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Tai-Lung ChaTaiwan
Speaker
Novel Target for GU Cancer Metastasis and TherapeuticsCancer progression is shaped by both cell-intrinsic adaptations and complex extrinsic interactions within the tumor microenvironment (TME). Here, we identify a transmembrane protein, Meta1, as a shared therapeutic target that exhibits a Janus-like role: promoting malignant phenotypes in cancer cells while restraining tumor-supportive functions in non-cancerous stromal and immune cells. Meta1 is expressed in both compartments of the TME, orchestrating a dual program that supports metastasis and immune evasion. Mechanistically, we uncovered a malignancy-promoting factor (MPF) that acts as a functional ligand for Meta1, selectively enhancing pro-invasive signaling in cancer cells. We further identify Meta1 as an unconventional G protein–coupled receptor (GPCR) that plays as an accelerator in cancer cells of the TME. Meta1 interacts with Rho-GDI and Gαq to activate RhoA-mediated cytoskeletal remodeling and amoeboid migration, facilitating metastatic dissemination. We further identify MPF binding to Meta1 initiates Gβγ signaling, elevating intracellular cAMP and activating Rap1, thereby amplifying cell motility and metastatic potential. Leveraging the Meta1–MPF interaction, we designed MPF-derived peptides that specifically bind Meta1 and serve as the basis for a novel peptide-based PROTAC, which efficiently induces degradation of Meta1 and abrogates its pro-metastatic functions. Our study unveils Meta1 as an atypical GPCR with canonical signaling capacity and topological divergence, representing a shared and targetable vulnerability that bridges cancer cell-intrinsic adaptation with extrinsic TME communication. These findings establish the Meta1–MPF axis as a compelling therapeutic target for suppressing metastasis and reprogramming the TME.
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Po-Hung LinTaiwan
Speaker
Robotic Prostatectomy Using da Vinci SP SystemIn this semi-live section I will demonstrate the steps of extraperitoneal-approach radical prostatectomy using DAVINCI SP system.How to Make the Best Decision with Systemic Therapy Sequence in Respective of Genetic AnalysisRenal cell carcinoma (RCC) is a biologically heterogeneous disease driven by a limited set of convergent pathways that together shape oncogenesis, immune evasion, and therapeutic response. Across clear-cell RCC (ccRCC), recurrent alterations include VHL, PBRM1, BAP1, and SETD2, mapping onto five dominant axes: hypoxia signaling (VHL–HIF), PI3K/AKT/mTOR, chromatin remodeling, cell-cycle control, and metabolic rewiring. These lesions variably interact—e.g., mTORC1 enhances HIF translation—creating therapeutic opportunities (VEGF tyrosine-kinase inhibitors, HIF-2α inhibition, mTOR blockade) and constraints (adaptive resistance via metabolic plasticity). While immune checkpoint inhibitors (ICIs) and ICI–TKI combinations have improved outcomes in metastatic RCC, robust predictive biomarkers remain elusive. Tumor mutational burden is typically low and noninformative; PD-L1 shows assay- and context-dependent utility; PBRM1 and BAP1 are more prognostic than predictive. Emerging signals include angiogenic versus T-effector/myeloid transcriptional signatures, sarcomatoid/rhabdoid histology as a surrogate of immune-inflamed state, and host factors such as HLA genotype and gut microbiome composition. Liquid-biopsy modalities (ctDNA and methylome profiling) and spatial/single-cell atlases reveal intratumoral heterogeneity, T-cell exclusion niches, and myeloid programs (e.g., TREM2⁺ macrophages) linked to recurrence or ICI benefit. Early data support metabolism-targeted strategies (e.g., glutaminase inhibition) and rational combinations co-targeting angiogenesis, hypoxia signaling, and immune checkpoints; however, toxicity management and resistance evolution require prospective, biomarker-integrated trials. A clinical schema that pairs baseline multi-omic and microenvironmental profiling with adaptive surveillance (serial liquid biopsies, functional imaging) can lead to dynamically select among ICI–ICI, ICI–TKI, targeted, and experimental regimens. Robotic Prostatectomy Using da Vinci SP System
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Jeremy TeohHong Kong, China
Speaker
