编者按：随着诊疗技术的快速发展，尿路上皮癌、前列腺癌等常见泌尿男生殖系统肿瘤的精准治疗研究和实践经验越来越丰富。在近日举行的2025年欧洲泌尿外科学会年会（EAU25）上，我国香港中文大学Jeremy Teoh（张源津）教授和四川大学华西医院鲍一歌教授均有重要研究成果入选大会交流或者获得殊荣嘉奖，展现了中国泌尿外科学者的学术实力和风采。《肿瘤瞭望》有幸邀请两位专家在现场进行精彩对话，分享其团队研究成果以及尿路上皮癌、前列腺癌精准治疗的研究进展和实践经验。

EAU“中国风”正起
港中大和华西研究成果引人瞩目

01
《肿瘤瞭望-泌尿时讯》
首先，我想请两位以各自的研究成果或研究兴趣来开启这次对话交流。我们知道鲍教授一项研究入选这次EAU大会，在UTUC患者中使用ADC联合免疫治疗的保肾策略，能否分享一下该研究成果？

鲍一歌 教授

四川大学华西医院

当然，非常高兴也很荣幸在此分享我们在 UTUC 保肾治疗方面的一些研究数据。目前 EAU 指南建议，只有低风险的 UTUC 患者可以选择保肾治疗。但在实际临床中，我们经常遇到一些特殊情况，比如患者仅有一个功能肾，或者存在双侧肿瘤，或者合并严重慢性肾病，这些患者如果接受根治性肾输尿管切除术（RNU）将面临透析风险。

因此，我们开展了两项结合局部与全身治疗的临床试验，探索高风险患者的保肾可能性。其中一项研究选取了 31 例 HER2 阳性的局限性高风险 UTUC 患者，采用 HER2 靶向抗体偶联药物 RC48（维迪西妥单抗）联合 PD-1 免疫检查点抑制剂及内镜激光消融治疗。中位随访时间为 24 个月，1年无转化生存（CFS）率为 91.2%，2年CFS率为 88.9%。也就是说通过这种局部+全身治疗，大部分患者成功保留了肾脏。

这一治疗策略为单肾或双侧病变患者提供了新的可行方案，也证明了即使在高风险 UTUC 人群中，经过严格筛选后仍可实现保肾治疗。

02
《肿瘤瞭望-泌尿时讯》
张教授所在的港中大也有非常多的研究入选，您有一项临床研究获得2025 EAU最佳论文奖（EAU Best Paper on Clinical Research Award 2025），是关于NMIBC经尿道膀胱整块切除的随机试验，能否分享一下该研究成果？

张源津 教授

香港中文大学

我们这项研究纳入了 350 名非肌层浸润性膀胱癌（NMIBC）患者，随机分配接受“整块切除术”或传统“分块切除术”。传统切除通常采用从上至下的分段方式。相比之下，“整块切除术”一次性完整切除肿瘤，能够减少肿瘤细胞播散风险、降低种植风险，并可通过明确切缘实现更彻底的切除。

我们发现，整块切除术将一年复发率从 38.1% 降低至 28.5%。尤其对低风险、单发肿瘤患者而言，仅手术治疗效果就非常好。而对于高风险患者，手术只是治疗的一部分。尽管高质量手术可以减少残留肿瘤，但肿瘤本身的生物学特征——如高级别、多灶性、原位癌等——也必须纳入考虑。对于高风险患者，整块切除联合 BCG 治疗可将一年复发率降至约 5%，两年约为 10%。

作为泌尿外科医生，我们认为高质量的手术是治疗的第一步。而在高风险病例中，优质手术结合有效辅助治疗，确实有可能实现治愈。我们能获得 EAU 最佳论文奖深感荣幸，也感谢香港各参与中心的共同努力。我也非常期待与鲍教授在未来 UTUC 研究中展开合作，相信我们可以做出有国际影响力的成果。

鲍一歌 教授

四川大学华西医院

我也想补充一句，这个奖项不仅对张教授意义重大，对所有中国泌尿外科医生来说也同样难能可贵。在 EAU 大会的展区里，有一个展示获奖论文的大牌子，张教授的论文就在中间，非常醒目。我看到的第一时间就拍了照片，那是我整天最喜欢的一张照片。

