BackTable Urology

Keeping patients on PARP inhibitors long enough to see real benefit often comes down to proactive side effect management. In this episode of BackTable Urology, Dr. Neeraj Agarwal and Dr. Arun Azad join host Dr. Alan Tan to discuss practical, evidence-based strategies for managing hematologic and GI toxicities in advanced prostate cancer patients receiving PARP inhibitors.

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This podcast is supported by an educational grant from Pfizer.

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Timestamps

00:00 - Introduction06:17 - Managing Anemia11:12 - Side Effect Profiles19:33 - Transfusions vs ESAs26:43 - Docetaxel vs PARP Inhibitors30:27 - Side Effect Management Pearls40:18 - Team Based Monitoring52:27 - Tissue Versus Liquid01:01:24 - Genetic Counseling Workflow01:07:07 - Trial Equity and Access

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More about this episode

The doctors discuss the importance of close anemia monitoring during the critical first 3 to 4 months of therapy, maintaining dose intensity, proactive antiemetic use, and the role of exercise and resistance training in combating fatigue. The conversation also covers differences in toxicity profiles between PARP agents, the value of multidisciplinary care teams, molecular advances in molecular and germline testing, and the evolving landscape of emerging therapies in prostate care.

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Resources

Talazoparib plus enzalutamide in men with metastatic castration-resistant prostate cancer: final overall survival results from the randomised, placebo-controlled, phase 3 TALAPRO-2 trialhttps://www.thelancet.com/journals/lancet/article/PIIS0140-6736(25)00684-1/abstract

BRCAAway: A randomized phase 2 trial of abiraterone, olaparib, or abiraterone + olaparib in patients with metastatic castration-resistant prostate cancer (mCRPC) bearing homologous recombination-repair mutations (HRRm).https://ascopubs.org/doi/10.1200/JCO.2024.42.4_suppl.19

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BackTable Urology is the go-to podcast for urologists, urologic oncologists, and urogynecologists.

Download the free BackTable app to get early access to new episodes, cases, and courses curated by physicians in your specialty.

► https://www.backtable.com/app

Male factor infertility accounts for nearly half of all infertility cases, yet male evaluation is often delayed or overlooked. In this episode of BackTable Urology, Dr. Robert Brannigan joins guest host Dr. Catherine Nam to unpack the 2024 AUA/ASRM Male Infertility Guideline update and discuss how the field is evolving beyond basic semen analysis.

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Timestamps

00:00 - Introduction04:12 - Rationale Behind the Updates09:37 - Concurrent Couple Evaluation15:01 - Diagnosis, Assessment and Evaluation20:33 - Y Chromosome Microdeletion Testing23:54 - Workup for Recurrent Pregnancy Loss33:57 - Pelvic MRI for EDO36:46 - MicroTESE40:15 - Future Research Directions44:09 - Closing Takeaways

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More about this episode

They review updated definitions of infertility, challenges with WHO semen reference ranges, and the need for comprehensive male assessment. The discussion also covers sperm DNA fragmentation, recurrent pregnancy loss, the role of pelvic MRI for ejaculatory duct obstruction, micro-TESE for nonobstructive azoospermia, and the latest directions in male infertility research.

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Resources

Increased risk of incident chronic medical conditions in infertile men: analysis of United States claims data:https://pubmed.ncbi.nlm.nih.gov/26674559/

Diagnosis and Treatment of Infertility in Men: AUA/ASRM Guidelinehttps://www.auanet.org/guidelines-and-quality/guidelines/male-infertility

Sixth edition of the World Health Organization laboratory manual of semen analysis: Updates and essential take away for busy clinicianshttps://pmc.ncbi.nlm.nih.gov/articles/PMC10929669/

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BackTable Urology is the go-to podcast for urologists, urologic oncologists, and urogynecologists.

Download the free BackTable app to get early access to new episodes, cases, and courses curated by physicians in your specialty.

► https://www.backtable.com/app

Are biomarkers the missing link in personalized prostate cancer care? What is the practical role of biomarkers across the prostate cancer treatment continuum? In this episode of BackTable Urology, Dr. Udit Singhal (University of Michigan) joins Dr. Ruchika Talwar (Vanderbilt University) to explore the evolving role of genomic classifiers and biomarkers in prostate cancer care.

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Get the BackTable apphttps://www.backtable.com/app

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This podcast is supported byVeracytehttps://www.veracyte.com/decipher-prostate

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Timestamps

00:00 - Introduction04:58 - Current State10:07 - Interpreting High Risk Scores13:25 - Intermediate Risk Decisions16:18 - Imaging vs. Genomics18:26 - Advanced Disease Evidence22:02 - AI and Clinical Trials29:52 - Conclusions

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More about this episode

They review commonly used assays, including Prolaris, Oncotype Dx, Decipher, and ConfirmMDx and emphasize how these tools complement traditional clinical and pathologic risk factors. The discussion highlights practical applications across the disease continuum from initial diagnosis and active surveillance to intermediate-risk management and post-prostatectomy salvage decisions. They also explore emerging AI-driven tools and ongoing trials, highlighting the importance of contextualizing biomarker data within the broader clinical picture and using it to inform, rather than dictate, patient-centered care.

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BackTable Urology is the go-to podcast for urologists, urologic oncologists, and urogynecologists.

Download the free BackTable app to get early access to new episodes, cases, and courses curated by physicians in your specialty.

► https://www.backtable.com/app

When Renal Cell Carcinoma (RCC) invades the veins, the stakes and the surgical challenges rise. Are you prepared? In this episode, Dr. Vidit Sharma (Mayo Clinic) joins guest host Dr. Daniel Roberson to review Renal Cell Carcinoma (RCC) with Venous Tumor Thrombus (VTT), seen in 4 to 10% of cases. They review Mayo level classification and how CT and MRI venography guide surgical planning by defining thrombus extent and IVC involvement.

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Get the BackTable apphttps://www.backtable.com/app

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Timestamps

00:00 - Introduction03:03 - What is a Venous Tumor Thrombus?12:32 - Presentation and Workup31:49 - Preoperative Considerations40:26 - Building the Dream Team46:06 - Preop Counseling and Risks51:24 - The Operation01:31:01 - Outcomes and Adjuvant Immunotherapy01:36:40 - Future Neoadjuvant Shrinkage01:39:40 - Final Takeaways

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More about this episode

They also cover key management decisions, including when anticoagulation is appropriate and why embolic urgency is often overestimated. Dr. Sharma highlights the importance of experienced multidisciplinary teams, reviews surgical considerations across thrombus levels, and discusses outcomes, including risk stratification with the TeNNiS model and evolving roles for systemic therapy.

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Resources

Outcomes for patients with renal tumors and venous tumor thrombushttps://www.mayoclinic.org/medical-professionals/urology/news/outcomes-for-patients-with-renal-tumors-and-venous-tumor-thrombus/mac-20570379

TeNNiS Scorehttps://www.goldjournal.net/article/S0090-4295(26)00078-6/fulltext

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BackTable Urology is the go-to podcast for urologists, urologic oncologists, and urogynecologists.

Download the free BackTable app to get early access to new episodes, cases, and courses curated by physicians in your specialty.

► https://www.backtable.com/app