Raoul S. Concepcion, MD, FACS

Raoul S. Concepcion, MD, FACS

U.S. Urology Partners

Nolensville, Tennessee

Raoul S. Concepcion, MD, FACS, is the Chief Science Officer of U.S. Urology Partners in Nolensville, Tennessee, where he is developing a precision medicine comprehensive cancer program centered on genomic testing, pathway development, data aggregation, and clinical trial work. He is additionally a co-founder and the CEO of UroVault in Nashville, Tennessee. Dr. Concepcion has served as a founding member and former president of the Large Urology Group Practice Association (LUGPA), the premier nonprofit association and advocate for independent urology practices. He is certified by the American Urological Association (AUA) and is a member of that organization, as well as the Southeastern Section of the AUA, Society of Urologic Oncology, American College of Surgeons, and the Nashville Surgical Society. 

Dr. Concepcion completed his residency in general surgery and urology at Vanderbilt University in Nashville, Tennessee, where he was Chief Urology Resident, and later served as a Clinical Associate Professor of Urology. Additionally, he was a research fellow in the Light Laboratories at Vanderbilt. More recently, he has completed the City of Hope Intensive Course on Cancer Risk Assessment for hereditary cancer and genomic testing. Dr. Concepcion has been in practice since 1990 and has been the principal or co-principal investigator on many clinical trials since then. His clinical interests focus on advanced prostate and bladder cancer and lower urinary tract reconstruction, as well as the role of genomics and genetic testing in GU tumors. Dr. Concepcion co-founded CUSP, a urologic research consortium in the United States that specializes in site and patient accrual for the pharmaceutical and biolab industries. Additionally, he is an advisor and/or speaker for many companies, including Dendreon, Pfizer, Astellas, Amgen, Cellay, and Janssen, and has served as editor for Urologists in Cancer Care.

Talks by Raoul S. Concepcion, MD, FACS

Final Results from ACIS Trial of Apalutamide Plus Abiraterone/Prednisone in Patients with Chemo-Naive mCRPC

| Dec 2021

Raoul S. Concepcion, MD, FACS, Chief Science Officer of U.S. Urology Partners in Nolensville, Tennessee, presents the final results of the ACIS trial, a random double-blind phase III study examining concomitant treatment with apalutamide and abiraterone plus prednisone against abiraterone and androgen deprivation therapy (ADT) in patients with chemotherapy-naïve metastatic castrate-resistant prostate cancer (mCRPC). He provides background, describes the study design and baseline characteristics, and reviews the findings. Dr. Concepcion explains the role of activated androgen receptors and intratumoral androgens in mCRPC. He also describes the concept of androgen annihilation, essentially blocking androgen at both the production and receptor level. The ACIS trial met its primary endpoint, radiographic progression-free survival (rPFS), at a median of 25.7 months of follow up, representing a 31% reduction in risk of radiographic progression or death. The risk reduction was maintained at 30% in long term follow-up at 54.8 months. However, overall survival was similar between treatment arms. Likewise, the secondary endpoints, time to initiation of cytotoxic chemotherapy, time to pain progression, and time to chronic opioid use, were also similar. Lastly, Dr. Concepcion notes that no new safety signals were observed and patient quality of life was comparable between treatment arms.

Read More

Genetic Testing and Prostate Cancer

| Aug 2021

Raoul S. Concepcion, MD, FACS, Chief Science Officer of U.S. Urology Partners in Nolensville, Tennessee, discusses genomics and DNA repair within the context of prostate cancer treatment to demonstrate the ability of next generation sequencing (NGS) to improve patient outcomes. He begins by giving basic definitions of genetics, genomics, and the genome before sharing data that supports an argument for performing genetic testing. Dr. Concepcion reviews studies on several related topics that all show higher rates of germline mutations in patients with metastatic and/or high-grade cancer. Dr. Concepcion explains that the link between germline mutations and higher rates of metastatic and higher-grade cancer shows that understanding DNA mutations and genomics can improve treatment. He then gives an overview of genomics, explaining how genetic code is formed and behaves and the different types of DNA mutations. He also gives an example of a pathogenic report expressing a nonsense mutation. Dr. Concepcion reviews the American College of Medical Genetics and Genomics (ACMG) classification system and how including testing as a part of treatment plans will improve that system. He then discusses the Knudson “two-hit” model hypothesis, presents data demonstrating that 60% of metastatic cancer patients do not undergo molecular testing, and explains that patients treated with targeted therapies based on genetic testing have 63% longer overall survival than other metastatic patients. Dr. Concepcion concludes by observing that an understanding of modern-day genomics and DNA repair is crucial to improving treatment.

Read More
The Effect of Local Antibiogram-Based Augmented Antibiotic Prophylaxis on Infection-Related Complications Following Prostate Biopsy

The Effect of Local Antibiogram-Based Augmented Antibiotic Prophylaxis on Infection-Related Complications Following Prostate Biopsy

| Dec 2019

Raoul S. Concepcion, MD, FACS, and E. David Crawford, MD, discuss a recent study Dr. Concepcion was involved with that looked at antibiotic-augmented prophylaxis based on local antibiograms as a method of reducing infections from prostate biopsies. They discuss the design and rationale of the study and methods for administering the prophylaxis, as well as the results, which showed a 53% reduction in infectious complications compared to historical data.

Read More
New Considerations for Oligometastatic Prostate Cancer

New Considerations for Oligometastatic Prostate Cancer

| Jun 2019

Raoul S. Concepcion, MD, FACS, discusses the management of patients with oligometastatic prostate cancer. Currently, there is no standard definition of what defines oligometastatic.  Additionally, questions remain about the handling of the primary tumor in this setting, as well as whether therapy directed at the primary has a long term benefit in overall survival.

Read More