Leonard G. Gomella, MD, FACS

Leonard G. Gomella, MD, FACS

Thomas Jefferson University

Philadelphia, Pennsylvania

Leonard G. Gomella, MD, FACS, is the Bernard W. Godwin, Jr. Professor of Prostate Cancer and chair of the department of urology at Sidney Kimmel Medical College of Thomas Jefferson University in Philadelphia, Pennsylvania, where he also serves as senior director for clinical affairs. Originally from New York, Dr. Gomella completed medical school and general surgery and urology training at the University of Kentucky in Lexington. After a urologic oncology fellowship in the surgery branch of the National Cancer Institute, National Institutes of Health in Bethesda, Maryland, he joined Thomas Jefferson University in 1988 and was appointed chair of the urology department in 2002. From 1998 until 2020 he was urology chair for the Radiation Therapy Oncology Group (RTOG) (now NRG Oncology) and from 2008 until 2019 he was clinical director of the Sidney Kimmel Cancer Center Network.

Dr. Gomella is involved in translational basic science and clinical research developing new diagnostic tests and treatments for prostate, bladder, and kidney cancer through the Sidney Kimmel Cancer Center where he has co-led the Biology of Prostate Cancer Program. Dr. Gomella's team was first to use molecular techniques (RT-PCR) in 1992 to detect circulating prostate cancer micrometastases, the first report of “liquid biopsy,” a discovery that led to a new field of investigation in this disease. Dr. Gomella is also recognized for developing the multidisciplinary clinic approach to prostate cancer and was an early contributor to urologic laparoscopy. He led the urology effort in the 2017 and 2019 Philadelphia Prostate Cancer International Consensus that provided the first multidisciplinary guidance on genetic testing for prostate cancer.

Dr. Gomella has given over 600 presentations nationally and internationally and written over 600 papers, chapters and monographs in urology. He has authored and edited 63 editions of 17 different books for medical students, residents, and practicing physicians, many of which have been translated into foreign languages. Dr. Gomella has consistently earned recognition for urologic oncology and prostate cancer, including a 2015 national recognition in Newsweek. In 2007, Men’s Health Magazine listed Dr. Gomella as one of the 20 top urologists in the US. Among other awards, in 2018 the Society of Urologic Oncology presented him with a “Distinguished Service Award.” In 2019, Dr. Gomella was named Enterprise Urology Vice President for Jefferson Health. Additionally, the American Urological Association (AUA) awarded him “Honorary Membership” status in 2023 in recognition for his contributions and leadership in urologic oncology. Dr. Gomella has been president of the Mid-Atlantic section of the AUA and elected to the American Association of Genitourinary Surgeons and the prestigious Clinical Society of Genitourinary Surgeons.

Disclosures:

Talks by Leonard G. Gomella, MD, FACS

The Bespoke Future of Cancer Care

Leonard G. Gomella, MD, explores the concept of “bespoke” cancer care, emphasizing its personalized, patient-centered approach. Originally a British term referring to custom-made items, “bespoke” now highlights the customization of cancer treatments through precision medicine, pharmacogenomics, AI technologies, and individualized care plans.

In this 10-minute presentation, Dr. Gomella stresses that innovations in cancer care reflect the growing trend of leveraging AI to enhance screening efficiency and reduce reliance on traditional biopsy methods. He discusses how precision medicine increasingly enables oncologists to tailor treatment plans by analyzing genetic mutations and matching patients to the most promising therapies or clinical trials. The need to balance technological advancements with affordability and patient access is a central concern.

Bespoke care offers better outcomes and underscores the importance of informed decision-making, empowering patients to actively participate in their treatment journey.

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Utilizing ctDNA in Bladder Cancer

Leonard G. Gomella, MD, FACS, explores the potential of circulating tumor DNA (ctDNA) and cell-free DNA (cfDNA) as biomarkers in cancer detection, treatment monitoring, and prognosis.

