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Gerald L. Andriole, Jr., MD

Gerald L. Andriole, Jr., MD

Prostatype Genomics

St. Louis, Missouri

Gerald L. Andriole, Jr., MD, is the global Chief Medical Officer at Prostatype Genomics. He previously was Professor and Director of Urology in the National Capital Region at the Brady Urologic Institute at Johns Hopkins University. He also formerly served as the Robert K. Royce Distinguished Professor and Chief of Urologic Surgery at Barnes-Jewish Hospital, the Siteman Cancer Center, and Washington University School of Medicine in St. Louis, Missouri. Dr. Andriole received his medical degree from Jefferson Medical College in Philadelphia, Pennsylvania. He trained in surgery at Strong Memorial Hospital and the University of Rochester and completed his Urology Residency at Brigham and Women’s Hospital and Harvard Medical School. Subsequently, he was a Fellow in Urologic Oncology at the National Cancer Institute in Bethesda, Maryland. Dr. Andriole has over 40 years of consistent contributions in the areas of prostate cancer screening and prevention research as well as BPH. He has contributed over 450 peer-reviewed publications. He chaired the Prostate Committee of NCI’s PLCO Cancer Screening Trial, the Steering Committee of the international REDUCE Chemoprevention Trial and the Prostate Committee of the SUO Clinical Trials Consortium. He is a member of the American Urological Association, the Academy of Master Surgical Educators of the American College of Surgeons, the American Surgical Association, the American Association of Genitourinary Surgeons, and the Clinical Society of Genitourinary Surgeons, among other societies.

He has received the Outstanding Achievement Award from the Urologic Oncology Branch of NCI, the Distinguished Clinician Award from Washington University, the Alumni Award from Jefferson Medical College and the Williams Award for Prostate Cancer Research Excellence from the AUA Urology Care Foundation, among others.

Disclosures:

Dr. Andriole has the following disclosures:

Employment: Prostatype Genomics

Talks by Gerald L. Andriole, Jr., MD

Micro Ultrasound and MRI of the Prostate

Dr. Gerald L. Andriole, Jr., MD, analyzes the evolving role of micro-ultrasound and MRI in the diagnosis and management of prostate cancer and discusses the advancements in imaging technologies that have significantly improved the accuracy of prostate cancer detection.

In this 13-minute talk, Dr. Andriole begins by examining the limitations of utilizing single imaging techniques, particularly in detecting small, clinically significant prostate tumors. Dr. Andriole explores the complementary role of micro-ultrasound and multiparametric MRI (mpMRI) in prostate cancer imaging. This combination of micro-ultrasound and MRI, he notes, enhances the accuracy of prostate cancer diagnosis.

Dr. Andriole also highlights the clinical implications of these imaging modalities and their potential to reduce the need for unnecessary biopsies and more effectively guide active surveillance strategies. He discusses the ongoing research and developments to integrate these technologies into routine clinical practice.

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Micro Ultrasound and MRI of the Prostate

Gerald L. Andriole, Jr., MD, is the global Chief Medical Officer at Prostatype Genomics. He previously was Professor and Director of Urology in the National Capital Region at the Brady Urologic Institute at Johns Hopkins University. Throughout this 13-minute presentation, Dr. Andriole underscores the importance of staying abreast of technological advancements in urology, as they can transform prostate cancer care.

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Prostate Cancer Screening Update

Gerald L. Andriole, Jr., MD, provides guidance on how urologists can effectively streamline their processes for prostate cancer screening. In his presentation, he discusses five supplemental areas where urologists can improve prostate cancer screening:

Identification of Above Average Risk Patients
Simplification of PSA Guidance for Patients and PCPs
Early Identification of Clinically Significant Prostate Cancer
Reduction of Unnecessary Initial and Repeated Biopsies
Enhanced Risk Stratification

For each area, Dr. Andriole outlines the current standard practice and suggests methods for improvement. To support the suggested methods, he presents data illustrating the method’s outcome for patients and practitioners.

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Point Counterpoint: Micro Ultrasound

Gerald L. Andriole, Jr., MD, presents the benefits of including micro ultrasound (microUS) in prostate imaging. He begins by noting that microUS is a relatively new technology compared to multiparametric magnetic resonance imaging (mpMRI).

Dr. Andriole presents examples of the detailed prostate images produced by microUS. He discusses the Prostate Risk Identification using MicroUltraSound (PRIMUS) classification system, intended as an analog to PRI-RADS, and the training required for practitioners using microsUS. He presents video examples of microUS-guided versus MRI-guided biopsies.

He concludes by comparing the specificity, sensitivity, and NPV of mpMRI and microUS biopsies in identifying clinically significant cancer. He presents recent studies which indicate that microUS alone may be as effective as mpMRI alone in the context of biopsies.

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PSA Screening in 2023

Gerald L. Andriole, Jr., reviews evidence supporting a more comprehensive family history and biomarkers in screening and treating prostate cancer. Andriole underscores the power of a well-taken family history. He suggests doctors counsel patients on their hereditary risk of prostate cancer, emphasizing the importance of one diagnosed high risk family member, to reduce the rate of mortality.

Describing the Germline Mutations in Metastatic PCa, Andriole recommends all patients with prostate cancer who have certain characteristics be encouraged to speak to their physicians about whether they may need genetic testing for an inherited mutation. When looking in detail at polygenic risk scores (GRS,) knowledge of high GRS decreased mortality rate.

Andriole highlights the Prompt Test, the direct to consumer, poly-genomic test in the US. In comparison, the UK Biobank data compares prevalence and hazard ratio to show the frequency is higher, some predict cancer aggressiveness. He expects to hear a lot about the prompt test in future.

Dr. Andriole recommends identifying patients with clinically significant PCa earlier through a lower PSA cutpoint. He suggests using image guided Micro US or MRI, or a transperineal biopsy to show potentially indicative biomarkers.

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