Gerald L. Andriole, Jr., MD

Gerald L. Andriole, Jr., MD

Prostatype Genomics

St. Louis, Missouri

Gerald L. Andriole, Jr., MD, is Chief Medical Officer of Prostatype
Genomics. He retired in June 2023 from Johns Hopkins University
where he was Professor and Director of Urology in the National Capital
Region. Previously, he had been the Royce Distinguished Professor and
Chief of Urologic Surgery at Washington University in St. Louis for
over 20 years.

Dr. Andriole participated in the 5-year accelerated medical program at
Penn State University and Jefferson Medical College, Philadelphia, PA.
He trained in surgery at Strong Memorial Hospital, University of
Rochester, NY and completed urology residency at Brigham and
Women’s Hospital, Harvard Medical School, Boston, MA. He served a
fellowship in Urologic Oncology at the National Cancer Institute of NIH
in Bethesda, Maryland prior to joining the faculty at Washington
University.

Dr. Andriole has significant expertise in prostate cancer screening and
prevention. He was continuously funded by NIH from 1993 and has
contributed over 450 peer-reviewed publications (H-index of 110). He
chaired the Prostate Committee of NCI’s PLCO Cancer Screening Trial
and led the international REDUCE Prostate Cancer Chemoprevention
Trial. He also chaired the Prostate Committee of the Society of Urologic
Oncology Clinical Trials Consortium.
Dr. Andriole is an elected member of the American Surgical
Association, American Association of Genitourinary Surgeons, and the
Clinical Society of Genitourinary Surgeons. He received the
Outstanding Achievement Award from the Urologic Oncology Branch
of NCI, the Distinguished Clinician Award from Washington University,
the Distinguished Alumni Award from Jefferson Medical College and
the Williams Award for Prostate Cancer Research Excellence from the
American Urologic Association Urology Care Foundation.

Talks by Gerald L. Andriole, Jr., MD

Non-Metastatic CRPC: Finding Advanced Disease with Next Gen Imaging Matters

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, defines non-metastatic castration-resistant prostate cancer (nmCRPC) as having rising PSA measurements on three consecutive measurements with a PSA of greater than two. He also defines next-generation imaging as PET scans. He discusses FACBC scans and PSMA-based PET scans, as well as the history and treatment of nmCRPC. Dr. Andriole reviews the SABR-COMET study, the STOMP trial, and the ORIOLE study. He concludes that next-generation imaging is necessary for patients with nmCRPC, that metastasis-directed therapy shows benefits, and that larger and longer trials are warranted.

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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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