Gerald L. Andriole, Jr., MD

Gerald L. Andriole, Jr., MD

Barnes-Jewish Hospital and Washington University School of Medicine

St. Louis, Missouri

Gerald L. Andriole, Jr., MD, is 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 35 years of consistent contributions in the areas of BPH and prostate cancer screening and prevention research. He has contributed well over 400 peer-reviewed publications and serves on the editorial boards of several prestigious journals. He is Chairman of the Prostate Committee of the National Cancer Institute’s Prostate, Lung, Colorectal and Ovarian (PLCO) Cancer Screening Trial, and PI of the NIDDK Multidisciplinary Approach to Urologic Pelvic Pain (MAPP) and Symptoms of Lower Urinary Tract Dysfunction Research Network (LURN). He was Chairman of the Steering Committee of the REDUCE Prostate Cancer Prevention Trial, as well as PI of both the NIDDK Medical Therapy of Prostatic Symptoms (MTOPS) BPH trial and the NIDDK Complementary and Alternative Medicine for Urinary Symptoms (CAMUS) study. He is a member of the American Urological Association, the American Association for Cancer Research, the American Society of Clinical Oncology, the American Surgical Association, the American Association of Genitourinary Surgeons, and the Clinical Society of Genitourinary Surgeons, among other societies.

Articles by Gerald L. Andriole, Jr., MD

PET Imaging for Prostate Cancer

Gerald L. Andriole, Jr., MD, 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, reviews the 2020 NCCN Guidelines, focusing on PET imaging for prostate cancer and related studies. He establishes that PET/CT and PET/MRI for detection of biochemically recurrent disease have been approved, though the majority of the data collected is specifically for the Ga-68 PSMA tracer. F-18 DCFBC, F-18DCFPyl, and F-18 PSMA 1007 are currently being evaluated for possible advantages over Ga-68 PSMA. Dr. Andriole then discusses several studies which demonstrate both the benefits and limitations of PET-directed therapies in the prostate cancer setting.Dr. Andriole concludes by looking at studies which compared PSMA PET to conventional imaging and found PSMA PET to be significantly more effective.

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Updates in Screening: Prostate Cancer Guidelines

Gerald L. Andriole, Jr., MD, a 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, reviews guidelines for prostate cancer screening, including the unchanged 2018 AUA guidelines and the 2020 updates to the NCCN and EAU guidelines. Following this, he explains why he disagrees with a 2020 article that suggests physicians use a PSA level of 10 ng/mL as the threshold when referring PCa patients to urology and thus biopsy. Lastly, he outlines five ways physicians can improve the early detection of prostate cancer.

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What Role Do Markers Play in Establishing Active Surveillance or Definitive Care?

Gerald L. Andriole, Jr., MD, explains that while active surveillance is on the rise, doctors can do a better job of selecting patients for it. He points out that NCCN and ASCO guidelines indicate that routine ordering of molecular biomarker tests is not recommended, and state that doctors should only perform active surveillance on low- and favorable-risk patients. He concludes that clinical criteria are very useful in determining when to use active surveillance, and notes that MRI and gene expression classifiers add some certainty to the decision. There are other markers that may aid in decision making, but the current data is sparse.

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Non-Invasive Molecular Imaging – Fluciclovine

Gerald L. Andriole, Jr., MD, discusses the unmet need for precise imaging of biochemical recurrent prostate cancer. He reviews data on imaging agents, especially 18F-fluciclovine PET/CT, ¹¹C-choline PET/CT, and 68Ga-PSMA-11, and deliberates on the impact of imaging-guided treatment changes on patient outcomes.

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Image Guided Prostate Biopsy

Gerald L. Andriole, Jr., MD, reviews the history of conventional transrectal ultrasound (TRUS) guided biopsy and the limitations of this technique that remain in the modern era. He then discusses current and emerging efforts to improve image guided prostate biopsies.

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