在外科领域开展随机对照试验本身就非常困难，尤其是要获得阳性结果更是难上加难。比如之前一些技术的对照试验——单极与双极 TURP、开放与机器人手术——能得出明确正向结论的很少。一个关键难点在于不同外科医生之间手术技术的差异性。这项研究共涉及香港 13 家医院，每家机构的患者数量、医生经验和技术水平都不同。那么，您是如何在多中心中保证手术质量和一致性的？

张源津 教授

香港中文大学

这完全取决于随机对照研究的设计与执行质量。首先，我们确保所有参与的医生都接受了整块切除术的标准化培训；其次，无论是术中操作、术后管理还是随访流程，我们都制定了统一的规范并严格执行。膀胱癌本身高度异质化，如果你改变了治疗的一部分，但没能控制其他环节的管理路径，那最终效果会被“稀释”，甚至得出负面结果。所以，确保标准化执行与质量把控至关重要。我相信，中国有足够的患者资源与临床人才，完全有能力进行高质量的研究。我也期待未来能与更多中心合作，共同设计影响国际实践的研究项目。

鲍一歌 教授

四川大学华西医院

我个人非常认可这项研究。我第一次读完后，就立刻推荐给我们整个科室的医生看，现在大家都已经耳熟能详了。过去我们提到整块切除术时，常说它是一个好技术，但缺乏有力证据。如今，这一局面发生了改变。我们有了高质量、强证据的临床数据。这项研究一定会被未来的指南引用，也将成为整块切除术教学的重要文献。再次恭喜您，感谢您能开展如此出色的一项研究。

英文原文

UroStream: First, I'd like to invite both of you to kick off this dialogue with your research findings or interests.Professor Bao, we know your study (abstract A0059) on kidney - sparing treatment with ADC and immunotherapy in UTUC patients was accepted at this EAU conference. Could you share the results?

Prof. Yige Bao: Sure, we're very happy and honored to share some of our data about kidney-sparing treatment for UTUC patients. According to current EAU guidelines, only low-risk UTUC patients are eligible for kidney-sparing treatments. However, in real-world practice, we frequently encounter patients who have only one functional kidney, bilateral tumors, or severe chronic kidney disease—situations where radical nephroureterectomy could lead to dialysis.

To address this, we conducted two clinical trials integrating local and systemic therapies for high-risk patients. One trial involved the HER2-targeted antibody-drug conjugate RC48 (disitamab vedotin) combined with a PD-1 immune checkpoint inhibitor and endoscopic laser ablation. This was applied in a selected cohort of 31 localized high-risk UTUC patients who were HER2-positive.

With a median follow-up of 24 months, the one-year conversion-free survival rate was 91.2%, and the two-year rate was 88.9%. These promising results demonstrate that, with systemic treatment support, most patients were able to preserve their kidneys.

This approach offers an important alternative for patients with a solitary kidney or bilateral disease and shows that, even in high-risk UTUC, kidney preservation is achievable in selected cases.

UroStream: Professor Teoh, your CUHK has many studies here. You have been awarded the 2025 EAU Best Paper on Clinical Research which is a randomized trial of transurethral en bloc resection of the bladder for NMIBC. Could you share this study with us?

Prof. Jeremy Teoh: In this study involving patients with non–muscle-invasive bladder cancer, we enrolled 350 participants who were randomized to receive either en bloc resection—removal of the tumor in one piece—or conventional piecemeal resection. Traditionally, resections were done in a top-down, fragmented manner. En bloc resection aims to reduce tumor cell spillage, lower the risk of implantation, and ensure a complete tumor removal by enabling clear margin evaluation.

We found that en bloc resection significantly reduced the one-year recurrence rate—from 38.1% to 28.5%. Moreover, for patients with low-risk, solitary tumors, surgery alone proved highly beneficial. In high-risk patients, surgery is only part of the equation. While a high-quality resection minimizes residual disease, tumor biology—including high grade, multifocality, or carcinoma in situ—must also be addressed.

