Cancer Along the Yellow Brick World. Looking forward to this talk at
#eanm21
next weekend! Thanks
@stefanofanti4
@officialEANM
for the invite. Sneak peak
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Well there you go!! 😲
Congratulations to PROFESSOR
@declangmurphy
- just promoted to the position of Full Professor within the Sir Peter MacCallum Department of Oncology
@unimelb
👏🎉
@PeterMacCC
@gu_onc
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What happens if you do a PSMA PET in “M0/non-metastatic” CRPC a là SPARTAN?? Answer - 98% have metastases!
@DrMHofman
@gu_onc
@PeterMacCC
#usanz19
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100
213
@benchallacombe
@nishanturo
Agree Ben. Here is my “standing aside” email for a global meeting I declined recently. No excuses. Convenors should take a position if we are to make a difference
#manel
12
18
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Happening now… Vip Patel using the Edge Medical robot on a patient in Harbin, China. But he is 1200km away in Beijing! Zero latency. Looks like a Da Vinci S HD
#telesurgery
#roboticsurgery
@gu_onc
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47
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Australian Government advisory committee issues positive recommendation for funding of PSMA PET/CT for primary staging and biochemical recurrence. Great day for Aussie prostate cancer patients. Hopefully
@GregHuntMP
will enact soon!
@pros_tic
@DrMHofman
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We are pleased to have our first patient on
#LuTectomy
trial - LuPSMA prior to robotic prostatectomy. Part of our
#UpFront
PSMA grant thanks to
@MovemberAUS
@CancerAustralia
@pros_tic
@PeterMacCC
@EJWFoundation
@Epworth
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Sitting here at
#ESMO23
watching randomized data on thousands of patients showing (yet again) that immunotherapy doesn’t improve outcomes for prostate cancer patients. And causes lots of side-effects. Give up folks!
11
35
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Congratulations to
@lawrentschuk
who has been appointed Head of Urology
@TheRMH
. Congrats Nathan!! Will continue ongoing roles
@PeterMacCC
@gu_onc
@Epworth
@EJWFoundation
and strong links to
@AustinUrology
. Fantastic boost for collaboration, training & research
@USANZUrology
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Looking forward to
#EAU21
next week. Although only virtual, it's still my favourite meeting of the year. Have loaded my "broadcasts", here's a trailer!
@Uroweb
#nomorepowerpoint
#fcpx
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A better question - can some women replace some men on the panel? Jeez. These are all great experts (and friends), but I do hate a
#manel
#ilooklikeasurgeon
#ilooklikeaurologist
Can
#FocalTherapy
replace
#Prostatectomy
in localized prostate cancer?
🗓️Feb/19/2021
⏰12pm ET🇺🇸; 9am PT🇺🇸; 5pm🇬🇧
📝Link
@ThomasPolascik
@pcarroll
@KlotzLaurence
@EmbertonMark
@FocalSociety
@Endo_Society
@NYUUrology
@UCSFUrology
@DukeUrology
@USC_Urology
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Impact factors are out! Well done to all the major urology journals
@BJUIjournal
@EUplatinum
@pcan_journal
@NatRevUrol
@JUrology
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LuTectony team heading towards Milan for
#eau23
.
@RenuEapen
presenting final data in Practice-Changing Plenary Friday am
@DrMHofman
@JonathanSOBrien
@gu_onc
@pros_tic
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3
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Nice break from winter in Melbourne in sweltering Singapore
3
0
101
95% of
@APCCC_Lugano
Panellists DO NOT recommend ARPI switch for mCRPC. Yet why do investigators (many of them Panellists) and FDA approve this as control arm for trials?? “Unethical” says
@AnthonyMJoshua
from the floor, as did
@VPrasadMDMPH
on GU Cast
@gu_onc
#APCCC24
7
36
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Happy St Patrick’s Day from very Irish team
@Epworth
today
@AoifeMcvey
. Including the patient, whose great great grandparents came on a boat fleeing famine in Ireland
#StPatricksDay2023
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Thanks to my old mates
@benchallacombe
@MattBultitude
for taking me to Twickenham yesterday to watch
#ENGvIRE
rugby. And for putting up with this happy Irishman at final whistle! ☘️
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#EAU22
Friendship Dinner. Great to catch up with old friends
@Uroweb
@cgratzke
@EUplatinum
@SigridCarlsson
5
13
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@tsoburol
delivers an outstanding talk to outline his vision for
@BAUSurology
Presidency. A masterful orator and irrepressible leader. Buckle up, its going to be big!!
