• GW Urological Oncology Program
  • Multi-Disciplinary, Patient Centered Cancer Care
  • The GW Cancer Center offers advanced treatment in urology, including minimally invasive, laparoscopic surgery for the management of urinary, prostate, kidney, and pelvic disorders.

Program Information

Urology is the branch of medicine that focuses on diseases of the male and female urinary tract system and the male reproductive organs. Urologic organs include the kidneys, adrenal glands, ureters, urinary bladder, urethra. The male reproductive organs include testicles, prostate, penis, and others.

Our program provides advanced diagnosis and treatment for patients with a urology cancer.

Research-based, Patient-Centered Cancer Care

The GW Cancer Center invests in research that will lead to future treatments and cures. As part of this, we’ve created a tissue bank for prostate, bladder, kidney, and testicular cancer. When new treatments become available, we will study them using saved tissue. The results translate into knowledge of which treatments work best for each tissue type.

This effort will lead to more individualized medicine. This is the future of cancer treatment. We will be able to offer better results when treatment plans are based on an individual’s genetics. 

Collaborative Care

We offer a multidisciplinary clinic where patients can conveniently interact with several specialists in one visit. Our team works together to provide an accurate diagnosis and to create the best treatment plan. Patients benefit when great minds collaborate on diagnosis and treatment options.

Patients who have received a diagnosis of testicular cancer should promptly consult our male fertility specialists prior to undergoing treatment. You can contact a specialist at saveyoursperm@mfa.gwu.edu and expect a prompt response. Our specialists will provide a quick evaluation and options for fertility preservation. You can then begin cancer treatment with little or no delay, confident that you have taken every step possible to allow yourself the option of children in your future.

Patient navigators support patients who have been diagnosed with cancer. Navigators steer patients through the process. They even help them with the financial aspects of a cancer diagnosis, such as working with insurers.

Clinical Research

Patients in clinical trials benefit from the latest developments in the field.

GW Cancer Center partners with these organizations to offer clinical trials for patients with urologic cancer:

  • The Genitourinary Multidisciplinary D.C. Regional Oncology Project (GUMDROP)
  • The National Cancer Institute (NCI) at the National Institutes of Health (NIH)
  • The Eastern Cooperative Oncology Group (ECOG)
Advanced Diagnosis and Treatment

GW Cancer Center offers specialized screening and treatment for urologic cancers:

  • The Oncotype DX prostate cancer test predicts how aggressive the cancer will be. This helps us better determine the right treatment approach.
  • Decipher gene testing following prostate surgery categorizes risk. It identifies which treatments will be necessary to avoid a recurrence or spreading of cancer.
  • For any cancer where systemic therapy is needed, we offer a specialized sperm analysis and retrieval procedure. This obtains viable sperm that can be stored and used after cancer treatment is complete.
  • Some men with testicular cancer will be eligible for partial removal of the testicle (partial orchiectomies).
  • Hormone therapies protect sexual health and performance in men after cancer treatment.
  • We offer a reconstructive surgical procedure to divert urine out of the body for patients whose bladder has been removed.
Leading Edge Technology

GW Cancer Center invests in state-of-the-art technologies for cancer diagnosis and treatment:

  • GW was the first in the area to use the da Vinci® robot for minimally invasive urologic surgery. We have performed the highest number of robotic cases in the greater Washington, D.C., area.
  • Cysview® Blue Light Cystoscopy increases detection of cancer by using a special dye that can be better seen in cancer cells. This technology is helping to decrease the recurrence rate of cancer by catching recurrent tumors in the earliest stages.
  • Urovysion™ Fluorescence In Situ Hybridization (FISH) gives researchers a way to map an individual’s genetic material with a urine sample. We use this information to determine if cancer-causing genetic problems exist.
  • The UroNav Fusion biopsy platform combines pre-biopsy magnetic resonance images (MRI) with ultrasound images to accurately guide a biopsy needle in real time. The system provides excellent visuals of the prostate gland and the needle. It results in better tissue collection.
Cancer Type & Condition Title Description
Phase III Randomized Trial of Standard Systemic Therapy (SST) Versus Standard Systemic Therapy Plus Definitive Treatment (Surgery or Radiation) of the Primary Tumor in Metastatic Prostate Cancer)

Primary objective:
To compare overall survival in metastatic prostate cancer patients who are randomized to standard systemic therapy (SST) plus definitive treatment of the primary tumor versus standard systemic therapy alone.