Among high-risk patients, those receiving en bloc resection plus BCG therapy achieved a one-year recurrence rate of approximately 5% and two-year rate around 10%.As urologists, we believe that performing a high-quality surgery is the foundational step. And in high-risk cases, combining surgery with effective adjuvant therapy can potentially cure many patients. We're truly honored to receive the EAU Best Paper award. This reflects the collaborative efforts of all participating centers in Hong Kong. I also look forward to working with Professor Bao on future UTUC trials—we have great potential to make meaningful international contributions.

Prof. Yige Bao: Yes, and I want to add that this prize holds great significance—not only for Dr. Teoh, but for all Chinese urologists. At the EAU conference, there was a display board listing all awarded papers, and Dr. Teoh’s study was prominently placed right in the center. The moment I saw it, I took a photo—it was my favorite snapshot of the entire day.

Conducting randomized controlled trials in surgery, especially with positive outcomes, is never easy. Consider previous technique trials—like monopolar vs. bipolar TURP or open vs. robotic surgery—very few surgical RCTs yield strong results. One major challenge is the variability in surgical techniques among different surgeons.In this study, 13 hospitals in Hong Kong participated, each with varying patient volumes, expertise levels, and surgical experience. So how did you ensure consistency and quality control across so many centers?

Prof. Jeremy Teoh: It all comes down to the design and execution quality of the randomized trial. First, we made sure all participating surgeons were well-trained in the en bloc technique. Next, the entire protocol—surgical, postoperative management, and follow-up—was standardized across all centers.Bladder cancer is highly heterogeneous. If we change one treatment component without controlling the rest of the management pathway, the effect gets diluted, possibly resulting in a negative outcome. So yes, ensuring protocol adherence and quality checks at every step is vital.I truly believe that with the patient volume and clinical talent in China, we’re well-positioned to run more high-quality trials. I look forward to collaborating with more centers in the future to design impactful studies that influence global practice.

Prof. Yige Bao: I really appreciated this paper. After I read it, I immediately recommended it to everyone in our department. Now it’s well known among all our colleagues. Before this, when we discussed en bloc resection, we said it was a promising technique but lacked solid evidence.

Now, that has changed. We have robust, high-quality data. This study will surely be cited in upcoming guidelines. And future generations learning en bloc resection will learn it through this paper.So once again, congratulations. It’s a remarkable study. Thank you for conducting it.

从治疗评估到动态监测
ctDNA为保器官治疗注入“强心针”

03
《肿瘤瞭望-泌尿时讯》
两位都提到了保器官治疗（包括保膀胱、保肾）的研究进展。近年来，也有研究将ctDNA液体活检应用于此类患者的随访监测，比如这次EAU大会的TOMBOLA研究。我想请两位教授分享一下对ctDNA在泌尿肿瘤领域应用探索和前景的看法？

张源津 教授

香港中文大学

我认为毫无疑问，器官保留治疗，尤其是膀胱保留治疗，将成为未来的方向。关键在于如何制定一个有效的临床路径：如何筛选合适的患者、给予合适的治疗，并进行有效的后续随访。过去我们缺乏可靠的筛选工具，这一过程相当困难。现在我们更频繁地使用影像学检查，比如术前和术后的MRI，来评估膀胱内是否仍有残留病灶。

以前做传统切除手术时，尤其是处理大体积肿瘤时，很多医生会采用所谓的 TURBT（经尿道膀胱肿瘤切除术）手术分期，但这样常常会在肿瘤基底留下明显残留。如果我们真的想推进膀胱保留治疗，那就必须从一开始就做到高质量、最大限度的切除。即使是采用整块切除（en bloc resection）术式，我们也会采用改良方法来确保最大限度的切除效果。

我们仍在探索如何预测系统治疗的反应。例如，在 PURE-01 研究中，一些生物标志物似乎可以预测患者对帕博利珠单抗的反应。虽然目前的证据还有限，但设想一下：如果你有一个体积较大的肿瘤，进行了良好的切除，那么这些组织就可以用于检测，预测哪种系统治疗可能更有效。最后就是您提到的ctDNA也非常有前景。比如我们给予患者一年或两年的治疗，然后用 ctDNA 进行随访。如果 ctDNA 持续阴性，或许可以安全停药；如果 ctDNA 从阴性转为阳性，提示有微小残留病灶，我们就可能需要重新启动治疗。

