Urology @ Massachusetts General Hospital. Urologic oncology fellowship @ MD Anderson Cancer Center. Currently @ Cleveland Clinic Florida. Urologic Oncology
Joined May 2019
- Tweets475
- Following251
- Followers449
- Likes1.4K
Alberto Pieretti retweeted
PROTEUS Substudy: Periop Apa + ADT with RP+PLND vs RP+PLND in HR PCa @urotoday #ESMO26
Periop APA + ADT (+ RP+PLND; n= 102) vs RP+PLND alone (n=306)
🚨EFS: HR 0.38, 95% CI 0.26–0.55
🚨MFS: HR 0.49, 95% CI 0.26–0.90
🚨TT 1st Sub Rx: HR 0.29, 95% CI 0.20–0.43
🚨All Gr Hot Flush: 64% vs 0.7%
Alberto Pieretti retweeted
Great day learning the fundamentals of robotic skills here in FL. Thanks to @IntuitiveSurg for setting up this awesome sim lab for our trainees!
Alberto Pieretti retweeted
Long-term oncologic outcomes of patients with grade group 1 #ProstateCancer and pT3a disease on final pathology.
In 40 men with centrally confirmed Grade Group 1 prostate cancer and pT3a disease, none developed metastases or died of prostate cancer. Adverse histology, not stage alone, drives clinically meaningful risk. #AuthorCommentary on UroToday > bit.ly/4hJBXDF @JaneNguyen44 @ZSchwen @MWatfa26 @CleClinicUro @pcan_journal
Alberto Pieretti retweeted
Calling all urology applicants!! 📢
We invite you to join us the Cleveland Clinic Florida Virtual Open House.
Come and learn about all the exiting things happening at our growing program.
Date: Tuesday September 15, 2026
Time: 5:00 to 6:00 PM EST
events.teams.microsoft.com/e…
Alberto Pieretti retweeted
Congrats to @DrFAbdollah and team on genuine 10-yr follow-up of a real RCT — rare and valuable, though at n=60/arm, randomization for continence outcomes can't fully protect against chance baseline imbalance in pathology. However, reporting outcomes honestly deserves real credit.
Worth reading past the headline:
• Post hoc analysis — trial was designed/powered for continence, not oncologic outcomes
• Surgeons were highly experienced anteriorly but early in their RS learning curve
• pT3 disease 45% (RS) vs 23% (anterior); PSM 25% vs 13%
• Only 9 patients remained at risk at the 10-yr mark
• Authors fairly call it "hypothesis-generating"
Good data, not a verdict. Bigger, prospective, contemporary RCTs will tell us more.
Long-term Oncological Outcomes of Retzius-sparing Versus Anterior Robot-assisted Radical Prostatectomy: Post Hoc Analysis of a Randomized Cohort by Alfonso Santangelo ...Firas Abdollah et al
buff.ly/OZUURYD
Thank you to all the authors for trusting EUO to publish your work!
@santangelo_alfo
@DrFAbdollah
@pr.morgan.roupret
@ric_campi89
@laura.marandino
@jteoh_hk
@davdandrea
@renu.eapen
@uroweb
@gu_cast_podcast
@oncoalert
@elsevier_oncology
@elsevier_connect
Alberto Pieretti retweeted
We’re a growing program with big ambitions and exciting things ahead. 🚀
New people. New ideas. New opportunities to advance urologic care across Florida ☀️
We’re just getting started. 😎🌴
newsroom.clevelandclinic.org…
Alberto Pieretti retweeted
📢@CleClinicUro_FL is growing! We are seeking a BE/BC urologist with fellowship training in sexual medicine, andrology and infertility. Exciting opportunity to join a high volume, world class team, and shape the training & research program in FL☀️🌴!
Alberto Pieretti retweeted
Late to the game on X, but not to urology.
