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80 Background: Exercise is recommended for patients with prostate cancer to manage treatment adverse effects, improve quality of life and potentially influence cancer-specific outcomes. Men with advanced prostate cancer and metastatic disease may be at increased risk of cardiac events due to their cancer treatment and comorbidities. The aim of this study was to assess the safety and efficacy of cardiopulmonary exercise testing (CPET) for assessing cardiorespiratory capacity and risk screening of patients with metastatic castrate-resistant prostate cancer (mCRPC) prior to engaging in a vigorous program of exercise medicine. Methods: Experimental design was a cross-sectional analysis of screening CPET’s from a Phase III Randomised Controlled Trial (INTERVAL-GAP4) within the clinical setting involving men with mCRPC. Testing incorporated medically supervised, symptom limited, CPET with electrocardiogram (ECG) performed on a cycle ergometer until volitional exhaustion or maximal oxygen uptake peak (V02.PEAK) attained. Outcome Measurements included safety (incidence and severity of adverse events), feasibility (completion of CPET) and efficacy (performance outcomes, screen-fails, and cardiac pathology). Descriptive statistics were calculated as mean and standard deviation. Results: 104 men (age 71.5 ± 8.4 years) with mCRPC completed a medically supervised CPET. Of these, 96 patients (92.3%) met the criterion for V02.PEAK attainment and were randomised to the INTERVAL-GAP4 trial, with 8 (7.7%) CPET screen-fails. Four positive cardiac abnormalities (3.8%) were observed, with these patients referred to a cardiologist for further assessment. Referred patients were all cleared to participate in vigorous exercise with no clinically significant cardiovascular disease or were determined to have newly diagnosed and subsequently controlled cardiovascular disease. Average V02.PEAK was 1.72 ± 0

80 Background: Exercise is recommended for patients with prostate cancer to manage treatment adverse effects, improve quality of life and potentially influence cancer-specific outcomes. Men with advanced prostate cancer and metastatic disease may be at increased risk of cardiac events due to their cancer treatment and comorbidities. The aim of this study was to assess the safety and efficacy of cardiopulmonary exercise testing (CPET) for assessing cardiorespiratory capacity and risk screening of patients with metastatic castrate-resistant prostate cancer (mCRPC) prior to engaging in a vigorous program of exercise medicine. Methods: Experimental design was a cross-sectional analysis of screening CPET’s from a Phase III Randomised Controlled Trial (INTERVAL-GAP4) within the clinical setting involving men with mCRPC. Testing incorporated medically supervised, symptom limited, CPET with electrocardiogram (ECG) performed on a cycle ergometer until volitional exhaustion or maximal oxygen uptake peak (V02.PEAK) attained. Outcome Measurements included safety (incidence and severity of adverse events), feasibility (completion of CPET) and efficacy (performance outcomes, screen-fails, and cardiac pathology). Descriptive statistics were calculated as mean and standard deviation. Results: 104 men (age 71.5 ± 8.4 years) with mCRPC completed a medically supervised CPET. Of these, 96 patients (92.3%) met the criterion for V02.PEAK attainment and were randomised to the INTERVAL-GAP4 trial, with 8 (7.7%) CPET screen-fails. Four positive cardiac abnormalities (3.8%) were observed, with these patients referred to a cardiologist for further assessment. Referred patients were all cleared to participate in vigorous exercise with no clinically significant cardiovascular disease or were determined to have newly diagnosed and subsequently controlled cardiovascular disease. Average V02.PEAK was 1.72 ± 0