虽然整个治疗路径尚未完全定义，但我们现在已经拥有了构建一个完整、稳健的膀胱保留策略所需的大多数核心要素。我们有很好的基础去设计出有价值的研究。

鲍一歌 教授

四川大学华西医院

是的，我非常同意张教授的观点。ctDNA 以及类似的 utDNA 等新型方法，毫无疑问是我们未来研究的重要方向之一。当前的挑战在于，虽然测序与分子分析技术正迅速发展，但用于处理和解释这些数据的统计工具却相对滞后。我们现在拥有大量的测序数据，但在解读这些数据方面，仍缺乏理想的统计方法。因为测序数据具有组合特性，它存在于一个封闭的欧几里得空间中，与传统的开放空间数据不同。因此，如果仍然采用传统的统计方法分析此类数据，就可能会出现较高的假阳性结果。因此，尽管我们已经认识到 ctDNA 和 utDNA 是非常有前景的工具，但要想真正实现其最佳应用，还需要更加稳健的数据支持、更完善的技术手段以及专门的统计方法。

张源津 教授

香港中文大学

您提到的内容非常发人深省。研究人员确实尝试过用 RNA 测序数据对膀胱癌进行亚型分类，但这些亚型的临床意义往往有限，特别是在指导治疗决策方面，因为这些分类并非基于真实的治疗反应。为了解决这个问题，我们需要基于长期疗效的真实世界数据。如果我们能拥有一组膀胱癌或上尿路上皮癌（UTUC）患者的测序数据，为他们提供化疗或免疫治疗，并追踪其疗效，那么我们就可以从中识别出能指导治疗选择的分子特征。放眼全球，这类真实世界的治疗反应数据仍然非常稀缺，这正是该领域迫切需要填补的空白。

鲍一歌 教授

四川大学华西医院

是的，开发新的统计模型当然是统计学家的职责，但我们作为泌尿外科医生的职责，是开展更多临床试验并生成相关数据，尤其是反映中国患者特征的数据。我们希望张教授未来能够带领更多中国本土主导的泌尿肿瘤研究项目，共同积累数据，推动这个领域不断进步。

英文原文

UroStream: Both of you mentioned organ - sparing treatments (e.g., bladder - sparing, kidney - sparing). Recently, ctDNA liquid biopsies have been used to follow - up such patients, like in the TOMBOLA study presented at this EAU conference. What are your views on the ctDNA applications in urological tumors?

Prof. Jeremy Teoh: So I think without a doubt, organ-sparing approaches, or bladder-sparing treatments, are going to be the future. The key challenge is how we plan an effective clinical pathway: selecting the right patients, offering the right treatment, and following up accordingly. In the past, this was difficult due to the lack of robust selection tools. Now, we use more imaging, like MRI scans—not only preoperatively but also postoperatively—to assess whether disease remains in the bladder.

Previously, when performing conventional resections, especially for large tumors, many surgeons used to perform a so-called staging TURBT where gross residual disease would remain at the base. If we want to truly adopt bladder-sparing treatments, we need a good, maximal resection from the start. Even in en bloc resections, we apply modified approaches to ensure maximum resection.

We're still developing ways to predict systemic treatment response. For example, in the PURE-01 study, some biomarkers appeared to predict response to pembrolizumab. Though the evidence is still limited, imagine you have a large tumor that has been well resected. The tissue from that resection could be tested for biomarkers to predict which systemic therapies will be effective.

Finally, what you’ve mentioned—ctDNA—is especially promising. Let’s say we give one or two years of treatment, then use ctDNA for follow-up. If ctDNA remains negative, perhaps we can safely stop treatment. If ctDNA changes from negative to positive, indicating minimal residual disease, we may need to restart therapy. While the entire treatment pathway hasn’t yet been fully defined, we now have most of the essential components to build a robust bladder-sparing strategy. We're in a good position to design meaningful studies.

