Using artificial intelligence (AI) to improve prediction of prostate cancer treatment response and biomarkers to enhance prostate cancer diagnosis were among the topics discussed by UCSF clinicians at the American Urological Association’s 2025 annual meeting. The meeting took place April 26 to 29 in Las Vegas and was attended by urologists, residents, researchers and advanced practice providers, many of whom presented on the latest advances and technologies in urology.
This year’s program featured innovative research and discussions by experts from the UCSF Department of Urology.
Leading UCSF presentations:
Matthew Cooperberg, MD, MPH, urologic cancer surgeon and co-leader of the UCSF Helen Diller Family Comprehensive Cancer Center's prostate program, presented “IP05-38: Predicting long term outcomes following radical prostatectomy using a validated pathology-based multimodal artificial intelligence biomarker” during the poster and podium session “IP05: Prostate Cancer: Markers.” Over the past decade, multiple biomarkers have been developed and validated for estimation of prostate cancer prognosis. However, these require access to archival tissue and central laboratory processing, making them labor-intensive and expensive. Deep learning models based on image analysis of standard clinical pathology slides may offer similar accuracy with improved access and lower cost. Multimodal artificial intelligence (MMAI) models have previously been validated to prognosticate as well as predict response to intensified treatment among patients undergoing radiation therapy and have been endorsed in the National Comprehensive Cancer Network (NCCN) guidelines. Cooperberg reported on the accuracy of an MMAI model in prognosticating outcomes after radical prostatectomy (RP) using tissue microarray (TMA) specimens.
Cooperberg was a speaker for “057IC - Incorporating Genomic Testing and Advanced Imaging For Prostate Cancer Into Your Practice.” There are multiple genomic tests and advanced imaging modalities (MRI, PSMA PET) currently available for detecting and risk-stratifying prostate cancer in men. The outcomes of these tests may lead to different detection strategies (such as observation or immediate biopsy) and treatment decisions (such as active surveillance, surgery, radiation and adjuvant therapy). Cooperberg discussed germline testing for screening, treatment, genetic counseling, and cascade testing of family members. He described the research that led to the approval of genomic testing for prostate cancer and the implementation of advanced imaging for prostate cancer as well as how to determine the appropriate genomic testing and advanced imaging technique based on a patient's unique clinical situation.
Cooperberg was also a speaker for “MP01: Prostate Cancer: Epidemiology & Natural History I.”
Tom Lue, MD, ScD (Hon), FACS, the Emil Tanagho Endowed Chair in Clinical Urology at UCSF, was a speaker for “Crossfire: Controversies in Urology: Shockwave Therapy Should be Offered as a Treatment for Erectile Dysfunction” during the Monday afternoon plenary session. He also hosted the World Chinese Urologic Society session and awards presentation at the conference.
Ira Sharlip, MD, UCSF professor of urology, was a speaker and director for “003IC: Vasectomy: A Very Practical Case-Based Course on Preoperative, Intraoperative and Postoperative Management.” With the US Supreme Court’s decision to allow states to reverse abortion rights, demand for vasectomy has increased in the United States. This session used actual cases to illustrate the most important points in the AUA vasectomy guideline, which is the first and only evidence-based guideline on this topic and the international gold standard for vasectomy surgeons. A robust discussion of ethical dilemmas related to vasectomy followed. Sharlip was also the featured speaker for “Deceptive and Dangerous Practices in the Dietary Supplement Industry” in the Sexual Medicine Society of North America (SMSNA)’s session.
Pablo Suarez, BS, UCSF medical student and member of the UCSF Li Lab, presented “IP04-34: Financial toxicity in benign prostatic hyperplasia” during “IP04: Health Services Research: Practice Patterns, Quality of Life and Shared Decision Making I.” Financial toxicity, generally defined as harm to patients caused by treatment cost, is poorly described in the nonmalignant setting. In benign prostatic hyperplasia, the costs of chronic treatment may result in significant burdens. The goal of this study was to characterize the association between financial toxicity and treatment of benign prostatic hyperplasia.
Suarez also presented “IP06-33: It's in the water: linking increased kidney stone burden to local water quality by census tract” during the podium and poster session “IP06: Stone Disease: Epidemiology & Evaluation.” Safe drinking water is a human right, yet water contamination remains a global health concern. Urolithiasis affects 10% of individuals and has been linked to environmental factors, such as climate and water hardness. However, there is a paucity of data regarding the quality of drinking water. This study examined the relationship between a census-based drinking water contamination index and kidney stone disease among California residents.
