European Urology Today: June/July 2023

Experience in highly specialised centre for renal cancer European Urological Scholarship Programme (EUSP)

Dr. Yasmin Abu Ghanem King’s College Hospital London (GB)

Overall, our study showed that 12 weeks of neoadjuvant axitinib/avelumab treatment in ccRCC led to significant dynamic changes in the tumour microenvironment for CD8+, PD-L1 and Foxp3+ expression. High baseline Foxp3+ infiltration is associated with an unfavourable outcome in most solid tumours. This data is encouraging and supports further evaluation for better detection of patients who may benefit from systematic treatment. My experience London is a beautiful city, famous for its charm, art, historical sites, trendy fashion, culture, nightlife, shopping and variety of food. I landed in London in late January 2020. Booked a cheap hotel room for a few weeks until I found a place to stay for the next six months. On 28 February 2020, the first case of Covid 19 was detected. Flats were difficult to find, and on 23 March 2020, the British prime minister announced the ¬first lockdown in the United Kingdom, ordering people to “stay at home”. From this point onwards, I was alone, shut in a tiny hotel room for six months during a national lockdown in a new city. The world was confused and so was I. I could not leave and I could not progress with my research due to operation cancellations, delayed tissue handling and


Dr. Abu Ghanem with Prof. Bex

London tube during COVID lockdown

with University College, London. The unit offers high volume robotic surgical training, as well as outpatient clinics. After the lockdown ended, I was lucky to join the team and gain a clinical fellowship that included intense surgical training in renal cancer as well as vast general urology activity which included flexible cystoscopies and time in the haematuria clinic. I had a wonderful experience and had the opportunity to publish numerous papers, work in a new environment and learn a lot about different health systems.

Thanks to the prestigious EUSP one-year scholarschip grant, I had the opportunity to visit and work with a leading renal surgeon, Prof. Axel Bex (GB) and his team in London. My research Over the last decade, the field of RCC has changed considerably. The increasing role of immune checkpoint inhibitors (ICI), given alone or in combination with antiangiogenics, has expanded the range of potential treatments and led to improved survival in patients with advanced metastatic disease. Neoadjuvant use of these combinations is associated with tumour downsizing, but dynamic effects on key immune biomarkers are uncertain. Our study aimed to examine the early dynamic changes in the tumour immune environment after neoadjuvant treatment with avelumab/axitinib as part of the Neoavax trail. Neoavax is an open label, single arm, phase II trial, investigating 12 weeks of neoadjuvant avelumab/axitinib prior to nephrectomy in patients with high-risk non- metastatic clear-cell (cc) RCC (cT1b-4N0-1M0). Paired, sequential tissue from the first 24 patients was analysed for immune biomarker expression before and after systemic treatment.

shipment. Being forced to stay, I made the best of my time and had the opportunity to see the beauty of London. Its breath-taking buildings, its endless history, and the English charm. After my time of cycling around and discovering all parks, London slowly opened again, and we had the chance to finish our tissue collection and complete the study. The programme My fellowship took place at the Centre for Kidney Cancer, The Royal Free London NHS Foundation Trust, under the supervision of Prof. Bex. It is a highly specialised centre for renal cancer, affiliated

• Only EAUN members can apply • Host hospitals in Belgium, Denmark, France, the Netherlands, Sweden, Switzerland and the United Kingdom • A great way of widening your horizon Visit a hospital abroad! 1 or 2 weeks - expenses paid Application deadline: 31 August 2023

For Fellowship application forms, rules and regulations and information on which specialities the hosting hospitals can offer please visit the EAUN website.

Dr. Abu Ghanem receiving the 2023 EAU Best Scholar Award, with Dr. Ekaterina Laukhtina (AT) and Prof. Axel Merseburger (DE)

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European Urological Scholarship Programme Office

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European Urology Today June/July 2023


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