@GuysUrology
@TUF_tweets
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Fundamental paradigm shift in prostate cancer diagnostics, from
@veerukasi
@mrsprostate
#EAU18
today, and
@NEJM
now online. What a day
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Director of
#Anaesthesia
@PeterMacCC
defaces urology textbooks; and we respond...
@DrDanielMoon
@VicPainGroup
@RACSurgeons
4
8
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So cute these little
#radonc
machines at
#SABR2023
Symposium
@PeterMacCC
. Why do they make them sound like surgery
@_ShankarSiva
@piet_ost
@alison_tree
?! Gamma knife. Cyber knife. Radio surgery 🔪😀
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4
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Always love getting
#maglev
train when in Shanghai. Hit 431km/h today. Fastest train in the world. 30km trip to the airport in 7min
@DrMHofman
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2
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Me to five yr old - "Slow down mate, we have to cycle 25k!" Reply: "My legs don't want to go slow Daddy"
#AroundtheBay
@bicycle_network
#T1D
4
7
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Supporting our Ukrainian friends with my mate
@lawrentschuk
at
#Melbourneprotest
today
#StandwithUkraine
#UrologistsForUkraine
3
7
81
@neerajaiims
@JAMAOnc
@OncoAlert
@urotoday
@dr_coops
@Huntsman_GU
@cdanicas
@GGiannarini
@AzadOncology
@scserendipity1
@SoaresAndrey
@montypal
@nsayeghmd
@BogdanaSchmidt
@ADesaiMD
On first reading, this is totally nuts!!! On second reading, still nuts! Thankfully, this will not be practice-changing. AS is not broken, certainly doesn’t need paradoxical oxymoronic enhancement by adding enzalutamide! GU Cast will dissect next week
@RenuEapen
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#Manels
laid bare in urology
@EUplatinum
; 85-97% male faculty in major urology meetings. Well done
@jteoh_hk
@MariaJRibal
@LoebStacy
et al. Work to do
@AmerUrological
@Uroweb
@SIU_urology
@Endo_Society
#UAA
#manel
#Ilooklikeaurologist
#ilooklikeasurgeon
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Outstanding news!! PSMA PET/CT reimbursement confirmed in Australia for initial staging and biochemical recurrence. All PSMA tracers included. Great day for Australian men with prostate cancer
@PCFA
@MovemberAUS
PSMA PET/CT (Ga-68 and F-18) will be reimbursed in Australia from 01 Jul 22 for staging intermediate-to-high risk and biochemical recurrence. Direct result of Australian led research
@PeterMacCC
@ANZUPtrials
#ARTnet
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Looking forward to talking about Imaging Recurrent Disease at the
#aua21
International Prostate Forum on Sunday
@EdwardSchaeffer
@Tilki_De
@erdemcanda
@FleshnerNeil
Video uploaded
@AmerUrological
Cheers!
3
5
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Entirely reasonable conclusions from
@DrSpratticus
on role of metastasis-directed therapy in oligometastatic prostate cancer. Some fantastic trials highlighted which we need to support rather than just offer in routine practice (which happens a lot and kills equipoise)
#apccc22
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Great to see this old chestnut from
@tsoburol
getting highlighted by
@AlbertoBreda1
in
#eau22
plenary. Why don’t Mercedes Benz do randomised trials? 🤫
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13
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Rugby explained
#ENGvNZL
@tsoburol
@benchallacombe
@MattBultitude
@KearsleyJamie
@birch_emma
@sivanrij
(thanks Susan)!
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I never tire of hearing
@Prof_Nick_James
describe the benefit of multiarm multistage trial design. Took 5 years to open initial STAMPEDE arms in 90 centres; then takes 6 weeks to add every subsequent arm! Incredibly efficient
@mattsydes
#UAA2019
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Our prospective Lu-PSMA study
@PeterMacCC
in Lancet Oncology today. Congrats
@DrMHofman
and team. Patient story here
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Great to see this in press in
@TheLancetOncol
Confirms what many have adopted in practice for years now - early salvage radiotherapy strikes the best balance; never do adjuvant. Congrats to
@TROGfightcancer
@USANZUrology
@ANZUPtrials
and all authors
#RAVES
RCT, signaling end of adjuvant
#radiotherapy
for
#ProstateCancer
. Compared to early salvage, same disease control but adjuvant 3x GU toxicity & overtreats 1/2 of men. No subgroup benefits. Same conclusions in ARTISTIC meta-analysis. Time to move on.
