Leo Reis MD MSc PhD MBA Fulbright UroScience

Accrual to cancer RCTs is very poor. Keeping the product (ie the trial) the same but changing the advertising has a very small effect doi.org/10.1002/cam4.7…. Alternatively , change the product pubmed.ncbi.nlm.nih.gov/39410769/: it is possible to rapidly accrue to large, single-center RCTs

Bladder Cancer Immunotherapy in 2025: ALBAN, CREST, POTOMAC, and the Winner Is BCG! intbrazjurol.com.br/pdf/vol52n02/e…

The molecular pathology of prostate cancer: an update for practising pathologists onlinelibrary.wiley.com/doi/10.1111/hi… This review summarizes the evolving 🧬molecular pathology🔬 of #ProstateCancer , highlighting key somatic and germline alterations relevant to clinical practice. Tumorigenesis is driven by transcription factor dysregulation, including C-MYC overexpression, ETS gene fusions such as ERG, and mutations in FOXA1. Molecular progression involves early driver events followed by subclonal alterations like PTEN loss. The article emphasizes biomarker testing and provides practical insights for surgical pathologists in diagnosis and clinician communication. @AngeloDeMarzo1 @OncoAlert 🚨 @Silke_Gillessen @AOmlin @weoncologists

How can artificial intelligence transform the training of medical students and physicians? sciencedirect.com/science/articl… via @nliulab et al @CoryRohlfsen @RichardLehman1 @raj_mehta

Detection of multiple diseases via a cell-free DNA methylation blood test at low cost pnas.org/doi/10.1073/pn…

Interesting technique taking advantage of iodinated contrast’s high fluid density to create a clear optical window to view the trigone during cysto in the setting of hematuria - @jpurology @lukha33

MEATIC technique (@lukha33) looks very useful. Will try instilling iodinated contrast in cystoscopy for clearer view of the ureteral orifice when there is a bloody field. sciencedirect.com/science/articl…

In the EV era are we underusing local control? 🚩Among 459 patients with advanced urothelial carcinoma> just 108 received bladder-directed therapy after EV pub alert @CleClinicUro @UrolOncol 💡Cystectomy had the strongest survival signal in select pts supporting earlier multi D discussion @hjwang26 @MoningiShalini @AmandaNizamMD

A new paper published in Nature Astronomy says if LLM can easily replicate what counts as your scientific contribution, then the deeper problem is not the model, but the fact that the work was too routine, formulaic, or low-value to begin with. --- nature .com/articles/s41550-026-02837-2

Redefining the Landscape of Genitourinary Cancer Precursors: The International Society of Urological Pathology Consensus Recommendations I am pleased to share that our Platinum Opinion article in European Urology @EUplatinum （journal impact factor 25) is now available online and indexed in PubMed (PMID: 41934039). This work represents the outcome of the ISUP Florence Multidisciplinary Consensus Conference, which established a contemporary framework for the definition and reporting of genitourinary cancer precursor lesions. By clarifying areas of consensus and highlighting key knowledge gaps, these recommendations provide practical guidance for the diagnosis and management of premalignant lesions in genitourinary cancers. Free full-text access:
authors.elsevier.com/a/1mtG514kpm4a… europeanurology.com/article/S0302-…

🚨 p53 is the most mutated gene in cancer… but still NO approved reactivator. That may finally be changing. A new wave of mutation-specific p53 reactivation is showing real clinical signal 👇 🧬 Why this matters ~50% cancers harbor TP53 mutations Tumor suppressors need restoration, not inhibition → historically “undruggable” 💊 The shift: precision reactivation Old approach ❌ “one-size-fits-all” (APR-246) → weak activity New approach ✅ mutation-specific targeting 👉 Rezatapopt (PC14586) Targets Y220C p53 pocket → refolds mutant protein 📊 PYNNACLE trial • ORR: 19.7% (14/71) • KRAS WT: 30.4% • KRAS mutant: 0% • Grade 3–4 AEs: ~50%, no grade 5 📌 Biology-driven selection = real signal 🧠 Big shift Not all p53 mutations are equal → Structural mutants can be rescued → Needs mutation-specific drugs + basket trials 🎯 Takeaway We are entering: 👉 Targeted therapy for tumor suppressors 👉 Ultra-precise oncology 🔖 Save this: p53 is back 📖 Full paper in comment ⬇️ #OncoTwitter #MedTwitter #PrecisionOncology #TargetedTherapy @OncoAlert @myesmo @esmo_open @ASCO @NEJM

Phase 3 KEYNOTE-905/EV-303 trial: Patients with muscle-invasive bladder cancer who are ineligible for cisplatin often proceed directly to surgery. Research evaluating perioperative enfortumab vedotin plus pembrolizumab is summarized in a new Quick Take video. nejm.org/do/10.1056/NEJ…

