Declan Murphy

Urologist & Director of GU Oncology, Peter MacCallum Cancer Centre | Professor, University of Melbourne | Podcasting at GU Cast. Views my own. RT = endorsement

[Himanshu Nagar @HimanshuNagarMD]

Putting STAMPEDE, ENZARAD, PROTEUS & DASL into context with the latest #ESMO26 updates:

STAMPEDE: Abiraterone-based intensification improved MFS AND OS, predominantly with RT. New #ESMO26 Decipher data suggests differential abi benefit in cN0 disease (interaction P=.01); using this to omit treatment still requires validation.

ENZARAD: At 8 years, MFS was 74% vs 72% (HR 0.88; P=.34). No significant overall MFS benefit from enza + ADT/RT. The cN1/planned pelvic RT subgroup signals remain hypothesis-generating.

DASL: new at #ESMO26: 1,106 patients; 96 weeks of daro v. placebo + ADT + prostate/bed AND pelvic RT. Four-year conventional-imaging MFS: 95% vs 88% (HR 0.42). Very-high-risk population, including selected postoperative patients. Interim analysis; OS immature.

PROTEUS main trial: Perioperative apa + ADT improved 5-year PSMA-inclusive MFS versus ADT alone: 78.2% vs 73.5% (HR 0.80). Conventional-imaging MFS was not statistically significant. #ESMO26 post hoc PSA-response analysis adds prognostic information.

PROTEUS randomized substudy: new at #ESMO26: Perioperative apa/ADT + RP/PLND (n=102) v. immediate RP/PLND (n=306). At 37.8 months’ follow-up:
• 3-year EFS: 63.0% vs 41.4%; HR 0.38.
• Secondary PSMA-inclusive MFS: HR 0.49; nominal P=.0193.
• Subsequent postoperative RT: 20% vs 43%.

The substudy strengthens a "perioperative strategy". But conventional-imaging entry followed by PSMA-inclusive endpoints matters. PSA-based EFS, conventional MFS and PSMA-inclusive MFS are different endpoints.

These trials support specific intensification strategies; they cannot rank the drugs or establish RP-versus-RT superiority. The decision remains who benefits enough to justify the ENTIRE treatment burden.

[Michael Hofman @DrMHofman]

LuCAB at #ESMO26 - Combination Lu-177 PSMA-617 + cabazitaxel in mCRPC, accepted in @TheLancetOncol

Adding taxane chemotherapy to LuPSMA may overcome heterogeneous PSMA expression and act as a radiosensitiser.

35 pts, post-docetaxel + ARPI:
🧪 No DLTs: cabazitaxel 20 mg/m2 + 7.4 GBq LuPSMA
⚠️ G3 TRAEs 24%, no G4/5
📈 RP2D (n=26): PSA50 73%, rPFS 10.9 mo, OS 16.5 mo

Impressive outcomes in an unfavourable cohort (29% M1c).

Randomised trials needed: chemo + LuPSMA together or in sequence?

🙏 Led by @LouiseKostos & @AzadOncology with @ButeauJames , Grace Kong, @pj_physics, @DrBenTran, @MHaskali, @declangmurphy @PeterMacCC and @drlouiseemmett @StVincentsSyd

Above all, thank you to the patients and families who took part.

Funded by @PCFnews through @pros_tic , with PSMA-617 supplied by @Novartis plus additional support.

@myESMO

[Deborah Mukherji @dmukherji]

PROTEUS substudy results at #ESMO26
Perioperative apalutamide + ADT vs surgery alone in high-risk localized #ProstateCancer
EFS HR 0.38
MFS HR 0.49
Subsequent treatment at 3 years: 35% vs 68%

Compelling evidence for perioperative intensification @OncoAlert

[Michael Hofman @DrMHofman]

Pushing Terbium-161 PSMA Theranostics to 9.5 GBq - VIOLET Clinical Trial results at the #EANM26 @EANM_NucMed

Terbium-161 emits beta radiation like lutetium-177, plus ultra-short range Auger and conversion electrons that may better target micrometastases. Our first-in-human VIOLET trial established safety up to 7.4 GBq (Lancet Oncology 2025).