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Myself and wife Lisa
@QuippeMedical
enjoying
@u2
live through the years - 2005 in Paris; 2009 in Dublin; and tonight in Melbourne. Who is ageing the best??!! Easy win for Lisa!!
#U2Melbourne
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@prokarurol
shows world’s first cadaveric robotic prostatectomy using new
@CMRSurgical
Versius robot. Doesn’t look as wristy as a daVinci, but prokar says it works well. Nice to see some competition!
#erus18
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Very proud of my nephew Sam who has just become the Irish Boys Golf Champion. What a star! 18 birdies over three rounds. Not sure have I hit 18 birdies in past 30 years. He’s looking for a US golf scholarship
@urogeek
, watch out!
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Does your anaesthetist chop down fresh rhubarb from his garden at 6am and leave by the console after a long day of prostate cancer surgery??! Cheers Chris Scarff!
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Myself and
@RenuEapen
little podcast project getting lots of downloads from all around the world
@this
month. Thanks to all the great guests who have joined us! Search GU Cast in usual places or find here
@Spotify
2
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Kicking off my sabbatical this week with a course on nuclear medicine at
@royalmarsdenNHS
@ICR_London
. Thanks to my mate
@DrMHofman
for igniting my interest. I am now encouraging him to do a sabbatical focusing on cancer surgery!
#nuclearurology
7
5
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Rome for a day trip today. Ancient and beautiful as ever
4
1
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“Avoiding obsolescence as a cancer surgeon”. Thanks
@RSMUrology
for asking me to talk about this at your Winter Meeting in Andermatt! From the beach in Noosa
#scicomm
4
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Review of procedure reimbursement by Australian Government leads to 20% increase in fee for transperineal prostate biopsy, and 50% REDUCTION in fee for transrectal biopsy! Driven by patients on review panel. Will other countries follow suit??!
#trexit
7
22
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Myself and
#USANZ23
Scientific Chair
@Goldurol
very excited to welcome Faculty and delegates to Melbourne for
@USANZUrology
ASM, kicking off today. Thanks especially to international faculty for coming down under
0
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Black tie glamour at
#EAU19
Friendship Dinner
@aherlema
@SimaPorten
@Caba_L
@UroDocAsh
@cgratzke
@dr_coops
@wandering_gu
@pcvblack
@jenniferrrider
2
7
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GU Cast/Uromigos podcast love-in at
#EAU22
@RenuEapen
@ChrisSweens1
@tompowles1
@Uromigos
@gu_onc
. Missing you
@brian_rini
!
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Love the morning ride to work in late Melbourne Summer. Down by the Yarra, past
@MCG
and
#AusOpen
, through CBD up to
@PeterMacCC
. AirPods in, favourite podcasts playing. Lovely start to the day
@bicycle_network
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2
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@neerajaiims
@OncoAlert
@PCF_Science
@urotoday
@guconnectinfo
@DrChoueiri
@montypal
@umangtalking
@TiansterZhang
@Huntsman_GU
@AzadOncology
@apolo_andrea
@shilpaonc
@PGrivasMDPhD
@Silke_Gillessen
Big sigh. Totally unsurprising. Yet another failed trial of immuno-oncology in metastatic prostate cancer. Can we please stop now? It’s never gonna work; toxicity is not OK; and the costs are ludicrous (hence the enthusiasm to persist). Try a different cancer folks
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5
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Hello twitter, I’ve taken a few months off to re-charge
#twitterdetox
. But I’m back! What a great
#GU18
in San Fran this week. Truly fabulous multidisciplinary GU Oncology and great to catch up with friends
@ASCO
2
3
57
Nice to share a
#StPatricksDay
Guinness with old friends
@mrsprostate
and
@Prof_Nick_James
in London today
0
2
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Congrats to our Peter Mac Cancer Surgery Team - top ranked team raising funds for
@PeterMacCC
#unitetofightcancer
And great fun along the way! Over $1.5m raised for cancer research
@PeterMacRes
@PeterMacRadOnc
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6
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@DrMHofman
@Uroweb
Spectacular LuTectomy case with PSA 340 and 5cm lymph node. Excellent PSA and imaging response with straightforward surgery and PSA undetectable at one year
#eau23
1
12
57
Stop the press - Nuc Med invade the operating room.