Prof. Yige Bao: Yeah, I strongly agree with Dr. Teoh. The use of ctDNA and related approaches like utDNA is certainly one of the future directions we will be working on. The challenge now is that, while sequencing and molecular analysis technologies are evolving rapidly, the statistical tools required to handle and interpret the data are still lagging behind. We have an abundance of sequencing data, but we lack ideal statistical methods for interpreting them effectively. Sequencing data is compositional—it exists in a closed, constrained system—unlike traditional open-space data. As a result, applying standard statistical methods may lead to a high risk of false-positive results. So while we already recognize ctDNA and utDNA as promising tools for the future, we still need more robust data, refined techniques, and specialized statistical methodologies to fully determine their optimal clinical application.

Prof. Jeremy Teoh: What you said is very thought-provoking. Researchers have used RNA sequencing to classify bladder cancer subtypes, but this classification often has limited clinical relevance—especially in determining which treatment to give—because these subtypes are not based on actual treatment response.

To overcome this, we need long-term, response-based data. If we had a cohort of bladder or UTUC patients with sequencing data, and we administered treatments like chemotherapy or immunotherapy, and tracked responses, we could then identify molecular signatures that guide treatment selection. Globally, we lack this kind of real-world treatment-response data, and it’s something the field urgently needs.

Prof. Yige Bao: Yes, developing statistical models is the job of statisticians, but it's our job as urologists to conduct more clinical trials and generate relevant datasets—especially data that reflects Chinese patient populations. We hope Dr. Teoh will lead more China-initiated urology trials so we can collectively contribute data and move this field forward together.

前列腺癌精准治疗
ctDNA检测应用和PARPi治疗经验

04
《肿瘤瞭望-泌尿时讯》
ctDNA在前列腺癌领域也有应用前景。我们知道PARP抑制剂已经开启了mCRPC精准治疗时代，HRRm患者可以获益于此类靶向联合内分泌治疗。那么，ctDNA检测HRRm是否可以等同于组织检测（实际上PROpel研究事后分析显示ctDNA和组织检测的一致性达85%以上）？两位如何看待这一问题。

鲍一歌 教授

四川大学华西医院

从我个人的角度来看，ctDNA 是一个非常优秀的选择，是 DNA 检测的一种极具前景的替代方案。通常情况下，我们会在患者进入 mCRPC 阶段时才进行基因检测，而这时患者往往已经在 mHSPC 阶段接受了三到五年的系统治疗。回头看他们最初的活检样本，其组织质量常常已经降解，不再适合用于 DNA 分析。有时我们尝试进行再次活检，但前列腺组织并不一定能提供代表性样本，尤其是在长期治疗后。要获取转移病灶的样本也很困难，尤其是当病灶位于骨骼或深层淋巴结（如会阴部位）时。

在这种情况下，ctDNA（也就是我们常说的“液体活检”）提供了一种非常方便的选择，只需血液样本即可。当前的数据表明，ctDNA 的检测结果在很大程度上与组织活检相符。当然，ctDNA 也存在一定局限。例如，它有时可能无法识别 BRCA2 同源性缺失（BRCA2-Holmdel）这类 DNA 修复缺陷，这类患者往往对 PARP 抑制剂反应最好，而这类缺失可能在 ctDNA 检测中被遗漏。但这种情况较为少见，大多数情况下，ctDNA 是一种非常有价值的检测工具。

张源津 教授

香港中文大学

在转移性疾病患者中，肿瘤负荷通常较高，我们往往可以检测到循环肿瘤细胞（CTCs）。这也是为什么在 PROpel 研究中，大多数患者在筛查时都能检测到 CTC 的原因。相比于首次组织样本检测或重新进行活检，血液检测要方便得多。对此我完全同意——ctDNA 是一个极具前景的选择。然而，在某些特定情况下，比如 ctDNA 检测结果不明确，或者需要组织学确认时，组织活检仍然是一种有效的方法。

在我们本地的临床实践中，特别是在 mCRPC 阶段，治疗选择开始变得有限，因此基因检测变得尤为关键。我们也会在家族史强烈的患者或年轻患者中进行基因检测，因为他们更有可能携带 HRR 突变。在这种情况下，PARP 抑制剂的精准治疗是值得考虑的。

英文原文

UroStream: In prostate cancer, PARP inhibitors have revolutionized mCRPC treatment by enabling precision therapy for HRRm patients. Can ctDNA HRRm detection replace tissue testing? As we know that PROpel study showed over 85% consistency between ctDNA and tissue testing, What's your take on this?