Kevin Shee, MD, PhD, UCSF urology resident physician, presented “PD10-03: Determining the role of the tumor microenvironment secretome on response to phosphoinositide 3-kinase pathway inhibition in prostate cancer” during poster and podium session “PD10: Prostate Cancer: Basic Research & Pathophysiology I.” The phosphoinositide 3-kinase (PI3K) pathway is a well-described resistance mechanism to therapeutics targeting androgen receptor (AR) signaling for advanced prostate cancer (PCa). Alterations in PI3K pathway genes are common in PCa, and preclinical studies have demonstrated the effectiveness of PI3K inhibitors (PI3Ki) in cell line–based models. These studies have led to many clinical trials testing PI3Ki in PCa patients, but clinical success has been limited. Shee and his colleagues hypothesized that the tumor microenvironment may play an important role in driving drug resistance to PI3Ki in PCa, and he reported on their study results.
Alan Shindel, MD, MAS, UCSF professor of urology, was a speaker for “020IC - Case-Based Approach to Understanding the AUA Sexual Medicine Guidelines.” Over the past nine years, numerous AUA/SMSNA guidelines have been published. In 2015, the first Peyronie's guidelines were released. In 2018, the AUA/SMSNA testosterone and erectile dysfunction guidelines were published. Finally, in 2021 and 2022, the AUA/SMSNA priapism and disorders of ejaculation guidelines were released. Many clinicians remain unaware of the latest recommendations on how to diagnose and treat these conditions. The purpose of this case-based course was to provide clinicians with key takeaways from each of the five sets of sexual medicine guidelines. The course objectives were that learners would be able to understand and implement the guideline recommendations, specifically on diagnosing and treating patients with hypogonadism, Peyronie’s disease, priapism, ejaculatory disorders and erectile dysfunction.
Spencer Behr, MD, UCSF professor of clinical radiology and associate director of precision imaging of cancer and therapy at the UCSF Department of Radiology & Biomedical Imaging, presented the radiology session “Urologic Radiology 101: The what, why and how.” During the session, Behr reviewed various imaging modalities, highlighted imaging in clinical scenarios, discussed how the radiologist would approach each study, and described how these specialists handle specific findings in different radiology modalities.
Behr was also a speaker for “031IC - Should I Order a PET Scan? Integrating Molecular Imaging into Urologic Oncology Clinical Practice: Current Approaches and Future Opportunities.” This session focused on optimizing detection, staging, and follow-up of genitourinary malignancies through the use of molecular imaging opportunities. It explored current diagnostic imaging modalities, their performance characteristics, and imaging guidelines for cancer staging.
Sima Porten, MD, MPH urologic oncology specialist and UCSF associate professor of Urology, was a speaker for “Case Discussions in NMIBC: Sequencing Therapy after BCG Failures during the Society of Urologic Oncology session. The session looked at potential sequencing of therapies in patients with Bacillus Calmette-Guerin (BCG)-refractory non-muscle invasive bladder cancer (NMIBC); evaluating different treatment options and survivorship considerations for favorable intermediate-risk cap; utilizing methods of adopting new surgical techniques into surgical practice; and determining management options for locally advanced or metastatic renal cell carcinoma, including sequencing of surgery versus systemic therapy and use of markers in urologic cancer, such as prostate and bladder cancers.
In addition, Porten presented “SunRISe-5: A phase 3, randomized, open-label study of TAR-200 compared with intravesical chemotherapy after bacillus Calmette-Guérin in recurrent high-risk non–muscle-invasive bladder cancer” during “Clinical Trials in Progress: Bladder Cancer” during “Clinical Trials in Progress: Bladder Cancer.” She was also the speaker for “Recent Breakthrough Advances in BCG Unresponsive NMIBC” during the Korean World Urologic Congress.
Samuel L. Washington III, MD, MAS, the Goldberg-Benioff Endowed Professor in Cancer Biology at UCSF, was the featured speaker for “Modifiable Exposures in Bladder Cancer Risk” during the Society of Urologic Oncology session. Washington focused on changing what is considered an exposure – impacting risk of worse outcomes for bladder cancer – by incorporating factors related to care implementation and the health care system.