Meet Cleveland Clinic Florida Urology. Following in the footsteps of our big sibling @CleClinicUro to expand education, innovation, research and first class patient care across the sunshine state ☀️ 🌴
Alberto Pieretti retweeted
Big week for #prostatecancer news @JAMA_current!
First @grace_syl for PROFOUND-VET: use of #activesurveillance is now 93% for low-risk disease and 62% for favorable intermediate. Huge news and proof that @VeteransHealth is leading the way in this area.
dx.doi.org/10.1001/jama.2026…
Alberto Pieretti retweeted
New in @JAMANetworkOpen: @SWOG S1600, a multicenter phase 3 RCT, found no reduction in 30- or 90-day complications w/ specialized immunonutrition vs standard nutrition after cystectomy. Exploratory DFS/OS favored immunonutrition. #BladderCancer
@JhamiltonReeves @DrJoeUnger @JMHolzbeierlein @FoxChaseCancer @BCM_Urology @JanetKukreja @eugenekanglee @URMCUrology @DrDawnHershman @fischmd @lynnhenrymd jamanetwork.com/journals/jam…
Alberto Pieretti retweeted
pCR at cystectomy have reached levels not seen before after neoadjuvant therapy and are increasingly being proposed as a surrogate endpoint for clinical trials, but ... does improving pCR reliably predict improving overall survival?
In our collaborative study in @EurUrolOncol we analyzed 12 prospective neoadjuvant trials (3,119 patients) using a formal two-step trial-level surrogacy framework. @Pietro9609 @AndreaNecchi @drenriquegrande @BenjaminPradere @DrShariat @AlisonBirtle @OncoBellmunt @MRoupret
@ThoSeisen @laconss @slusarczyk_alek @UroMoschini
🧵
Alberto Pieretti retweeted
Another day another 📝 by our super team
🧬 New @AnnSurgOncol if one has preop ctDNA before radical Cystectomy ( post Turbt NOT turned -with chemo) can it flag who’s truly node-negative at surgery .?? Def 👌What we found:
• NPV 96% | Sens 86% | Spec 79% ( → 1 false-neg (sampled during NAC)
• Simulated LND omission ‼️spares LND in 27/40, misses 1 limited pN1
• Pooled w/ Ben-David (n=149): NPV 92%
Of course LND stays standard. But ctDNA– as a low-risk signal is worth a prospective trial. 🔬 don’t need super extended LND with persistently negative ctDNA @NateraGenetics
link.springer.com/article/10…
Alberto Pieretti retweeted
Alberto Pieretti retweeted
📢 Calling all rising BE uro chiefs 🚨excellent 1 year opportunity to fine tune your robotics/MIS/onc skills here @CleveClinicFL in 2027! ✅High volume program ✅collegial & talented group ✅ attending/instructor privileges ✅ DaVinci SP & multiport ✅ ☀️🌊 location!! DM me
Alberto Pieretti retweeted
Thrilled to share #PRIMARY2 Trial Results. This is the first randomised trial to show that adding [⁶⁸Ga]Ga-PSMA-11 PET-CT to MRI can safely halve the number of men needing a prostate biopsy.
Hot off the press in @TheLancetOncol 🎉
In 660 men across Australian sites with PI-RADS 2-3 but high clinical risk, PSMA-PET:
- Avoided biopsy in nearly half (49%)
- Was non-inferior for detecting clinically significant cancer (12% vs 16%)
- Halved the overdiagnosis of insignificant cancer (32% to 14%)
Fewer biopsies, less overdiagnosis, whilst not missing clinically significant prostate cancer: a real step forward for the diagnostic pathway.
Enormous congratulations to @ButeauJames @PeterMacCC , who led this as the centrepiece of his PhD and presented it as a plenary at #EAU26 in London. And to my brilliant co-lead @drlouiseemmett - this was a true partnership across our two centres.
Thank you to the UROLOGISTS @DrDanielMoon @declangmurphy (& many others), nuclear medicine physicians, technologists, radiopharmaceutical scientists across every site, and to @AnnetteVDHeyden and the @pros_tic who held it all together.