In this 12-minute presentation, Dr. Gomella reviews recent studies, such as those conducted at the European Association of Urology (EAU), demonstrating ctDNA’s potential for early detection, risk assessment, treatment response evaluation, and post-treatment surveillance in bladder cancer. Trials such as InVigor010 highlight ctDNA’s prognostic utility, where analysis revealed that ctDNA positivity predicted a higher risk of relapse.

Gomella reports that innovations extend to ctDNA detection in urine, offering a non-invasive method to monitor disease burden. These developments and the integration of advanced sequencing technologies mark a new era in cancer management, facilitating earlier interventions and more effective treatment planning.

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Role of Precision Medicine in the Diagnosis and Management of Prostate Cancer

Leonard G. Gomella, MD, FACS explores the rapid evolution of precision medicine, particularly in the context of prostate cancer, highlighting the shift from a one-size-fits-all approach to more personalized, genomics-based strategies. Precision medicine aims to tailor treatment and prevention strategies to the individual, moving beyond traditional methods to incorporate genetic, genomic, and molecular data.

In this 12-minute presentation, Dr. Gomella discusses key components of precision medicine in prostate cancer, including biomarkers, risk prediction, stratification, and drug repurposing. Advances in imaging technologies, such as improved MRI and ultrasound, as well as liquid biopsies, allow for deeper insights beyond histology, utilizing biomarkers, RNA tumor markers, and detailed genomic analysis. These innovations facilitate a more precise understanding of individual patients’ cancer profiles, helping to refine screening and treatment decisions.

Further, he asserts that precision medicine has substantially impacted the management of advanced prostate cancer, with targeted therapies tailored to genetic mutations and molecular characteristics. This approach exemplifies the precision targeting of treatments based on individual tumor profiles, optimizing outcomes and minimizing unnecessary interventions.

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Panel Discussion: Next Generation Genomics and Prostate Cancer Biomarkers

Leonard G. Gomella, MD, FACS, leads a panel discussion with Gerald L. Andriole, Jr., MD; Alan H. Bryce, MD; Brian F Chapin, MD; E. David Crawford, MD; Steven E. Finkelstein, MD, FACRO; A. Karim Kader, MD, PhD; and Neal D. Shore, MD, FACS on how biomarkers are being used to treat prostate cancer. Biomarkers are used to diagnose PCa and to decide whether or not to biopsy or repeat biopsy. They also discuss how biomarkers are used to treat localized disease and advanced disease. Both tissue and liquid biopsies are used for somatic DNA mutations, with liquid biopsies becoming increasingly important since it gives real-time results. Guidelines for germline testing and counseling are being updated, and germline testing for family members is becoming increasingly important. PARP inhibitors are now approved for detecting BRCA mutations. There is broader approval for the medication olaparib for both germline and somatic testing. They also review the updated biomarker map. They discuss how these changes will shape precision medicine and personalized care. It is essential for the urology community to be familiar with all these aspects of testing and clinical applications. They discuss why the PCA 3 test has been declining. They also discuss the need to send a clear message to primary care physicians.

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How Academic Urology Institutions are Coping with the COVID-19 Pandemic

Leonard G. Gomella, MD, FACS, the Bernard W. Godwin, Jr., Professor of Prostate Cancer and Chairman of the Department of Urology at the Sidney Kimmel Medical College at Thomas Jefferson University, discusses how academic urologic institutions are coping with the COVID-19 crisis. He highlights how the pandemic has created an asymmetric practice model as cases go before an OR committee to determine which can be postponed and which need to go forward. This asymmetric model may affect relative value units (RVUs) as the year goes on, but Dr. Gomella emphasizes the need to care for patients in this time of crisis over worrying about the details of reimbursement. He further discusses the need to transition to telehealth but also recognizes that this is not a practical solution for some older patients who are not confident in their use of technology. Phone visits have proven to be an effective solution in these cases, as cross-state licensing rules have been temporarily abolished. Dr. Gomella also speculates on the potential need to suspend all truly non-life threatening surgeries and its impact on patients.

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