Prof. Yige Bao: Thanks. Well, from my personal point of view, ctDNA is a great option—an excellent alternative for DNA testing. Often, the decision to perform DNA sequencing is made when a patient enters the mCRPC phase. By then, the patient has usually been receiving systemic therapy for about three to five years, during the mHSPC stage. Looking back at their original biopsy samples, the tissue is often degraded, and its quality may be suboptimal for DNA analysis.

Sometimes we attempt a re-biopsy, but the prostate may not yield a representative or positive sample, especially after prolonged systemic therapy. Targeting metastatic lesions can also be challenging—particularly when they involve bone or deep lymph nodes in areas like the perineal region.

At that point, ctDNA—or what we call liquid biopsy—offers a very convenient alternative. It only requires a blood sample. Current data suggests that ctDNA provides highly representative results, comparable to tissue biopsy. One caveat, however, is that ctDNA may occasionally miss certain DNA repair mutations, especially the homologous BRCA2 deletions (BRCA2-Holmdel), where both BRCA2 alleles are entirely deleted. These patients tend to respond best to PARP inhibitors, but such deletions might go undetected by ctDNA testing. Still, this is a rare exception. In most cases, ctDNA is a highly valuable tool for gene testing.

Prof. Jeremy Teoh: In the context of metastatic disease, tumor burden is generally higher, and we can often detect circulating tumor cells (CTCs). That’s also why, in the PROpel study, most patients were CTC-positive at the time of screening.Blood-based tests are much more convenient than going back to archived biopsy samples or attempting re-biopsies, which are often technically difficult. I fully agree—ctDNA is a promising option. However, in very specific cases, particularly when ctDNA results are inconclusive or when histological confirmation is required, a tissue biopsy remains a valid approach.

In our region, especially at the mCRPC stage when treatment options start narrowing, gene testing becomes increasingly relevant. We also consider genetic testing in patients with strong family histories of prostate cancer, or in young patients, where HRR mutations may be more likely. In such cases, precision therapy with PARP inhibitors is worth considering.

05
《肿瘤瞭望-泌尿时讯》
无论是ctDNA还是组织检测，我们希望能够尽可能让每位mCRPC患者尽可能获得有效的PARPi精准治疗，因为PROpel等研究已经证实其生存获益。最后想请教两位分别来自香港和内地的专家，你们在临床实践中会在什么时机、采用什么方法进行基因检测？以及您在PARPi单药或联合治疗方面的管理经验？

张源津 教授

香港中文大学

如前所述，尤其是在疾病进展较快的患者中，我们通常会为 60 岁以下的年轻患者，或具有非典型组织学特征（如导管型前列腺癌），或者有一级亲属前列腺癌家族史的患者安排基因检测，并据此推进精准治疗。PARP 抑制剂无论是单药使用还是联合治疗，其耐受性良好，副作用也较易管理。目前在香港，这种治疗方式已越来越广泛地被采用。

鲍一歌 教授

四川大学华西医院

我非常赞同张教授的观点。在中国内地，基因检测通常是在患者进入 mCRPC 阶段时提出的。不过在某些情况下，我们也会在初诊时与患者讨论尽早检测的可能性，尤其是针对年轻患者或有明确家族史者。我们目前也在开展一项临床研究，观察在 mHSPC 治疗 6 年后 PSA 反应较差的患者中，DNA 突变的发生率。这类患者更可能存在可治疗的基因变异。

针对活检样本质量差的问题，我们正在探索一种替代方案——在初诊活检时即进行 DNA 提取并冷冻保存。这项服务成本较低，将来患者若进入 mCRPC 阶段，我们就可以直接利用保存的样本进行检测，从而避免了后期再获取组织样本的困难。

英文原文

UroStream: Both ctDNA and tissue testing aim to ensure mCRPC patients get effective PARPi treatment, as proven beneficial in PROpel and other studies.When and how do you conduct gene testing in clinical practice? Also, share your experience in managing PARPi monotherapy and combination therapy.