We are grateful to our funders: @PCF_Science, @nhmrc, St Vincent's Curran Foundation, Peter MacCallum Cancer Foundation, and @ANZUPtrials
Most of all, thank you to the 660 men who took part.
Open Access article: thelancet.com/journals/lanon…
Alberto Pieretti retweeted
Congratulations @chadritchmd and the entire @CleveClinicFL team. Looking forward to all the innovation ahead and the impact this platform will have for patients across Florida.
@CleClinicUro @CleClinicMD
Excited to launch 🚀the @IntuitiveSurg DaVinci SP single port robotic program here @CleveClinicFL w our first cases in the 📚!!Thanks to the pioneering work from @CleClinicUro @drjkaouk. We look forward to expanding the use of this platform in Florida!
Alberto Pieretti retweeted
PARP and Androgen-Signaling Inhibition plus ADT in Metastatic Prostate Cancer : TALAPRO3
nejm.org/doi/abs/10.1056/NEJ…
In metastatic androgen pathway modulation–sensitive (APMS) #ProstateCancer with HRR gene alterations, talazoparib + enzalutamide was compared with enzalutamide alone in a phase 3, double-blind trial (~600 patients).
📊 Efficacy
At 3 years, imaging-based PFS was 77% vs 56%, translating to a 52% reduction in risk of progression or death (HR 0.48; P<0.001).
Interim OS showed a numerical trend:
• 78% vs 72% (HR 0.77; 95% CI 0.56–1.04)
⚠️ Safety
• Serious AEs: 42% vs 32%
• Grade ≥3 anemia: 51%
• Two treatment-related deaths in the talazoparib arm
💡 Take-home: Adding talazoparib significantly improves PFS in HRR-altered APMS prostate cancer, supporting earlier use of PARP inhibition, but with increased hematologic toxicity.
@neerajaiims
@AzadOncology
@quimmateo
@nealshore
@cvulsteke
@OncoAlert
@Silke_Gillessen
@AOmlin
@weoncologists
Alberto Pieretti retweeted
JUST In: TALAPRO-3 published in @NEJM
Adding #talazoparib to enzalutamide/ADT
=>3-year rPFS: 77% vs 56% in HRR-deficient metastatic prostate cancer !
Looking forward to full presentation by @neerajaiims who keeps changing SOC, one trial at a time.
@ASCO #ASCO26 @OncoAlert
Alberto Pieretti retweeted
People have been DM and asking me: with an HR of 0.68 for durvalumab + BCG in POTOMAC, why isn’t this for every high-risk NMIBC patient?
Here’s how hazard ratios work – and why they can mislead you if you stop there. 🧵 #ASCO26
@tompowles1 @WesKassouf @shilpaonc @DrFelixGuerrero
The approval answers one question, but leaves another unanswered: which patients truly derive enough benefit to justify escalation beyond optimized BCG?
The FDA approval of durvalumab plus BCG in high-risk NMIBC was driven by a meaningful improvement in disease-free survival (HR 0.68), mainly recurrence free survival. Checkpoint inhibitors are not benign therapies, carrying ~ 15% risk of serious treatment-related adverse events.
At the same time, this trial also demonstrated that patients with BCG-naïve high-risk NMIBC have low rates of progression and bladder cancer mortality, when treated with BCG appropriately.
For many patients, the balance between reducing recurrence and exposing them to potentially significant toxicity is not straightforward.
That raises a practical question: who should actually receive treatment intensification?
Alberto Pieretti retweeted
It's entirely plausible that renaming Grade Group 1 (Gleason 6) PrCa can save a whole lot of lives.
Consider reading and discussing.
Editorial by @OtisBrawley
@dr_coops @VickersBiostats @GladellPaner @UCLAHealth @UCLAHealthJCCC
jamanetwork.com/journals/jam…
