Dr. Claire de la Calle

I think when I really tell them everything that I'm thinking about in that way, it can help reassure them that we're a team, we're in this together, and we're going to make sure that we do what's safe.

Yeah.

I mean, the short answer is that essentially really long-term prospective data, when I say long-term, I'm talking about over 10 years, looking at the risk of metastases and death in intermediate risk patients managed on active surveillance, it's very limited.

So some of it is extrapolating from PROTECT.

And then there are other studies that have synthesized multiple studies that are more what we consider more contemporary.

So in the 2000s and beyond, as a lot of these studies have used MRI, and I

We'll quote that so far it looks like the risk of prostate cancer-specific mortality and metastases is very, very low, similar to low-risk patients in those patients that have gray group 2 prostate cancer with low PSA density, overall favorable factors.

But essentially, we need to wait a little bit longer to get prospective active surveillance data.

Yes.

Yes, there's a lot of exciting research, I think, going on.

PSMA PET-guided biopsies.

There are several studies going on right now.

I'm very excited to see the results of them.

Maybe they will help with misclassification.

And we know that misclassification is a big deal in active surveillance patients.

And so if we knew from the get-go exactly what they have...

It'll help us determine better what the plan should be for them.

Other things I'm excited about is better understanding the role of germline genetics.

And this is a personal interest of mine, so maybe that's why I'm very excited about it.

But there are essentially only two studies that have really looked at rare populations.