So we asked: can we go higher? 12 men with mCRPC, 9.5 GBq, up to 6 cycles:
- Remarkably well tolerated: just 1 grade 3 toxicity (anaemia)
- PSA50 response 75%, PSA90 response 33%
- Median PSA-PFS and rPFS not reached

The answer is yes - and we’re not stopping ... Cohort C, a dose-dense cohort with shorter intervals between early cycles, is now underway.

Huge thanks to @PCF_Science Young Investigators @ButeauJames , @LouiseKostos and @AzadOncology , and to the whole @PeterMacCC @pros_tic team who made this investigator-initiated trial possible.

Grateful to @Isotopia_Global and the for their support

#TOP (Top Rated Oral Presentation)

[Andrea Necchi, MD, FASCO @AndreaNecchi]

This further #ESMO26 @ESMO_Open simultaneous publication is very important for me. @SanRaffaeleMI @MyUniSR
Outcomes of pts with MIBC who decline RC in perioperative setting:
Take-home message:
1. cCR (Milan criteria) is a reliable biomarker and indicator of outcomes with Systemic Rx and reTURBT
2. Pts who do not get cCR could have a very poor prognosis under bladder-saving approaches > intensification with RC/chemoRT is very much needed

Looking forward to ongoing trials (eg EV209, EV309). Congrats to the entire team, also getting Best Poster! @OncoAlert @myESMO @CMercinelli @Anto_cigliola @BrigidaMaiorano @urotoday Piacentini Nasso Serafin et al.

Outcomes of patients with muscle-invasive bladder cancer who declined radical cystectomy in perioperative therapy trials conducted at San Raffaele Comprehensive Cancer Center - ESMO Open https://t.co/VhOHVA1GWH

[Matt Cooperberg @dr_coops]

When "cancer" is a diagnosis but not really a disease

A slightly more philosophical piece than my usual—on what we mean by cancer, and whether the word itself can sometimes do more harm than good.... let me know what you think!

Many thanks @pam3001 @aeonmag

https://t.co/PkCJFQzWLe

[GU Cast | Urology podcast! @gu_onc]

Great few days at the Irish Society of Urology meeting in Killarney. @RenuEapen and @declangmurphy loved the hospitality and scientific exchange. A GU Cast Live Event and conference highlights to come @RCSI_Irl

[GU Cast | Urology podcast! @gu_onc]

Spectacular #livesurgery at the @Uroweb ERUS Meeting in Padua. #robotic #surgery #telesurgery. @declangmurphy @RenuEapen and GU Cast bringing you highlights @ERUSrobotics @AlbertoBreda1

[Firas Abdollah @DrFAbdollah]

In a 10-yr follow-up of a randomized trial, Retzius-sparing RARP (better early continence) showed worse long-term cancer control than the anterior approach — 2.64x higher progression risk after adjustment. Post-hoc, hypothesis-generating. free link:https://t.co/WhcUr6NCkK

[Declan Murphy @declangmurphy]

@daviesbj For sure! “Exhaustive” list of virtues not an onerous request old mate! Should be able to put away the required minute over the weekend 😉😘

[Declan Murphy @declangmurphy]

Sigh. That sinking feeling when you know the monopolar shears is on its last life 😭#safetyscissors #roboticsurgery

[GU Cast | Urology podcast! @gu_onc]

GU Cast tackles “randomised trials that did not change practice”! Kidney cancer and robotic prostatectomy. With our Journal Club Editors @elena_k_berg @carlosdelgadord and Hosts @RenuEapen @declangmurphy https://t.co/BODmbasw06

[GU Cast | Urology podcast! @gu_onc]

@AshTewariMD joins GU Cast to talk all things nerve-sparing #roboticprostatectomy. And cricket! Fascinating 20yr journey to get to his technique today. Includes surgical footage #prostatecancer @MountsinaiUro @RenuEapen @declangmurphy https://t.co/JkLCXKURpA

