Laurence Klotz, MD, FRCSC, presented “Genomics and Natural History of MRI Invisible vs Visible Cancers – Implications for Clinical Practice” during the 8th Global Summit on Precision Diagnosis and Treatment of Prostate Cancer on October 8, 2024.
How to cite: Klotz, Laurence. “Genomics and Natural History of MRI Invisible vs Visible Cancers – Implications for Clinical Practice.” October 8, 2024. Accessed Dec 2024. https://grandroundsinurology.com/genomics-and-natural-history-of-mri-invisible-vs-visible-cancers-implications-for-clinical-practice/
Genomics and Natural History of MRI Invisible vs Visible Cancers – Implications for Clinical Practice – Summary
Laurence Klotz, MD, FRCSC, explores the genomics and natural history of MRI-visible versus invisible prostate cancers and their clinical implications.
In this 12-minute presentation, he highlights that while MRI is transformative in identifying significant prostate cancer, it misses about 15% of “invisible cancers.” Recent research reveals that the invisibility of these tumors correlates with favorable genomic profiles, including fewer genetic aberrations and reduced aggressivity.
Dr. Klotz presents compelling evidence linking visible tumors to adverse molecular features and worse clinical outcomes, whereas invisible cancers are largely indolent. He underscores the potential of radiogenomics in guiding treatment decisions, advocating for management strategies based on imaging rather than solely histology.
Dr. Klotz considers avoiding unnecessary systematic biopsies in favor of targeted MRI approaches can minimize patient anxiety and reduce overdiagnosis of insignificant cancers. However, challenges remain in addressing gray areas, such as PI-RADS 3 lesions and visible but low-grade cancers, which may require more nuanced management.
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
Laurence Klotz, MD, FRCSC, is a professor of surgery at the University of Toronto and the Sunnybrook Chair of Prostate Cancer Research. Dr. Klotz was the founding editor-in-chief of both the Canadian Journal of Urology and the Canadian Urology Association Journal (CUAJ), and he is now editor emeritus of the CUAJ. Dr. Klotz obtained his medical degree and completed his residency at the University of Toronto. He was also a uro-oncology fellow at Memorial Sloan Kettering Cancer Center in New York.
Dr. Klotz has 550 peer review publications and eight books. He coined the phrase “active surveillance” and successfully championed this approach for men with favorable-risk prostate cancer against substantial resistance. He was the associate editor of the Journal of Urology, responsible for prostate cancer, for eight years. Dr. Klotz received the Queen’s Jubilee Medal for outstanding public service, the University of Toronto's Lister Prize, the Society of Urologic Oncology’s SUO Medal, the American Urological Association’s Richard Williams Award, the University of Toronto's Lifetime Achievement Award, the Canadian Urological Association Lifetime Achievement Award, and the Harold Warwick Award from the Canadian Cancer Society for “outstanding contributions to cancer control.” In 2015 he was inducted as a Member of the Order of Canada, Canada’s highest civilian award.