@DrMHofman
turned up in the OR today to oversee a
#LuTectomy
robotic prostatectomy and predicts
#LuPSMA
will render us obsolete 😂
Thanks
@declangmurphy
@OmarAlghazo86
for teaching me how to perform a prostatectomy today. The robot makes it all surprisingly easy. Next, I will reciprocate and teach the surgeons how to read PSMA PETs. Pt
#9
on our LuTectomy study
@gu_onc
1
7
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3
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Totally horrifying. Urology world devastated to lose such a talented and fabulous young star. So sad for his family and friends and all who tried to save him. Vale
@dan_christidis
3
13
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2018 impact factors are out.
@NatRevUrol
continues big rise; most else remain steady. Thanks Annette Fenner for the table and well done to your team!
1
17
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I find a good Guinness in a local Irish bar is a great way to kick the jetlag every time i land in Europe (level 4 evidence). And also toasting wife
@QuippeMedical
on her birthday back in Melbourne! 😘🎂
#aaeu19
@Uroweb
0
1
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Highly anticipated Brisbane RCT of open vs robotic RP coming in Lancet next week. Brace yourselves!
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39
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Most enjoyable session at virtual
#eau20
! But looking forward to return of physical meetings at some stage
#eau21
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2
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This funny patient day 1 post-robotic prostatectomy insisted we play leprechaun dress up games prior to discharge. He’d “earned” the merch in an Irish bar one St Patrick’s Day and brought into hospital! Happy to wallow in my Irishness 🇮🇪 ☘️
3
1
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“It’s unethical to prescribe ADT alone for metastatic prostate cancer”. Strong words from Urologist Prof Fred Saad on latest GU Cast. Also, “urologists shouldn’t dabble in metastatic prostate cancer”. Don’t be a dabbler!
Urologists take note! ARPIs getting reimbursed for mHSPC. GU Cast is back with with Fred Saad,
@ciaraconduit
@RenuEapen
@declangmurphy
1
5
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Myself and
@eliomazzone
getting anxious about the updated EAU Prostate Cancer Guidelines about to be released in Paris!!
#urology
#eau24
#podcast
#prostatecancer
@uroweb
@gu_onc
4
7
52
I haven’t sat through a stone lecture for at least a decade. If they’re all as good as this one on complications by
@sproietti81
at
#USANZ22
I might just sit through a few more!
#everybodylovesstones
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5
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Prospective LuPSMA study
@DrMHofman
@PeterMacCC
in Lancet Oncology. Hopeless group of mCRPC patients (see baseline characteristics); well tolerated, some truly dramatic results. RCT underway
@ANZUPtrials
1
24
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Good morning on Day 1
#usanz18
. Myself and
@lawrentschuk
looking forward to a great few days. Welcome to our fantastic
@USANZUrology
Faculty
5
13
51
Happy team after performing first case on the new
@Epworth
robots. Six new robots up and running; 2 x Xi dual console; 2 x Xi single; 2 x X single.
@OmarAlghazo86
@device_robotics
@cancerspec
1
6
51
I love visiting my USA friends but your coffee is terrible! Nice to be home
@Melbourne
#AUA16
#latteart
#coffee
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Or even earlier! Our
#LuTectomy
trial is well underway. 1-2 cycles of Lu-PSMA prior to surgery
@gu_onc
@pros_tic
@EurUrolFocus
@DrMHofman
@RenuEapen
@OmarAlghazo86
@DrDanielMoon
@lawrentschuk
We agree! See
#UpFrontPSMA
- our Ph II study of ADT + Docetaxel +/- Lu-PSMA x 2 in de novo high volume mHS
#ProstateCancer
. Currently recruiting very well. See attached infographic (credit
@DrMHofman
) and protocol paper.
#ASCO21
@ASCO
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17
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Weird seeing US friends get excited about HIFU. Nearly 10yrs since we suspended HIFU program due to bad outcomes
5
40
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This will be our single most enduring family investment of
#covid19
#lockdownMelbourne
. Can’t see myself or the two boys going back to the barber other than maybe an annual repair job!
2
1
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My friend John Yaxley (who performed all the open RP in the Brisbane RCT of open vs robot RP), demonstrates his nerve-sparing approach during robotic RP. That’s right, he doesn’t perform open RP any more
#evidencebasedmedicine
#ebm
#APCC18
4
14
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That’s the end of that methinks. As expected, fluciclovine-based PET imaging pretty useless compared with PSMA. Not sure why amino acid-based Imaging was ever expected to perform well in detecting low volume prostate cancer
Fluciclovine (Axumin) vs PSMA PET-CT in biochemical recurrence: the results are in and there is a clear winner - 26% be 56% detection rate.
@gu_onc
proud to contribute this
@UCLATheranostic
research.