Transurethral En Bloc Resection of Bladder Tumor: Where Are We Now?There is increasing evidence that transurethral en bloc resection of bladder tumour (ERBT) could lead to better peri-operative and oncological outcomes in patients with non-muscle-invasive bladder cancer. Modified approaches of ERBT have also been proposed to expand its indications for larger bladder tumours. The quality of resection is also the key for bladder-sparing treatment for muscle-invasive bladder cancer. We foresee an exciting journey ahead for ERBT, and as a urologist, we must embrace this novel technique for the best interest of our bladder cancer patients. To Publish or not to Publish? Navigating the path to academia in urologyDoing good science is the basis for technological advancement in healthcare. However, pursuing a path to academic in urology is often tough, stressful and frustrating. In this talk, I will share with you what I have learnt throughout my 15 years of research work. I will let you know what's the best and fastest way to become a globally renowned and successful researcher. Most importantly, I will explain what it takes to develop a great team and create a positive impact in people's lives. Believe in yourself! If I can do it, so can you.SIU Lecture: Role of MISTs in Male LUTS Surgical Management (Will TUR-P/ Laser Prostatectomy be Replaced?)Transurethral resection of prostate (TURP) is the current gold standard in treating patients with benign prostatic hyperplasia. Laser prostatectomy has also been used widely especially in patients who are on anticoagulants. However, both TURP and laser prostatectomy are associated with several problems including the need of spinal / general anaesthesia and the risk of male sexual dysfunction. In the past decade, we have witnessed the introduction of multiple new technologies including Rezum, Urolift, iTind and Aquablation. in this SIU lecture, we will discuss about the technical details, as well as the pros and cons of every new technology. We will also invite you to be our jury and decide whether TURP and laser prostatectomy will be replaced in the future. Novel Intravesical Therapeutics in the Evolving Landscape of NMIBCNon-muscle-invasive bladder cancer (NMIBC) is well known to be a difficult disease to manage, with a 1-year recurrence rate of up to 61% and 5-year recurrence rate of 78%. Despite the use of intravesical BCG therapy, NMIBC patients may still experience recurrence and develop what we call BCG-unresponsive NMIBC. Conventionally, we offer upfront radical cystectomy for patients with BCG-unresponsive NMIBC, however, this is an ultra-major surgery with significant risk of complications and could also lead to significant deterioration in quality of life in the long run. We are in urgent need for novel therapies to manage this difficult condition. In this lecture, we will discuss the evidence on the different novel intravesical therapies in treating BCG-unresponsive NMIBC. SIU Lecture: Role of MISTs in Male LUTS Surgical Management (Will TUR-P/ Laser Prostatectomy be Replaced?)
Tuan Thanh NguyenVietnam
Speaker
Debate: Bladder Preservation Should Be Considered for All Cases of MIBCPractice Changing Papers
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Noor Ashani Md YusoffMalaysia
Speaker
Technical Pearls: Node Dissection in Robotic CystectomyHighlight and Limitation in Urology Service in MalaysiaRobotic Pelvic LN Dissection: A critical Component of Bladder Cancer Surgery
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Lui Shiong LeeSingapore
Speaker
Technical Pearls: Robotic Intra-Corporeal OBSThis session will demonstrate the key steps required in the intra-corporeal creation of a Studer type orthotropic bladder substitute.
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Bannakij LojanapiwatThailand
Moderator
PSA Kinetics Following PADT in mHSPC. Is It a Real-World Tool for Predicting Oncologic Outcome?PSA Kinetics following Primary Androgen Deprivation Therapy
(PADT) in mHSPC. Is it a Real-world Tool for Prediction Oncologic Outcome?
Bannakij Lojanapiwat, M.D.
Professor of Urology, Chiang Mai University, Thailand.
Of recent guidelines, upfront primary androgen deprivation monotherapy or combination therapy (PADT) is recommended for the treatment of metastatic hormone sensitive prostate cancer (mHSPC). Limitation of real-world treatment such as culture difference, financial barrier, geographic access to treatment and high operation/ radiation risks associated with medical comorbidity led to underutilization of combination therapy as the standard guideline. Prognostic factors are important in clinical practice which can predict the clinical outcome that offer the pre-treatment counseling for patients to select the optimal treatment.
Prostate specific antigen (PSA) levels is one of the important key prognostic markers. PSA kinetics of nadir PSA level and time to nadir PSA following the treatment are the important role for progression to CRPC and oncologic outcome. Our study and the previous studies reported better oncologic outcome especially overall survival, cancer specific survival and time to developed CRPC in mHSPC patients received upfront PADT who decline PSA≥95% (deep responder), PSA nadir ≤ 0.2 ng/ml (low PSA nadir level), time to PSA nadir ≥ 6 month and PSA decline velocity <11 ng/ml/month.