© 2015 European Association of Urology. Context Given the highly variable behavior and clinical course of prostate cancer (PCA) and the multiple available treatment options, a personalized approach to oncologic risk stratification is important. Novel genetic approaches offer additional information to improve clinical decision making. Objective To review the use of genomic biomarkers in the prognostication of PCA outcome and prediction of therapeutic response. Evidence acquisition Systematic literature review focused on human clinical studies reporting outcome measures with external validation. The literature search included all Medline, Embase, and Scopus articles from inception through July 2014. Evidence synthesis An improved understanding of the genetic basis of prostate carcinogenesis has produced an increasing number of potential prognostic and predictive tools, such as transmembrane protease, serine2:v-ets avian erythroblastosis virus E26 oncogene homolog (TMPRSS2:ERG) gene fusion status, loss of the phosphatase and tensin homolog (PTEN) gene, and gene expression signatures utilizing messenger RNA from tumor tissue. Several commercially available gene panels with external validation are now available, although most have yet to be widely used. The most studied commercially available gene panels, Prolaris, Oncotype DX Genomic Prostate Score, and Decipher, may be used to estimate disease outcome in addition to clinical parameters or clinical nomograms. ConfirmMDx is an epigenetic test used to predict the results of repeat prostate biopsy after an initial negative biopsy. Additional future strategies include using genetic information from circulating tumor cells in the peripheral blood to guide treatment decisions at the initial diagnosis and at subsequent decision points. Conclusions Major advances have been made in our understanding of PCA biology in recent years. Our field is currently exploring the early stages of a personalized approach to augment traditional

© 2015 European Association of Urology. Context Given the highly variable behavior and clinical course of prostate cancer (PCA) and the multiple available treatment options, a personalized approach to oncologic risk stratification is important. Novel genetic approaches offer additional information to improve clinical decision making. Objective To review the use of genomic biomarkers in the prognostication of PCA outcome and prediction of therapeutic response. Evidence acquisition Systematic literature review focused on human clinical studies reporting outcome measures with external validation. The literature search included all Medline, Embase, and Scopus articles from inception through July 2014. Evidence synthesis An improved understanding of the genetic basis of prostate carcinogenesis has produced an increasing number of potential prognostic and predictive tools, such as transmembrane protease, serine2:v-ets avian erythroblastosis virus E26 oncogene homolog (TMPRSS2:ERG) gene fusion status, loss of the phosphatase and tensin homolog (PTEN) gene, and gene expression signatures utilizing messenger RNA from tumor tissue. Several commercially available gene panels with external validation are now available, although most have yet to be widely used. The most studied commercially available gene panels, Prolaris, Oncotype DX Genomic Prostate Score, and Decipher, may be used to estimate disease outcome in addition to clinical parameters or clinical nomograms. ConfirmMDx is an epigenetic test used to predict the results of repeat prostate biopsy after an initial negative biopsy. Additional future strategies include using genetic information from circulating tumor cells in the peripheral blood to guide treatment decisions at the initial diagnosis and at subsequent decision points. Conclusions Major advances have been made in our understanding of PCA biology in recent years. Our field is currently exploring the early stages of a personalized approach to augment traditional

Social media use is becoming common in medical practice. Although primarily used in this context to connect physicians, social media allows users share information, to create an online profile, to learn and keep knowledge up to date, to facilitate virtual attendance at medical conferences, and to measure impact within a field. However, shared content should be considered permanent and beyond the control of its author, and typical boundaries, such as the patient-physician interaction, become blurred, putting both parties at risk. The European Association of Urology brought together a committee of stakeholders to create guidance on the good practice and standards of use of social media. These encompass guidance about defining an online profile; managing accounts; protecting the reputations of yourself and your organization; protecting patient confidentiality; and creating honest, responsible content that reflects your standing as a physician and your membership within this profession. © 2014 European Association of Urology.

Social media use is becoming common in medical practice. Although primarily used in this context to connect physicians, social media allows users share information, to create an online profile, to learn and keep knowledge up to date, to facilitate virtual attendance at medical conferences, and to measure impact within a field. However, shared content should be considered permanent and beyond the control of its author, and typical boundaries, such as the patient-physician interaction, become blurred, putting both parties at risk. The European Association of Urology brought together a committee of stakeholders to create guidance on the good practice and standards of use of social media. These encompass guidance about defining an online profile; managing accounts; protecting the reputations of yourself and your organization; protecting patient confidentiality; and creating honest, responsible content that reflects your standing as a physician and your membership within this profession. © 2014 European Association of Urology.