Secondary objectives:

  1. To compare overall survival in metastatic prostate cancer patients who received SST plus surgical excision of the primary tumor versus SST alone in the subset who specify the surgical intent stratification factor.
  2. To compare the rate of symptomatic local progression between the treatment arms.
  3. To compare progression-free survival (PFS) between the two treatment arms.
  4. To compare rates of progression-free survival between arms for the subsets of patients with and without metastasis directed therapy (MDT) to oligometastatic sites.

Inclusion Criteria:

  1. All patients must have a histologically or cytologically proven diagnosis of adenocarcinoma of the prostate. Patients with pure small cell carcinoma* (SCC), sarcomatoid, or squamous cell carcinoma are not eligible. (*morphology must be consistent with SCC; synaptophysin or chromogranin positive by immunohistochemical staining is insufficient to diagnose SCC).
  2. Patients must have an intact prostate. No prior local therapy for prostate adenocarcinoma is allowed (e.g., brachytherapy, high-intensity focused ultrasound [HIFU], cryotherapy, laser ablative therapies). Any prior therapy for benign conditions, such as obstruction, are acceptable (e.g., transurethral resection of the prostate, greenlight laser ablation, microwave ablation).
  3. Patients must have evidence of metastatic disease on technetium bone scan and computed tomography (CT) or magnetic resonance imaging (MRI) within 42 days prior to starting standard systemic therapy. Metastatic disease that is detected by positron emission tomography (PET) scan only (sodium fluoride [NaF], prostate-specific membrane antigen [PSMA], anti-1-amino-3-18F-fluorocyclobutane-1-carboxylic acid [FACBC], carbon [C]11) but not conventional imaging (technetium [Tc]99 bone scan, CT or MRI) or solitary metastases by conventional imaging, must be confirmed histologically or cytologically.
  4. Patients with known brain metastases are not eligible. Brain imaging studies are not required for eligibility if the patient has no neurologic signs or symptoms suggestive of brain metastasis. If brain imaging studies are performed, they must be negative for disease.
  5. Patients must have received no more than 28 weeks of standard systemic therapy (SST). SST is defined as current National Comprehensive Cancer Network (NCCN) guidelines for metastatic prostate cancer.
  6. Patients must not have progressed while on SST.
  7. Patients with oligometastatic prostate cancer may receive metastasis directed therapy to up to four sites of disease prior to randomization.
  8. Patients must have a complete physical examination and medical history within 28 days prior to registration.
  9. Patients must have a PSA documented prior to initiation of SST and within 28 days prior to registration. Any additional PSAs measured while receiving SST should be recorded.
  10. Patients must have a testosterone lab documented within 28 days prior to randomization. Any additional testosterone labs measured while receiving SST should be recorded as well as pretreatment initiation if available.
  11. No other prior malignancy is allowed except for the following: adequately treated basal cell or squamous cell skin cancer, adequately treated stage 0, I or II cancer from which the patient is currently in complete remission, or any other cancer from which the patient has been disease free for three years.
  12. Patients must be offered the opportunity to participate in translational medicine studies and specimen banking for future studies.
  13. Patients who can complete Patient-Reported Outcome instruments in English, Spanish or French, must participate in the quality of life studies.
  14. Patients must be informed of the investigational nature of this study and must sign and give written informed consent in accordance with institutional and federal guidelines.
Immunotherapy With Nivolumab and Ipilimumab Followed by Nivolumab or Nivolumab With Cabozantinib for Patients With Advanced Kidney Cancer, The PDIGREE Study

Primary objective:
To compare the overall survival (OS) in patients with metastatic RCC treated with ipilimumabnivolumab followed by either nivolumab versus cabozantinib-nivolumab.

