Urologic oncologist & surgeon-scientist @SmithInstUro @CSHL | Alum @UrologyMSK @washu_uro @washumedicine @mcmasteru @SMCS1852 | Toronto native
New York, USA
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New in @JAMAOnc: Our study of >11,000 PLCO participants shows that ~25% of elevated PSA values fall below threshold within a year, but persistent elevations rarely do (<10%), and should proceed directly to further eval.
@SigridCarlsson @MariaPereMD @UrologyMSK @VickersBiostats
Many elevated PSA levels normalize within a year, but consistently high values warrant direct diagnostic evaluation without repeated testing.
ja.ma/488K3S3
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Nick Pickersgill, MD retweeted
🧵 We wrote this paper on prostate cancer diagnosis and treatment in the USA.
The TLDR figure is here (n=716,830 [!]):
🔻 Moderate declines in low-risk prostate cancer diagnoses (top panels)
🔻🔻🔻 Massive decline in how many of those patients are going on to treatment (bottom panels).
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Nick Pickersgill, MD retweeted
Out now in @BJUIjournal: our study on re-evaluating active surveillance eligibility through measurement of the total length of Gleason pattern 4 on biopsy, which provides improved & more nuanced risk prediction compared to GG or NCCN groups
bjui-journals.onlinelibrary.…
mm pattern 4 on biopsy far superior predictor of prostate cancer outcome than stage, grade, PSA, cores. We show using mm criteria rather than "favorable intermediate risk" would increase the number of US men eligible for active surveillance by >50,000. bjui-journals.onlinelibrary.…
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Nick Pickersgill, MD retweeted
mm pattern 4 on biopsy far superior predictor of prostate cancer outcome than stage, grade, PSA, cores. We show using mm criteria rather than "favorable intermediate risk" would increase the number of US men eligible for active surveillance by >50,000. bjui-journals.onlinelibrary.…
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Among cisplatin-eligible patients with muscle-invasive bladder cancer undergoing cystectomy, perioperative enfortumab vedotin–pembrolizumab led to significantly better event-free survival outcomes than cisplatin–gemcitabine. Full phase 3 KEYNOTE-B15/EV-304 trial results: nej.md/4wh8FB9
Editorial: A New Standard in Muscle-Invasive Bladder Cancer — The End of the Cisplatin Era? nej.md/4b67lZi
ALT A graph from an Original Article published in the New England Journal of Medicine article titled "Enfortumab Vedotin and Pembrolizumab in Cisplatin-Eligible Bladder Cancer." The graph shows event-free survival. The trial name, KEYNOTE-B15/EV-304, is in parentheses after the title. The NEJM identity sits at the bottom.
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Nick Pickersgill, MD retweeted
Our review on neoadjuvant intraprostatic immunotherapy for high-risk localized prostate cancer, out now in @NatRevUrol. @NickPickersgill @CGaffMD @UrologyMSK
nature.com/articles/s41585-0…
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Nick Pickersgill, MD retweeted
Congrats to our stellar class of graduates! Looking forward to celebrating tonight!
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New in @BJUIjournal: PSMA-PET/CT in pN1 prostate cancer
• Poor sensitivity for LNI in high-risk pts; negative PSMA-PET does not justify omitting PLND
• PSMA+ nodal disease = nearly guaranteed BCR & radiographic progression (1-yr BCR ~84%)
• Do these patients need adjuvant treatment intensification? Prospective trials needed
@UrologyMSK @SeanFletcherMD @VickersBiostats
bjui-journals.onlinelibrary.…
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Nick Pickersgill, MD retweeted
🚨 In our meta-analysis in @EUplatinum, longer RCT follow-up now provides HIGH certainty in a prostate cancer mortality benefit from screening
authors.elsevier.com/a/1n2mP…
Earlier syntheses found uncertain evidence of little or no PCSM benefit
Some thoughts/highlights below 👇
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Nick Pickersgill, MD retweeted
"Due to low sensitivity, PSMA-PET/CT without evidence of nodal disease does not obviate the need for PLND" BUT "PSMA-avid nodal disease portends ... nearly inevitable ... recurrence and radiographic progression, supporting treatment intensification." bjui-journals.onlinelibrary.…
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Nick Pickersgill, MD retweeted
We’re proud to celebrate @Dr_Brian_McNeil on being named a 2025–2026 RWJF Health Policy Fellow! This elite program prepares leaders to serve as senior health policy advisors in Washington, DC. During his fellowship he will serve in the office of a @SenAdamSchiff and help advance meaningful health policy work at the national level.
Brian is thrilled for the opportunity to represent urologists, the field of urology, and the AUA in this influential role. Please join us in applauding this outstanding accomplishment and exciting new chapter in his leadership journey! 👏✨
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Nick Pickersgill, MD retweeted
Nomogram for pcRPLND pathology based on @UrologyMSK @Annals_Oncology pub is finally available to the public - we hope that this tool can be used for counseling and surgical decision-making after first line chemotherapy for metastatic NSGCT. Check it out: mskcc.org/nomograms/testicul…
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Nick Pickersgill, MD retweeted
Clinically significant #ProstateCancer: Not all pattern 4 #ProstateCancer is the same. Presentation by @rovingatuscap @MSKCancerCenter. #SUO25 written coverage by @RKSayyid @UAUrology > bit.ly/44cWhpQ @UroOnc #SUO2025
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Nick Pickersgill, MD retweeted
#SUO25 @uropro presents SYNC-T SV-102 for mPCa
🧬 Image-guided intratumoral immunotherapy targeting 4 immune axes
👥 n=15 (Phase 1) | post-ARPI or hormone-declined | bone mets in 87%
🔹 ORR: 87% | CR: 53%
🔹 Bone mets resolved in 7/13 pts incl. >50 lesions in 1 case
🛡️ 95% Grade 1–2 AEs | no Gr 4/5
✅ Early signal for durable, systemic immunity via local delivery
@UroToday @UroOnc
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Nick Pickersgill, MD retweeted
Genetic ancestry and stage-specific differences in #ProstateCancer genomic alterations. Presentation by @NickPickersgill @MSKCancerCenter. #SUO25 written coverage by @zklaassen_md @GACancerCenter > bit.ly/48ysE3r @UroOnc
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Nick Pickersgill, MD retweeted
New data on outcomes after consolidative nephrectomy published in EU Oncology!
Our findings suggest that a major pathologic response after ICI therapy for metastatic RCC is associated with long PFS and OS.
Full study here: sciencedirect.com/science/ar…
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Nick Pickersgill, MD retweeted
Remains one of the cheapest/easiest ways to minimize unnecessary testing, biopsy, diagnosis, or treatment: repeat a newly elevated PSA (without empiric abx)
jamanetwork.com/journals/jam…
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Nick Pickersgill, MD retweeted
At 23 years of follow-up, population-based PSA screening of asymptomatic men led to a sustained reduction in prostate cancer mortality, although overdiagnosis remains a concern. Full ERSPC study results: nej.md/42YYsg7
Editorial: Early Detection of Prostate Cancer — Time to Fish or Cut Bait nej.md/47tKwfA
ALT Original Article | Oct 30, 2025 European Study of Prostate Cancer Screening — 23-Year Follow-up Figure 2B. Prostate Cancer–Specific Mortality. The NEJM identity sits at the bottom.
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