编者按：2026年欧洲泌尿外科学会（EAU）年会于英国伦敦盛大召开，汇聚全球泌尿领域顶尖专家，共同探讨泌尿生殖系统肿瘤的最新研究进展与临床实践变革。会议期间，肿瘤瞭望-泌尿时讯特邀加拿大蒙特利尔大学医学中心Fred Saad教授，围绕本次大会其团队发布的重磅研究、前列腺癌领域突破性进展，以及未来治疗方向展开深度分享。

您及团队在今年的EAU会议上展示了哪些研究进展？您认为这些发现对目前的临床实践有何影响？

今年我们团队在本次EAU大会上，公布了一项在加拿大开展的随机Ⅱ期研究数据，该研究聚焦于接受雄激素受体通路抑制剂（ARPI）治疗后疾病进展的转移性去势抵抗性前列腺癌（mCRPC）患者，旨在对比卡巴他赛与多西他赛在此类人群中的疗效与安全性。

既往我们开展的FIRSTANA研究，已在mCRPC患者中对比了多西他赛与卡巴他赛的治疗效果，结果显示两组主要终点总生存期（OS）无显著统计学差异。但需要明确的是，FIRSTANA研究开展时，入组患者在接受化疗前均未使用过ARPI治疗。而当前临床实践中，绝大多数mCRPC患者在化疗前都会接受ARPI治疗，且ARPI治疗失败后再使用多西他赛的临床疗效有限，患者往往很快出现疾病进展。因此，我们始终希望明确，在ARPI经治的背景下，卡巴他赛是否能较传统多西他赛带来更优的临床获益。

基于这一临床问题，我们开展了这项随机Ⅱ期研究，将入组患者1:1随机分配至多西他赛组与卡巴他赛组。研究结果显示，卡巴他赛治疗组患者的影像学无进展生存期（rPFS）与总生存期（OS）均显著优于多西他赛组：1年生存率方面，卡巴他赛组约90%的患者仍存活，而多西他赛组这一比例仅为50%左右。

安全性方面，卡巴他赛的整体耐受性更优，治疗相关不良事件发生率更低，其中脱发、神经病变的发生率显著低于多西他赛，而两组血液学不良事件发生率无显著差异。

总而言之，尽管这是一项小样本的随机Ⅱ期研究，但其结果为临床实践提供了重要启示：对于ARPI治疗失败后的mCRPC患者，卡巴他赛在疗效、安全性与耐受性方面，均显著优于多西他赛，有望成为此类患者化疗方案的更优选择。

Oncology Frontier: Professor Saad, it is a great honor to interview you. It is wonderful to see you at the 2026 EAU Annual Congress in London. What research advances has your team presented at this EAU meeting, and how do you believe these findings will impact current clinical practice?

Professor Fred Saad: At this year’s EAU congress, our team presented data from a randomized Phase II study conducted in Canada, which focused on patients with metastatic castration-resistant prostate cancer (mCRPC) who had progressed after androgen receptor pathway inhibitor (ARPI) therapy. The study aimed to compare the efficacy and safety of cabazitaxel versus docetaxel in this patient population.

Our previous FIRSTANA study compared docetaxel and cabazitaxel in unselected mCRPC patients and showed no statistically significant difference in the primary endpoint of overall survival (OS) between the two arms. However, it is important to note that at the time FIRSTANA was conducted, none of the enrolled patients had received prior ARPI therapy before chemotherapy. In current clinical practice, the vast majority of mCRPC patients receive ARPI therapy before chemotherapy, and docetaxel shows limited efficacy after ARPI failure, with patients often experiencing rapid disease progression. We therefore sought to clarify whether cabazitaxel could provide superior clinical benefit compared with conventional docetaxel in the ARPI-pretreated setting.

To address this key clinical question, we performed this randomized Phase II study, in which enrolled patients were randomly assigned 1:1 to receive docetaxel or cabazitaxel. The results demonstrated that patients treated with cabazitaxel achieved significantly better radiographic progression-free survival (rPFS) and OS than those in the docetaxel arm. Approximately 90% of patients in the cabazitaxel group were alive at 1 year, compared with only around 50% in the docetaxel group.

In terms of safety, cabazitaxel exhibited a more favorable overall tolerability profile with a lower incidence of treatment-related adverse events. Notably, the rates of alopecia and neuropathy were significantly lower than those with docetaxel, while hematologic adverse events were comparable between the two arms.