Secondary objectives:

  • To determine PFS of patients treated with nivolumab versus nivolumab-cabozantinib
  • To evaluate the 12-month complete response rate in patients treated with ipilimumabnivolumab followed by cabozantinib-nivolumab versus ipilimumab-nivolumab followed by nivolumab (patients who have CR and relapse before 12 months will not be counted as a CR at 12-months)
  • To evaluate the rates of discontinuing therapy at 1 year
  • To compare objective response rates (ORR, assessed by RECIST 1.1 and irRECIST criteria) for patients treated with ipilimumab-nivolumab followed by cabozantinib-nivolumab versus ipilimumab-nivolumab followed by nivolumab.
  • To document the adverse event profile of ipilimumab-nivolumab followed by cabozantinibnivolumab.

Inclusion Criteria:

  1. Histologically documented renal cell carcinoma with clear cell component, including patients who have sarcomatoid features.
  2. Any metastatic disease, including visceral, lymph node, other soft tissue and bone, measurable per RECIST 1.1.
  3. Measurable disease as defined in the protocol.
  4. Must be intermediate or poor risk patient per International Metastatic Renal Cell Carcinoma Database (IMDC) criteria (1 or more of the following: Karnofsky performance status [KPS] < 80, < 1 year from diagnosis [including initial nephrectomy] to systemic treatment for metastatic disease, hemoglobin less than lower limit of normal [LLN], corrected calcium concentration greater than upper limit of normal [ULN], absolute neutrophil count greater than ULN, platelet count > ULN).
  5. Central nervous system (CNS) disease permitted, if stable and not otherwise causing symptoms or needing active treatment.
  6. Karnofsky performance status >= 70%.
  7. No prior treatment with PD-1, PD-L1, or CTLA-4 targeting agents (including but not limited to nivolumab, pembrolizumab, pidilizumab, durvalumab, atezolizumab, tremelimumab, and ipilimumab), or any other drug or antibody specifically targeting T-cell co-stimulation or checkpoint pathways. The only exception is for prior treatment with nivolumab or other PD-1/PD-L1/CTLA-4 targeting therapy on pre- or post-operative trials, as long as > 1 year since completion of systemic therapy.
  8. No prior previous systemic therapy for renal cell carcinoma (prior HD IL-2 [> 28 days] and prior adjuvant sunitinib > 180 days since completion and prior immunotherapy as above are allowed).
  9. No cancer therapy less than 28 days prior to registration; this includes radiation therapy, except for bone lesions less than 14 days prior to registration. There must be a complete recovery and no ongoing complications from radiotherapy.
  10. Not pregnant and not nursing, because this study involves an agent that has known genotoxic, mutagenic and teratogenic effects. Therefore, for women of childbearing potential only, a negative serum or urine pregnancy test done =< 14 days prior to registration is required.
  11. Age >= 18 years
  12. Absolute neutrophil count (ANC) >= 1,500/mm^3.
  13. Platelet count >= 100,000/mm^3.
  14. Hemoglobin >= 8 g/dL.
  15. Calculated (Calc.) creatinine clearance >= 30 mL/min.
  16. Urine protein =< 1+ or urine protein to creatinine (UPC) ratio < 1.
  17. Total bilirubin =< 1.5 x upper limit of normal (ULN).
  18. Aspartate aminotransferase/alanine aminotransferase (AST/ALT) =< 2.5 x upper limit of normal (ULN) or < 5 x ULN if hepatic metastases present.
  19. STEP 2 REGISTRATION ELIGIBILITY CRITERIA
  20. Successful completion of at least 1 cycle of ipilimumab/nivolumab.
  21. Resolution of any treatment-related adverse events to grade 1 or less per dose modification section (this criteria does not include any adverse events [AEs] not attributable to treatment which are present due to disease). Exceptions for this criteria include patients receiving replacement hormone treatments (such as levothyroxine for treatment-related hypothyroidism or glucocorticoid replacement for adrenal insufficiency). Please contact study chair if further discussion is needed.
  22. No more than 70 days from last dose of ipilimumab/nivolumab.
Bladder Cancer Phase III Randomized Adjuvant Study of MK-3475 (Pembrolizumab) in Muscle Invasive and Locally Advanced Urothelial Carcinoma (Ambassador) versus Observation

Primary objective:
To determine DFS and OS in all patients with muscle-invasive bladder and upper-tract urothelial carcinoma treated with adjuvant MK-3475 (pembrolizumab) vs. observation.

