Hashim Ahmed, MD, PhD, presented “Focal Therapy is Now Ready for Prime Time” during the 7th Global Summit on Precision Diagnosis and Treatment of Prostate Cancer on September 21, 2023.

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How to cite: Ahmed, Hashim. Focal Therapy is Now Ready for Prime Time.” September 21, 2023. Accessed Nov 2024. https://grandroundsinurology.com/focal-therapy-is-now-ready-for-prime-time/

Focal Therapy is Now Ready for Prime Time – Summary

Hashim Ahmed, MD, PhD, advocates for wider adoption of focal therapy (FT) as a treatment option for localized prostate cancer. Dr. Ahmed contends that by identifying and ablating the index lesion, FT can control disease with fewer side effects than radical therapy.

Dr. Ahmed outlines UK criteria for FT, explaining it is an alternative to radical therapy, not an alternative to active surveillance. He lists the side effects of radical therapy compared with those of FT.  He cites “reassuring” survival data on FT and calls this important because the data does not support the concern of FT resulting in greater instances of metastasis. 

Dr. Ahmed explains data on outcomes of focal cryotherapy before turning to a comparison of FT vs. radical therapy outcomes, with little difference in failure-free survival. Dr. Ahmed cites randomized studies that experienced significant dropout rates in their radical therapy arms compared to FT.

Dr. Ahmed concludes by reiterating why FT confers similar oncological outcomes and improved genitourinary function compared with radical therapy. He contends FT is a legitimate treatment option, with current outcomes now justifying FT’s use in standard care, highlighting that it avoids damage to collateral tissue and the resulting side effects.

The Global Summit on Precision Diagnosis and Treatment of Prostate Cancer is a unique multi-disciplinary forum organized to inform the key health care stakeholders about the emerging advances in clinical case and research and create a consensus-based vision for the future of precision care and educational and research strategy for its realization. The mission of the Summit is to fill the currently existing gap between the key experts of in vivo imaging, the world authorities in the in vitro fluid- and tissue-based molecular diagnostics, including genomics, and thought leaders in the development of novel observation strategies (e.g., active surveillance, or AS) and therapeutic interventions.

ABOUT THE AUTHOR

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Hashim Ahmed, MD, PhD is currently Professor and Chair of Urology at Imperial College London. Dr. Ahmed is an internationally renowned expert in prostate cancer diagnosis, imaging, and biopsy, and also focuses on minimally invasive therapies for prostate cancer. His research interests are in Health Technology Evaluation, including multi-parametric multiparametric resonance imaging (MRI), histoscanning, tissue type imaging, as well as therapeutic interventions such as high intensity focused ultrasound (HIFU), irreversible electroporation, photodynamic therapy, cryotherapy, and radiofrequency ablation.

Dr. Ahmed qualified from the University of Oxford where he attended St Peter's College and Linacre College. Whilst he was a student, he was awarded the William Osler Prize in Medicine. He then held house office posts in Queen Elizabeth Hospital, Birmingham and University Hospitals Manchester before returning to Oxford for an Anatomy Prosector post. Dr. Ahmed then held senior house jobs in surgery in the Royal Free Hospital, London rotation followed by specialist registrar posts at West Middlesex Hospital, Charing Cross Hospital/Imperial College, University College Hospital, and Watford General Hospital as part of the Imperial College Urology Rotation. Dr. Ahmed was a Pelican Cancer Foundation Research Fellow followed by a MRC Clinician Research Training fellowship at University College London, at which time a number of imaging and focal therapy trials were started. He currently holds a £2.1M Wellcome Trust Senior Clinical Research Fellowship and is Director of the Wellcome Trust Prostate Research in Imaging and Surgical Methodology (PRISM) Programme. A team led by Dr. Ahmed was recently awarded the BMJ/BMA Innovation Award 2015 and the Health Services Journal Acute Sector Innovation Award 2016.