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Genitourinary Oncology Overview

Genitourinary Oncology Overview. Douglas S. Scherr, M.D. Clinical Director, Urologic Oncology Department of Urology. Clinical/Research Activities. Clinical Activities Surgical Advancements Basic Science Research. Clinical Research Trials. Prostate Cancer Bladder Cancer Kidney Cancer

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Genitourinary Oncology Overview

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  1. Genitourinary Oncology Overview Douglas S. Scherr, M.D. Clinical Director, Urologic Oncology Department of Urology

  2. Clinical/Research Activities • Clinical Activities • Surgical Advancements • Basic Science Research

  3. Clinical Research Trials • Prostate Cancer • Bladder Cancer • Kidney Cancer • Testis/Solid Tumor/Sarcomas

  4. Clinical Research TrialsProstate Cancer • Phase I/II Dose Escalation Trial of Multiple Doses of MLN2704 in Subjects with Metastatic Androgen Independent Prostate Cancer -toxin-conjugated J-591 anti-PSMA • Phase II Trial of 177Lu Radiolabeled Monoclonal Ab J-591 in Patients with Androgen Independent Prostate Cancer • Phase II TCG Chemotherapy + Herceptinas First Line for Metastatic CaP • Phase I Open-Label Study Evaluating Atrasentan (Endothelin-1 receptor antagonist) in Combination with Docetaxel and Estramustine in Chemo-naïve patients with Hormone Refractory CaP

  5. Clinical Research TrialsBladder Cancer • Phase II TCG + Herceptin as First Line for Metastatic Disease • CALBG 90104 Phase III AG-TP vs GC • Observational Immunotherapy BCG Trial • Serum Level-targeted Study Investigating the Safety and Pharmacokinetics of Orally Administered Gallium Maltolate (for those who have failed or unable to tolerate standard chemo)

  6. Clinical Research TrialsKidney Cancer • Phase II Trial of all-trans Retinoic Acid (ATRA-IV) + Interferon alpha in patients with metastatic RCC • Phase I Trial of ATRA-IV and Sodium Valproate (Histone Deacetylase Inhibitor HDAC) in Patients with Advanced Solid Tumor Malignancies • High Risk Adjuvant Trial with Monoclonal Antibody to G250 for Clear Cell Renal Cell Ca

  7. Missing Links in the Clinical Trial Programs • High Risk Prostate Cancer Patientsin Neoadjuvant and Adjuvant Trials • Advanced Pelvic Sarcomas • Upper Tract Urothelial Carcinomas • Greater Effort to enroll in collaborative national trials with Radiation Oncology and Urology • Educate the Voluntary Faculty to Improve patient accrual

  8. Surgical AdvancementsProstate Cancer • Endorectal MRI

  9. * * * Image 8 I 54.44 mm Image 9 I 57.56 mm H H H H H H H H H H H H H H H H H H vc sc vc H H H H H H H H

  10. Pubis Distalanastomosis Urethra Right nerve graft Rectum Proximalanastomosis Left nerve graft Surgical AdvancementsProstate Cancer • Cavernosal Nerve Grafting

  11. Prostate Cancer • Cryotherapy • Uses real time ultrasound to monitor “ice ball” • Adjustments can be made intraoperatively to ice ball based on ultrasound • Uses multiple freeze-thaw cycles to enhance cell kill • Urethral warming catheter used to prevent urethral damage

  12. Robotic Surgery

  13. Surgical AdvancementsTesticular Cancer

  14. Surgical AdvancementsBladder Cancer • Continent Urinary Diversions • Advances in Surgery For Advanced Disease • Total Pelvic Reconstruction

  15. Surgical AdvancementsKidney Cancer • Laparoscopic Renal Surgery • Cryotherapy • Radiofrequency Ablation • Preoperative Histologic Determination

  16. Basic Science Research Efforts • Bander Laboratory • Nanus Laboratory • Scherr Laboratory • Gudas Laboratory

  17. Future Goals • Improve Outcomes Research – Dr. Tewari • Increase Volume of Urologic Oncology • Enhance Collaborative Efforts

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