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0
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Enjoying a multidisciplinary beer with my very talented
@PeterMacCC
colleagues
@AzadOncology
@DrMHofman
. Protocol writing and plotting the next array of PSMA-themed studies
#pcsm
@gu_onc
@PeterMacRes
3
0
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Finn’s 12th birthday today and he is out on his bike. Chooses his own soundtrack! Happy birthday Finny!
2
0
47
Dr Walsh has updated his famous book, now in 4th edition. Very chuffed to get a signed copy at
#APCC18
@brady_urology
2
2
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Imaging gurus
@APCCC_Lugano
Ken Herrmann
@ProfPadhani
@stefanofanti4
@DrMHofman
. Almost every session here today is dominated by imaging questions. Good to have you here!
#apccc22
0
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GU Cast has reached >750 downloads in its first month! Thanks to all who have contributed. Please send topics and let us know if you want to get involved
@PeterMacCC
@declangmurphy
@RenuEapen
@DrDanielMoon
@DrMHofman
1
9
45
#anzup19
MDT sessions - highly entertaining! “I get a PSMA PET/CT on every patient - low/intermediate/high risk, and some pre-biopsy. It helps with AS selection. Patients happy to pay.” 😳 PSMA = Prostate Scanning Madness Abounds 😂😂😂
@Prof_IanD
@ANZUPtrials
2
9
45
Myself and my personalized
#MannekenPis
(gift from
@EveraertsW
) defiant today during consulting
#JeSuisBrussels
0
16
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Outstanding!
#UpFrontPSMA
: Randomised Controlled Trial using Lu-177 PSMA first-line rather than last-line in men with newly diagnosed advanced prostate cancer (hormone-sensitive). Launched today at Peter Mac. Big milestone. Thanks
@MovemberAUS
for funding this world first trial.
@AzadOncology
4
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1
7
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Bringing
#LuPSMA
another step forward. Another prospective randomized trial from Australian teams, led by
@AzadOncology
@PeterMacCC
@gu_onc
Just Published: UpFrontPSMA: A Randomised Phase 2 Study of Sequential 177 Lu‐PSMA617 and Docetaxel versus Docetaxel in Metastatic Hormone‐Naïve
#ProstateCancer
by
@declangmurphy
@DrMHofman
and colleagues
0
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1
7
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46yo, cT3, ISUP GG 5, PSA 14. CT/bone scan normal; PSMA PET (proPSMA RCT) extensive pelvic and RP nodes up to L4. Your thoughts please
@ChapinMD
and urotwitterati
24
15
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4
4
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What are your thoughts on
#precision
? As enthusiastic as me? Or perhaps more skeptical?!! Add your comments to
@BJUIjournal
blog
#eau18
New on Blogs
@BJUI
- PRECISION delivers on the PROMIS of mpMRI in early detection of
#ProstateCancer
by
@declangmurphy
#EAU18
1
43
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4
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Spectacular live surgery display
#erus18
. Gigantic 3D HD displays with parallel robotic surgeries; >600 delegates in beautiful Marseilles. Looking forward to doing a live RARP with
@lambwben
tomorrow. Fantastic logistics
@Uroweb
@ERUSrobotics
2
4
44
GU Onc team
@PeterMacCC
officially supporting Belgium 🇧🇪 tonight in honour of current fellow
@ElodieBeels
(pictured here with my surgical Manneken Pis), and past Fellows
@EveraertsW
@SiskaVB
! Sorry French friends! Go
@BelRedDevils
1
7
43
Wonderful morning with colleagues, kids, friends, and some inspiring patients - $1.3m raised for
@PeterMacCC
#unitetofightcancer
1
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@_ShankarSiva
provides some very compelling arguments for SABR for oligometastatic renal cancer. Likely very underutilized albeit best data is relatively recent
#gu23
@gu_onc
@PeterMacRadOnc
1
11
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@ChapinMD
@dr_coops
@LondonProstate1
@BadarMian1
@jimhumd
@urogeek
@CanesDavid
@daviesbj
@jdhdavis
@fabriziodalmoro
@uretericbud
@matthayn
@DrMHofman
@UCSFCancer
PSMA costs USD$500 here. I am opening a new medical tourism agency offering PSMA-themed trips to Australia. Take in the Great Barrier Reef/Australian Open/Melbourne Cup/F1 etc. We can tailor to your interests! Cheaper to fly business class from US for a scan and have a holiday 😂
10
7
43
Can you believe it took myself,
@dr_coops
and
@DrMHofman
four hours to cycle 8km around the Alster Lake??!
#hamburgsummit
@Tilki_De
5
1
43