In summary, although this is a small-sample randomized Phase II study, its results carry important implications for clinical practice: for mCRPC patients with disease progression after ARPI therapy, cabazitaxel is significantly superior to docetaxel in efficacy, safety, and tolerability, and may emerge as the preferred chemotherapy option for this population.

在您的专业领域内，本次EAU会议上哪些研究或演讲给您留下了最深刻的印象？它们有哪些突出之处，又将如何塑造未来的治疗模式？

本届EAU大会上，多项前列腺癌领域的研究发布了突破性数据，其中ARTO研究的更新结果给我留下了极为深刻的印象。

本次大会期间公布的ARTO研究长期生存数据，聚焦于寡转移性前列腺癌患者，探索了转移灶定向放疗的临床价值。该研究的早期结果已证实，相较于单纯接受雄激素剥夺治疗（ADT）联合ARPI的系统治疗方案，在此基础上联合转移灶定向放疗可显著改善患者的rPFS。而本次大会更新的长期随访数据显示，转移灶定向放疗的加入可显著改善寡转移性去势抵抗性前列腺癌患者的OS，实现了总生存的明确获益。

这一结果具有里程碑式的临床意义，它明确了转移灶定向放疗在寡转移前列腺癌全程管理中的核心价值，为晚期早期寡转移去势抵抗性前列腺癌患者的治疗策略优化提供了高级别循证依据，将深刻改变此类患者的临床治疗模式，推动转移灶定向放疗成为寡转移前列腺癌系统治疗基础上的标准联合方案。

Oncology Frontier: Within your field of expertise, which studies or lectures at this EAU meeting left the deepest impression on you? What are their key strengths, and how will they shape future treatment models?

Professor Fred Saad: At this year’s EAU congress, multiple studies in prostate cancer have reported breakthrough data, among which the updated results of the ARTO study were particularly impressive.

The long-term survival data of the ARTO study, unveiled during this congress, focused on patients with oligometastatic prostate cancer and investigated the clinical value of metastasis-directed therapy (MDT). Early results from the study had already confirmed that adding MDT to standard systemic therapy with androgen deprivation therapy (ADT) plus ARPI significantly improved rPFS compared with systemic therapy alone. The updated long-term follow-up data presented at this congress further showed that the addition of MDT significantly improved OS in patients with oligometastatic castration-resistant prostate cancer, delivering a clear overall survival benefit.

This finding carries landmark clinical significance. It establishes the central role of MDT in the holistic management of oligometastatic prostate cancer, provides high-level evidence for optimizing treatment strategies in patients with early oligometastatic castration-resistant prostate cancer, and will profoundly transform the clinical treatment paradigm for these patients, promoting MDT as a standard combination regimen on the basis of systemic therapy for oligometastatic prostate cancer.

您将在不久的将来前往中国，您有什么想对中国的专家或患者说的吗？也请您简要展望一下2027年的EAU会议。

我曾多次到访中国，非常享受在中国的交流时光，也十分珍惜与中国同道的合作机会。中国的泌尿外科专家在临床诊疗与科研领域都取得了极为出色的成就，为全球多项前列腺癌领域的大型临床研究做出了举足轻重的贡献，在此向中国同道致以诚挚的感谢与敬意。

对于前列腺癌治疗的未来发展，我充满期待。未来一年，我们将持续聚焦于为患者提供更优的治疗方案与更个体化的全程管理，尤其是在转移性激素敏感性前列腺癌（mHSPC）领域，将迎来诸多突破性进展。

目前，前列腺癌的个体化精准治疗已成为主流趋势：针对PTEN缺失的患者，已有数据显示AKT抑制剂治疗可带来显著的生存获益；新型放射性配体治疗的应用时机也在不断前移，有望更早惠及转移性前列腺癌患者。此外，TALAPRO-3研究预计将于今年晚些时候公布核心数据，该研究将明确PARP抑制剂在携带同源重组修复基因突变（尤其是BRCA突变）的mHSPC患者中的治疗价值，有望为此类患者的一线治疗提供新的高级别循证依据。

我坚信，未来我们对于mHSPC患者的全程管理将愈发精准、规范。与此同时，新型放射性配体疗法也在持续研发突破，比如基于锕-225的α粒子发射剂放射性配体疗法，无论是对于激素敏感性、去势抵抗性转移性前列腺癌患者，还是镥-177治疗失败后的患者，均展现出了极具前景的治疗潜力。我对未来一年前列腺癌领域即将迎来的诸多突破性进展，充满期待与信心。

最后，我期待2027年在下一届EAU年会上与全球同道再次相见，相信届时我们将见证更多振奋人心的临床研究新数据，共同推动前列腺癌诊疗领域的持续发展。

Oncology Frontier: Thank you very much for your insights. Finally, we understand that you will be visiting China again soon. Would you like to share a message with Chinese experts or patients? Please also briefly share your outlook for the 2027 EAU congress.