MRI before prostatectomy isn’t just staging… it’s prognostic. New meta-analysis in JAMA Oncology shows MRI predicts outcomes independently. 🧵 📌 Study: Pretreatment MRI as prognostic factor after radical prostatectomy 📊 40 studies | 24,941 patients 👨‍⚕️ Population Men undergoing radical prostatectomy with pre-treatment MRI ⚔️ Key MRI features → Strong outcome predictors 🔴 Extraprostatic extension (mrT3a) •BCR: HR 2.16 •Metastasis: HR 3.18 •Cancer-specific mortality: HR 10.9 (!!) 🔴 Seminal vesicle invasion (mrT3b) •BCR: HR 2.74 •Metastasis: HR 5.58 📊 Quantitative MRI also matters •PI-RADS 4–5 → HR ~2.1 •Tumor ≥20 mm → HR ~2.35 •Low ADC → HR ~2.4 💡 Key insight MRI adds independent prognostic value beyond PSA, Gleason, and pathology 👉 Not just imaging 👉 A biologic risk signal before surgery ⚠️ Practice-changing angle MRI T-staging may be stronger than DRE-based clinical staging → Enables better pre-op risk stratification → Potential for treatment intensification / de-escalation 🎯 Takeaway If you’re still using MRI only for staging… You’re underusing it MRI = prognosis + decision-making tool 🔖 Save this for clinic discussions 📖 Full paper in comment ⬇️ #OncoTwitter #MedTwitter #ProstateCancer #UroOncology @OncoAlert @myesmo @esmo_open @asco

🚨Preop MRI before radical prostatectomy isn't just for surgical planning, it predicts survival.🚨 New meta-analysis (n=24,941) in @JAMAOnc : 🔬 mrT3a (EPE): HR 2.16 for BCR, HR 10.93 for PCSS ⚠️ mrT3b (SVI): HR 2.74 for BCR, HR 5.58 for MFS 📊 PI-RADS 4/5: HR 2.15 for BCR 📏 Tumor >20mm: HR 2.35 for BCR 🌊 Low ADC (<0.9): HR 2.39 for BCR All independent of PSA, Gleason, and pathologic stage. 🧲 Your preop MRI is a prognostic biomarker. Start treating it like one! 🔗shorturl.at/yq3q9 @PCFnews @PCF_Science @UrologyTimes @urotoday

🚨 Excited to share our review on “New approach methodologies for drug discovery,” published in @CELL and selected as a Featured Article. 🔗sciencedirect.com/science/articl… @WenqiangLiu0201, @pdpang, @StanfordDeptMed, @StanfordDeptMed, @StanfordMed, @ncats_nih_gov, @NIH, @GreenstoneBio

Unveiling the Clinical Potential of Prostate Cancer Three-dimensional Models: A Systematic Review euoncology.europeanurology.com/article/S2588-… Patient-derived organoids and slice cultures provide 3D models that preserve #ProstateCancer architecture and molecular features. This systematic review found variable establishment success but strong genomic🧬 fidelity, maintaining key alterations and tumor heterogeneity. Organoids enable biomarker🎯 discovery and drug testing, reflecting clinical responses and resistance mechanisms. Despite limitations such as low scalability and absent microenvironment, these models show strong potential as precision oncology tools for personalized treatment strategies. @ArthurPeyrottes @NorbertDEBREK @MRoupret @UrologieParis @MejeanArnaud @CharlesDariane @OncoAlert 🚨 @Silke_Gillessen @AOmlin @weoncologists

🔹 @IBCG_BladderCA IR stratification → now in @NCCN guidelines 🔹 Our new @BJUIjournal study supports & simplifies it 🔹 3 factors → low / intermediate / high risk IR NMIBC Easy to use in a busy clinic. No loss in accuracy. A practical tool for real🌎 #BladderCancer @ClevelandClinic @CCLRI @CleClinicUro as always free access >> doi.org/10.1111/bju.70…

"Where and how people live may be as important for brain aging as the specific disease they develop." Physical and social exposome factors associated with accelerated brain aging across 34 countries Physical factors primarily linked with structural MRI brain aging; social with functional aging @NatureMedicine

Wow

Radiographic Progression With and Without Prostate-Specific Antigen Rise in Patients With Advanced Prostate Cancer Treated With Enzalutamide ascopubs.org/doi/10.1200/JC… This post hoc analysis of ARCHES and PROSPER trials found that radiographic progression (rPD) without PSA rise occurs in a notable subset of patients treated with enzalutamide in mHSPC and nmCRPC. Discordance between imaging and PSA was more frequent with enzalutamide than control. Patients with rPD had worse overall survival, and liver metastases were more common. #ProstateCancer Findings support routine imaging surveillance despite stable or nonrising PSA levels. @AarmstrongDuke @AzadOncology @AStenzl @cnsternberg @OncoAlert 🚨 @Silke_Gillessen @AOmlin @weoncologists