At the 2024 Society of Urologic Oncology (SUO) annual meeting in Dallas, TX, Dr. Seth Lerner was awarded the prestigious Huggins Medal, recognizing his significant contributions to the field of urologic oncology. Lerner's work, particularly in bladder cancer research, has advanced understanding of the disease and improved patient outcomes.
Acknowledging Team Science
Dr. Lerner began by acknowledging Dr. Charles Huggins, whose work on hormonal treatment of prostate cancer earned him the Nobel Prize in Physiology or Medicine in 1966. Lerner emphasized the importance of team science, a collaborative effort leveraging diverse expertise to address complex scientific challenges. He quoted Dr. Huggins, highlighting the collaborative nature of scientific discovery.
Lerner thanked his family and mentors from Virginia Mason Clinic, Baylor College of Medicine, and The University of Southern California, including urologic stone expert Dr. Don Griffith, for their support and guidance.
Bladder Cancer Research Consortium
One of Dr. Lerner’s early experiences in team science was building the Bladder Cancer Research Consortium in 2003, in collaboration with colleagues from Baylor, Johns Hopkins, and UT Southwestern. This consortium included 958 patients who underwent radical cystectomy plus pelvic lymph node dissection. The group's work, aided by biostatistician Pierre Karakiewicz, led to seminal studies on muscle-invasive bladder cancer, including the identification of lymphovascular invasion as an adverse prognostic feature.
The Cancer Genome Atlas (TCGA) MIBC Project
Dr. Lerner highlighted his involvement in The Cancer Genome Atlas (TCGA) MIBC project, a comprehensive molecular characterization of urothelial bladder carcinoma tissue specimens. This project involved a large team of researchers and a complex pipeline for analyzing tissue samples from patients with cT1-4aN0-3M0-1 disease. The TCGA data, publicly available for researchers worldwide, has led to almost 1,400 studies and the discovery of bladder cancer molecular subtypes, including luminal papillary, luminal infiltrated, luminal, basal squamous, and neuronal.
These molecular subtypes have been demonstrated to be associated with different survival outcomes and treatment responses, influencing the design of clinical trials like the SUBTYP trial, which compares standard of care therapy to subtype-directed therapy in muscle-invasive bladder cancer patients.
Southwest Oncology Group (SWOG) and NCTN
Dr. Lerner reflected on his experiences with the Southwest Oncology Group (SWOG), NCI National Clinical Trials Network (NCTN), and Cancer Therapy Evaluation Program (CTEP). He emphasized the importance of validation studies, citing the SWOG S1011 trial, published in The New England Journal of Medicine, which evaluated extended pelvic lymphadenectomy for muscle-invasive bladder cancer. The trial, which took over a decade to complete, did not demonstrate a survival benefit but highlighted increased mortalities associated with extended lymphadenectomy.
Lerner highlighted ongoing trials led by the SWOG GU committee, including studies on oligometastatic prostate cancer (S1802), metastatic bladder cancer (S1937), and aggressive variant mCRPC (S2312).
Guidance for Single Arm Registrational Trials
Dr. Lerner discussed his involvement with the FDA, AUA, and SUO in establishing guidance for single-arm registrational trials for agents in BCG-unresponsive NMIBC. This effort has led to the approval of several agents for this condition, including pembrolizumab, nadofaragene, and N803.
In conclusion, Dr. Lerner emphasized the importance of collaboration, mentorship, and having fun in the pursuit of scientific discovery.