Professor Fred Saad: I have visited China many times and have thoroughly enjoyed my time exchanging ideas there. I truly value the opportunities to collaborate with Chinese colleagues. Chinese urological experts have achieved remarkable accomplishments in clinical practice and scientific research, and have made pivotal contributions to numerous large-scale global clinical trials in prostate cancer. I would like to express my sincere gratitude and respect to all Chinese peers.

I am highly optimistic about the future of prostate cancer therapy. In the coming year, we will continue to focus on delivering better treatment regimens and more individualized whole-patient management, especially in metastatic hormone-sensitive prostate cancer (mHSPC), where multiple breakthrough advances are anticipated.

Precision and individualized therapy have already become the dominant trend in prostate cancer care. For patients with PTEN loss, emerging data indicate that AKT inhibitors confer significant survival benefits. The application timing of novel radiopharmaceutical therapies is also being advanced continuously, with the potential to benefit metastatic prostate cancer patients at earlier disease stages. Furthermore, the TALAPRO-3 study is expected to report key data later this year, which will define the therapeutic value of PARP inhibitors in mHSPC patients harboring homologous recombination repair gene mutations, particularly BRCA mutations, and is poised to provide new high-level evidence for first-line treatment in this subgroup.

I am confident that the holistic management of mHSPC patients will become increasingly precise and standardized. Meanwhile, novel radiopharmaceutical therapies continue to evolve rapidly. For instance, actinium-225-based α-particle emitting radiopharmaceutical therapy has demonstrated promising potential across the spectrum of metastatic prostate cancer, including hormone-sensitive, castration-resistant, and even patients with disease progression after lutetium-177 therapy. I am eagerly anticipating the many breakthrough advances that will emerge in prostate cancer over the next year.

Lastly, I look forward to reuniting with global colleagues at the 2027 EAU Annual Congress. I am confident that we will witness more inspiring clinical data and jointly advance the continuous development of prostate cancer diagnosis and treatment.

Fred Saad 教授

加拿大蒙特利尔大学医院中心泌尿肿瘤学主任

Fred Saad是加拿大蒙特利尔大学外科系的教授和主任，蒙特利尔大学医院中心泌尿肿瘤学和临床研究的主任，以及前列腺癌分子肿瘤学研究实验室的负责人。

他的研究兴趣包括前列腺癌的新型治疗方法、分子预后标志物和进展机制。他目前有超过40个临床和基础研究项目在进行中，并获得了超过5000万的研究资助。Saad教授目前担任15个国际临床试验的指导委员会成员，并参与多个指南委员会。

在过去的25年中，他在大多数改变实践的晚期前列腺癌临床试验和出版物中发挥了领导作用并担任共同作者。他是多个编辑委员会的成员，包括《柳叶刀肿瘤学》（Lancet Oncology）、《美国医学会杂志肿瘤学》（JAMA Oncology）和《自然泌尿学》（Nature Urology）。

Saad教授发表了超过1000篇经过同行评审的文章，拥有152的h指数和超过130,000次引用，自2015年以来每年都被列为全球引用最多的科学家之一。

Saad博士还担任过多个领导职位，包括加拿大泌尿学会（CUA）和魁北克泌尿学会（QUA）的会长，以及加拿大国家癌症研究所泌尿生殖组（NCIC G-U）和加拿大泌尿肿瘤学组（CUOG）的主席。他获得了众多奖项和荣誉，包括CUA和QUA的终身成就奖、美国泌尿学会（AUA）的杰出贡献奖，并被选为加拿大健康科学学院和美国泌尿外科医师协会的院士。鉴于他的众多贡献，他被授予魁北克国家勋章骑士称号，这是魁北克省政府授予的最高荣誉。