Washington was also one of the speakers for the poster and podium session “IP25: Improving Access and Outcomes Across All Populations Il.” In the session, presenters discussed their work looking at various factors that impact clinical care and clinical outcomes across a multitude of urologic disease and diagnoses.
Micha Cheng, MD, MPH, UCSF urology resident physician, presented “MP30-05: OAB patient utilization of neuromodulation rates decrease as bladder botox rates increase; trends from the AUA AQUA registry” during the poster and podium session “MP30: Urodynamics/Lower Urinary Tract Dysfunction/Female Pelvic Medicine: Overactive Bladder I.” Overactive bladder is a common condition affecting millions annually. Treatments include behavioral, pharmacotherapy and minimally invasive therapies. While several minimally invasive options exist – bladder botox, tibial nerve stimulation, sacral neuromodulation – overall utilization remains low. This study’s purpose was to evaluate treatment trends over time, particularly focusing on sacral neuromodulation. Cheng reported on findings from the study, which looked at how to better understand preferences and limitations when selecting a minimally invasive therapy.
Hao Nguyen, MD, PhD, Richard and Leilani Grinold Endowed Professor in Urology at UCSF, presented “IP21-30: A novel DNA methylation-based approach to detect clinically significant prostate cancer in seminal fluid in a large multi-center clinical study” during poster and podium session “IP21: Prostate Cancer: Detection & Screening III.” While prostate-specific antigen (PSA) is widely used for prostate cancer screening, it is associated with overdiagnosis. Magnetic resonance imaging (MRI) is increasingly used as a reflex test for high PSA but has associated limitations with cost, disparities in access, variations in interpretation, and moderate sensitivities and specificities. Since the prostate contributes an estimated 37 to 44% of ejaculate volume, the researchers sought to determine whether seminal fluid harbors biomarkers that can reveal clinically significant prostate cancer and to explore seminal fluid analysis as a cheaper and more convenient alternative to MRI for post-PSA reflex testing. Nguyen reported that in this cohort, the use of MRI still resulted in unnecessary biopsies 69.4% of the time. The researchers also demonstrated that seminal fluid cfDNA methylation was a powerful biomarker for identifying clinically significant prostate cancer, with both high sensitivity and specificity, and that at-home semen collection offers a convenient alternative to in-lab testing.
Sha Zhu, MD, PhD, postdoctoral scholar in the Chu Lab at UCSF, presented “PD35-07: FACS-based Whole-genome CRISPRi Screen to Uncover STEAP1 Regulators in Prostate Cancer” during the poster and podium session “PD35: Prostate Cancer: Basic Research and Pathophysiology III.” Six-transmembrane epithelial antigen of the prostate 1 (STEAP1) is a transmembrane protein frequently overexpressed in prostate cancer (PC). Several antibody-based therapies targeting STEAP1 have demonstrated promising preclinical and clinical outcomes. Despite its widespread and specific overexpression in PC, the molecular regulation and biological function of STEAP1 remain largely unexplored. Zhu reported on study findings that established a strong association between STEAP1 and androgen-receptor-driven metastatic castration-resistant prostate cancer subtypes. The discovery of STEAP1 regulators through the CRISPRi screen provides critical insights into its role in prostate cancer biology, which may inform the development of combination therapies, strategies to prevent resistance, and better ways to identify patient populations most likely to benefit from STEAP1-targeted treatments.
Benjamin N. Breyer, MD, MAS, the Taube Family Distinguished Professor in urology and chair of the UCSF Department of Urology, was a panelist for “Case-based Guidelines Panel Discussion: Incontinence After Prostate Treatment” during the Tuesday Plenary Session.
Mack Roach III, MD, FACR, UCSF professor of radiation oncology and urology, was a speaker for the podium and poster session “MP39: Prostate Cancer: Localized: Radiation Therapy.”
Michelle Van Kuiken, MD, UCSF assistant professor of urology, presented “Continence Pessary” during the “Moderated Point-Counterpoint: SUI in Younger Women” session of the Society of Urodynamics, Female Pelvic Medicine & Urogenital Reconstruction.
Please visit AUA2025 for complete meeting abstract and session information.
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