PSA Kinetics following Primary Androgen Deprivation Therapy (PADT) is one of a real-world tool for prediction oncologic outcome in the treatment of mHSPC.
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Peter Ka-Fung ChiuHong Kong, China
Speaker
Minimal Invasive Therapy: Where do We Stand in 2025Endourological, Laparoscopic and robotic surgeries have replaced most open surgeries in Urology. Emergence of new robotic platforms have provided urologists with new opportunities. Both boom-type and module-type robots have been used, and they each have their strengths in practice. Tele-surgeries have provided a new paradigm of long-distance robotic surgeries to facilitate new surgical possibilities and proctorship. State of the art robotic surgeries in retrograde intrarenal surgeries and enbloc resection MDT Discussion: Personalizing Treatment in High Volume CSPCN/ADebate: Should We Only Offer Consolidative Cytoreductive Nephrectomy in Metastatic RCC?N/AFocal Therapy in Asia – Is It Prime Time?The increase in incidence of Prostate cancer has been rapid in Asia in the past 10 years. While Robotic radical prostatectomy and Radiotherapy has been the commonest treatments for localized prostate cancer, significant long-term morbidities are observed after surgery or radiotherapy including incontinence, erectile dysfunction and irradiation injury to the bladder and rectum. In the current era of MRI-guided prostate biopsy, focal diseases can be targeted and diagnosed, and image-guided focal therapy emerged as an alternative treatment. Although Focal therapy has a relatively higher rate of local recurrence, it has the advantages of minimal or no long-term complication after treatment, and it is possible to perform retreatment with focal therapy, prostatectomy or radiotherapy. In properly selected patients, the need for salvage prostatectomy or radiotherapy after focal therapy is less than 20% at 8 years, and patients’ quality of life could be preserved. In well-selected patients, focal therapy is an attractive option. Current focal therapy for prostate cancer available in Asia includes HIFU, Cryotherapy, Targeted Microwave Ablation (TMA), irreversible electroporation (IRE) and TULSA.
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Enrique Ian LorenzoPhilippines
Speaker
Debate: PIRADS 4/5 Negative Biopsies ShouldDebate: Should We Only Offer Consolidative Cytoreductive Nephrectomy in Metastatic RCC?
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Tanet ThaidumrongThailand
Speaker
Technical Pearls: Retzius SparingTreating SRM in a 65-Year-Old ECOG 1 with Multiple Previous Operations-Is Minimally Invasive Treatment Feasible?
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Hung-Jen WangTaiwan
Speaker
Technical Pearls: Nerve-SparingPreserving the neurovascular bundles (NVB) during robotic-assisted radical prostatectomy (RARP) is crucial for maintaining postoperative continence and sexual function, while still ensuring complete cancer removal. We will share "technical pearls" for nerve-sparing in RARP, emphasizing practical innovations that enhance surgical precision without compromising oncologic control.
Retrograde nerve-sparing involves a bottom-up (apex-to-base) dissection of the NVB using an athermal, gentle approach. This technique, adapted from open surgery, allows early identification and release of the nerves under direct vision. By minimizing traction and avoiding cautery near the NVB, it reduces inadvertent nerve injury and even lowers the risk of positive margins at the prostatic base. Clinically, adopting a retrograde approach (often with 30° lens “toggling”) has been linked to faster functional recovery of potency, contributing to potency rates approaching 90% at 1 year in fully nerve-sparing cases.
Parallel advances in augmented reality (AR) are providing real-time surgical navigation. AR technology superimposes 3D virtual models (e.g. from MRI) onto the operative field, enhancing visualization of patient-specific anatomy. Surgeons can pinpoint tumor location relative to the NVB, enabling selective, confidence-guided nerve preservation even in locally advanced disease. This approach helps modulate nerve-sparing extent on a case-by-case basis, maintaining oncologic safety (low positive surgical margin rates) while maximizing nerve preservation.
Finally, refined anatomical landmarks have emerged to guide nerve-sparing. A notable example is the identification of a consistent small arterial branch (“landmark artery”) at the NVB’s medial aspect. This vessel serves as a guide for partial nerve-sparing: dissecting just lateral to it yields an approximate 3 mm tissue margin from the prostatic capsule, sufficient to clear potential extracapsular extension while preserving the remaining nerve fibers. Such landmark-oriented dissection provides a reproducible framework for tailoring nerve-sparing to tumor risk, moving beyond the traditional “all-or-none” approach.