[European Urology Oncology @EurUrolOncol]

🎤Our very own @mroupret & @Ric_Campi chats with @declangmurphy and @RenuEapan, hosts of @gu_onc and its spin off, European Urology Podcast.
https://t.co/K97blySTVI or listen wherever you find your podasts
Watch on You Tube: https://t.co/nKpdn5JQIP

📢Papers highlighted in this podcast include:

🩺Expanding Risk-adapted Early Detection of Prostate Cancer: A Call to Action for Men at High Risk by Maike K. Klett...Alicia K. Morgans et al
https://t.co/iA0IhdmcDO

🩺Blood and Urine Circulating Tumor DNA in Urothelial Bladder Cancer: State of the Art and Clinical Perspective by Igor Duquesne...François Audenet et al
https://t.co/4ldBN0Y0P0

🩺Cambridge kidney One-Stop Mass Investigation Clinic (CkOSMIC): A Nonrandomised Feasibility Study by Chiara Re...Grant D. Stewart et al
https://t.co/pVDXuocg1K

🩺Improved Shared Decision-making for Patients with Renal Cell Carcinoma: Results of the SDM-RCC Study by Cato C. Bresser...Paul B. van der Nat et al (for the SDM-RCC Study Group)
https://t.co/2xWwxaeERh

@uroweb
@GPloussard
@jteoh_hk
@CaPsurvivorship
@LauraMarandino
@Ecastromarcos
@OncoAlert
@Sciencedirect

Enjoy!

[Daniel D Eun MD @md_eun]

UAA 2026 in Manila, Philippines! Come join the congress for tips/tricks, updates and the famous hospitality that the Filipinos are known for. It’s going to be a great meeting!

[OncoAlert @OncoAlert]

We warmly invite you to join @OncoAlert 🚨 in Lugano, Switzerland🇨🇭 , from April 29 to May 1, 2027, for #LPCCC27 — the Localized Prostate Cancer Consensus Conference.

👉 https://t.co/hwCK8gdcJt
🔗 Register now and be part of #LPCCC27 in Lugano!

Building on the success and trusted format of APCCC, LPCCC will bring together leading international experts, clinicians, researchers, and patient advocates every other year to address the most important challenges in the diagnosis and clinical management of localized #ProstateCancer

📅 Register early and save!

Take advantage of early-bird rates and exclusive discounts for students, nurses, charity representatives, and participants from LICs and LMICs attending in person.

🌐 Free registration is available for patient representatives, press representatives, and online participants from LICs and LMICs.

Join the global forum shaping the future of localized prostate cancer care!

#ProstateCancer #GUOncology #UroOnc #CancerCare #PrecisionMedicine #Oncology

@Silke_Gillessen
@ProfKHerrmann
@LoebStacy
@declangmurphy
@DrSpratticus
@Tilki_De
@piet_ost
@alison_tree
@AOmlin
@ResearchWyatt
@ckcding
@stefanofanti4

Ping
@nataliagandur
@scocmem
@AmandaNizamMD

[Ash Tewari, MD @AshTewariMD]

A great conversation about ABC of Nerve Sparing robotic prostatectomy with Mr. Declan Murphy and Dr. Rene Eapen. Thanks Declan and Renu for your podcast. https://t.co/CFmXUOaEHk

[Declan Murphy @declangmurphy]

Thanks so much @NehaVapiwala for inviting me to dial into this great @ASTRO_org webinar with @AmarUKishan. I learned a lot! Great to talk multidisciplinary approaches to high-risk prostate cancer

[Declan Murphy @declangmurphy]

7.15am here, patient should be going to sleep. But World Cup final just went to extra time. “Will my prostate cancer deteriorate if we delay 45 min? No” Come on Spain!

[GU Cast | Urology podcast! @gu_onc]

@Uromigos Happy 500th Episode!! @gu_onc salutes you @brian_rini @tompowles1 @RenuEapen @declangmurphy #podcast🎙️🥂