Prof. Jeremy Teoh: As mentioned, especially in advanced cases, we tend to test for mutations in younger patients—typically under 60—or in those with atypical histology, like ductal-type prostate cancer, or a strong family history involving first-degree relatives. Based on those findings, we proceed with precision therapy. PARP inhibitors—either as monotherapy or in combination—are quite well tolerated and easy to manage in terms of side effect profiles. In Hong Kong, this approach is increasingly accepted and implemented.

Prof. Yige Bao: I strongly agree with Dr. Teoh. In clinical practice, DNA testing is most commonly discussed when the patient transitions into the mCRPC phase. However, in certain situations, we even discuss early testing at diagnosis, especially for younger patients or those with clear family histories.We’re also running a clinical study examining the rate of DNA mutations in patients showing poor PSA response after six years of HSPC treatment. These cases are more likely to harbor actionable mutations.To address the issue of suboptimal sample quality, one solution we're working on involves early DNA extraction. At the time of initial diagnosis, when patients undergo systemic biopsy, they can opt to have DNA extracted and stored. This is a low-cost process, and the DNA can be frozen and used later if the patient progresses to mCRPC. That way, we avoid challenges in acquiring viable tissue at later stages.

▌参考文献：

[1]Ye J., et al.Kidney-sparing approach for selected localized high-risk upper tract urothelial carcinoma: A pilot study combining endoscopic Thulium laser ablation with perioperative Disitamab vedotinand immune checkpoint inhibitors.EAU25,Abstract A0059

[2]Yuen-Chun Teoh J, Cheng CH, Tsang CF, et al. Transurethral En Bloc Resection Versus Standard Resection of Bladder Tumour: A Randomised, Multicentre, Phase 3 Trial. Eur Urol. 2024;86(2):103-111. doi:10.1016/j.eururo.2024.04.015

[3]Reike MJ, Raggi D, Mercinelli C, et al. Distinct Gene Expression Patterns Identify Patients who Relapse After Neoadjuvant Pembrolizumab and Radical Cystectomy in the PURE-01 Study. Clin Genitourin Cancer. 2024;22(6):102214. doi:10.1016/j.clgc.2024.102214

[4]Andrew J. Armstrong,et al.Detection of mutations in homologous recombinationrepair genes in tumour tissue and circulating tumourDNA from patients with metastatic castration-resistantprostate cancer in the Phase ll PROpel trial.ESMO 2022,Abstract 2690

张源津 教授

香港中文大学医学院助理院长（对外事务）

香港中文大学泌尿外科副教授

香港中文大学医院泌尿外科中心主任

中国香港中文大学医院机器人手术服务主任

维也纳医科大学（Medical University of Vienna）客座教授

欧洲泌尿学协会（EAU）NMIBC指南成员

EAU指南办公室传播委员会成员

欧洲泌尿学杂志（European Urology）咨询编辑

欧洲泌尿肿瘤学杂志（European Urology Oncology）副编辑

EAU年轻泌尿学家上皮癌工作组成员国际泌尿学协会（Societie Internationale d’Urologie）大会组委会主席

国际泌尿学协会创新者会员（SIU Innovators）

2021 国际泌尿学协会创新者大奖得主

2021香港十大杰出青年奖得主

发表了400多篇受同行评审的论文获得超过8000万港币的研究经费资助

鲍一歌 教授

四川大学华西医院

医学博士、理学博士、副教授

四川大学华西医院甘孜医院泌尿外科学科主任

中国医师协会泌尿外科医师分会青年副主任委员

中国研究型医院学会泌尿外科专业委员会青年委员

四川省医师协会泌尿外科分会青年委员会副主任委员

四川省生殖医学专业委员会青年委员

在国际国内期刊发表论文十余篇，参编专著一部，负责国家自然科学基金青年基金一项，参与一项国家专家共识的编写

（来源：《肿瘤瞭望-泌尿时讯》编辑部）

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