These advanced techniques and concepts are empowering robotic surgeons to achieve optimal outcomes. By integrating retrograde nerve-sparing, AR-assisted navigation, and anatomical landmark guidance, one can improve early continence recovery and postoperative sexual function for patients without sacrificing cancer control.
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John YuenSingapore
Speaker
Technical Pearls: Total Extraperitoneal TechniquePractice-Changing Development in RaLRP
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John YuenSingapore
Moderator
Technical Pearls: Total Extraperitoneal TechniquePractice-Changing Development in RaLRP
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Tanet ThaidumrongThailand
Speaker
Technical Pearls: Retzius SparingTreating SRM in a 65-Year-Old ECOG 1 with Multiple Previous Operations-Is Minimally Invasive Treatment Feasible?
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Jeffrey TuanSingapore
Speaker
Treating SRM in a 65-Year-Old ECOG 1 with Multiple Previous Operations-Is SBRT the New Kid on the Block?The management of small renal masses (SRMs) in older adults with prior surgical histories remains complex, particularly in patients with limited physiological reserve and increased perioperative risk. We present the case of a 65-year-old patient with an ECOG performance status of 1 and multiple prior abdominal surgeries, highlighting the challenges of repeated surgical intervention and the evolving role of stereotactic body radiotherapy (SBRT) as a non-invasive alternative. SBRT offers ablative doses of radiation with sub-millimeter precision, enabling tumor control while preserving renal function and minimizing treatment-related morbidity. Emerging data support its safety and efficacy in medically inoperable patients or those at high surgical risk. This case underscores the need to reconsider SBRT as a frontline therapeutic option in selected patients with SRM, particularly when traditional surgical or ablative approaches are contraindicated or carry significant risk. Further prospective studies are warranted to define optimal patient selection and long-term outcomes
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Enrique Ian LorenzoPhilippines
Speaker
Debate: PIRADS 4/5 Negative Biopsies ShouldDebate: Should We Only Offer Consolidative Cytoreductive Nephrectomy in Metastatic RCC?
Peter Ka-Fung ChiuHong Kong, China
Speaker
Minimal Invasive Therapy: Where do We Stand in 2025Endourological, Laparoscopic and robotic surgeries have replaced most open surgeries in Urology. Emergence of new robotic platforms have provided urologists with new opportunities. Both boom-type and module-type robots have been used, and they each have their strengths in practice. Tele-surgeries have provided a new paradigm of long-distance robotic surgeries to facilitate new surgical possibilities and proctorship. State of the art robotic surgeries in retrograde intrarenal surgeries and enbloc resection MDT Discussion: Personalizing Treatment in High Volume CSPCN/ADebate: Should We Only Offer Consolidative Cytoreductive Nephrectomy in Metastatic RCC?N/AFocal Therapy in Asia – Is It Prime Time?The increase in incidence of Prostate cancer has been rapid in Asia in the past 10 years. While Robotic radical prostatectomy and Radiotherapy has been the commonest treatments for localized prostate cancer, significant long-term morbidities are observed after surgery or radiotherapy including incontinence, erectile dysfunction and irradiation injury to the bladder and rectum. In the current era of MRI-guided prostate biopsy, focal diseases can be targeted and diagnosed, and image-guided focal therapy emerged as an alternative treatment. Although Focal therapy has a relatively higher rate of local recurrence, it has the advantages of minimal or no long-term complication after treatment, and it is possible to perform retreatment with focal therapy, prostatectomy or radiotherapy. In properly selected patients, the need for salvage prostatectomy or radiotherapy after focal therapy is less than 20% at 8 years, and patients’ quality of life could be preserved. In well-selected patients, focal therapy is an attractive option. Current focal therapy for prostate cancer available in Asia includes HIFU, Cryotherapy, Targeted Microwave Ablation (TMA), irreversible electroporation (IRE) and TULSA.
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Henry HoSingapore
Speaker
Technical Pearls: Wheel-Barrow TechniquesBringing Innovation to PatientRobotic Partial Nephrectomy: Beyond Technique
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Tuan Thanh NguyenVietnam
Speaker
Debate: Bladder Preservation Should Be Considered for All Cases of MIBCPractice Changing Papers
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Lui Shiong LeeSingapore
Speaker
Technical Pearls: Robotic Intra-Corporeal OBSThis session will demonstrate the key steps required in the intra-corporeal creation of a Studer type orthotropic bladder substitute.
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