Secondary objectives:

  1. To determine DFS and OS in PD-L1 positive and negative patients with muscle-invasive bladder and upper-tract urothelial carcinoma treated with adjuvant MK-3475 (pembrolizumab) vs. observation.
     
  2. To characterize the safety and tolerability of MK-3475 (pembrolizumab) when administered in the adjuvant setting in patients with muscle-invasive bladder and upper-tract urothelial carcinoma.

Other objective(s):
Results of the primary analysis will be examined for consistency, while taking into account the stratification factors and/or covariates of baseline QOL and fatigue.

Inclusion Criteria:

  1. Histologically confirmed muscle-invasive urothelial carcinoma of the bladder, urethra, upper tract, or lymph node positive (LN+) disease; variant histology allowed as long as urothelial carcinoma is predominant (any amount of squamous differentiation is allowed); any component of neuroendocrine carcinoma is excluded
  2. Paraffin tissue samples obtained by transurethral resection of muscle-invasive bladder tumor, upper tract resection, or other surgery must be available; this specimen submission is mandatory prior to registration as results will be used for stratification; specimens from radical/definitive surgery (radical cystectomy/nephrectomy/ureterectomy /nephroureterectomy/cystoprostatectomy and LN dissection) are preferred over transuretheral resection, if available
  3. Patient must fit into one of the following three categories:
    • a) Patients who received neoadjuvant chemotherapy and pathologic stage at surgical resection is >= pT2 and/or N+ OR
    • b) Patients who are not cisplatin-eligible (according to >= 1 of the following criteria: Eastern Cooperative Oncology Group [ECOG] performance status of 2, creatinine clearance <60 mL/min, grade >= 2 hearing loss, grade >= 2 neuropathy, or New York Heart Association class III heart failure and pathologic stage at surgical resection is >= pT3 or pN+) OR
    • c) Patients that decline adjuvant cisplatin-based or other systemic chemotherapy based on an informed discussion with the physician and pathologic stage at surgical resection is >= pT3 or pN+
  4. The 7th edition of American Joint Committee on Cancer staging will be utilized; patient must have had radical cystectomy (cystoprostatectomy for men) and lymph node dissection (for bladder primary), or nephrectomy, nephroureterectomy or ureterectomy (for uppertract tumors) or urethrectomy (in addition to a radical cystectomy-either simultaneously or in the past) >= 4 weeks but =< 16 weeks prior to pre-registration; patients who have had a partial cystectomy as definitive therapy are not eligible
  5. No gross cancer at the surgical margins; microscopic invasive urothelial carcinoma positive margins are allowed; carcinoma in situ (CIS) at margins is considered negative margins
  6. No evidence of residual cancer or metastasis after surgery; patients with upper tract urothelial carcinoma must have a negative cystoscopy within 3 months prior to pre-registration; if the bladder has been removed a cystoscopy is not required
  7. No metastatic disease (or radiologic findings "concerning" for metastatic disease) on cross-sectional imaging (according to Response Evaluation Criteria in Solid Tumors [RECIST] version [v]1.1 criteria)
  8. No active autoimmune disease or history of autoimmune disease that might recur, which may affect vital organ function or require immune suppressive treatment including systemic corticosteroids; these include but are not limited to patients with a history of immune related neurologic disease, multiple sclerosis, autoimmune (demyelinating) neuropathy, Guillain-Barre syndrome, myasthenia gravis; systemic autoimmune disease such as systemic lupus erythematosus (SLE), connective tissue diseases, scleroderma, inflammatory bowel disease (IBD), Crohn's, ulcerative colitis, hepatitis; and patients with a history of toxic epidermal necrolysis (TEN), Stevens-Johnson syndrome, or phospholipid syndrome because of the risk of recurrence or exacerbation of disease; human immunodeficiency virus (HIV) (+) patients are eligible as long as they have: cd4 > 200, undetectable viral load and on highly active antiretroviral therapy (HAART) therapy
  9. No current pneumonitis or prior history of non-infectious pneumonitis that required steroids within the previous 5 years
  10. Patients with vitiligo, endocrine deficiencies including type I diabetes mellitus, thyroiditis managed with replacement hormones including physiologic corticosteroids are eligible
GWCC Urological Oncology Program
2150 Pennsylvania Ave, NW 2nd Floor
Washington , DC
United States

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202-741-3123