Phillip Koo:

A lot of us hear about focal therapy. We see ads direct to patients about focal therapy in every city, every billboard, but we really need trials like this to help inform us on how does it really perform against the current standard of care?

So, it sounds like right now, so far, we're seeing that in terms of some of the side effects, it's better, but the true sort of endpoint would be, alright, does it really control the cancer as well as what we're currently doing? And when do we expect to see those results, Zach?

Zachary Klaassen:

Yeah, probably the first oncological endpoint's at about 3 years, so it'll be some time, and then they'll follow them long-term for 4 to 10 years, so I anticipate we'll see several presentations on this trial, even before that 3-year point, but really, we'll start to see some of those important oncological outcomes. It'll take us several years still.

Phillip Koo:

Alright, and you know, there are a lot of different ways in which focal therapy can be performed. I presume we'll need trials using each of those different types of therapies, but what's sort of your thoughts in general on the types of therapy?

Zachary Klaassen:

Yeah, I think… I think they all generally work pretty well. So, we talked about ultrasound with TULSA. There's also HIFU, which is very similar to TULSA. There is cryoablation, which freezes the tissue rather than heats it up. There's, NanoKnife, or IRE, which uses electricity. There's laser ablation. They're all kind of similar. They damage the cancer cells in different ways.

But I think the thing I always talk about with focal therapy is it's all about patient selection. So this is not for the person who has disease on both sides of their prostate, high risk, Gleason 9 prostate cancer. That's not the patient. It's typically for unilateral 3 plus 4, 4 plus 3, areas we can see on the MRI. Those patients are likely good candidates for considering it. So, again, patient selection for everything we do is super important. It's very important for focal therapy.

Phillip Koo:

Great. So there are some questions about, you know, the names, what is TULSA? I think TULSA, I believe, is a brand name. Electricity is a technique, HIFU is a different technique, so a lot of different ways, but they all fall underneath the umbrella of focal therapy. So, I think this is exciting, I think it's definitely informative.

Probably not practice changing today, is that correct?

Zachary Klaassen:

I think that's fair. I think it's great to see a head-to-head trial against, you know, a gold standard such as removing the prostate. You know, we're using, you know, focal therapy itself in those selected patients we talked about is being done, and I think in the right hands of the physicians and the providers that are counseling patients.

I think it's reasonable. But to see head-to-head data, and eventually to see the oncological outcomes, we're looking for non-inferior here. We're not looking for better, we're looking for the same, and I think that's important.

Phillip Koo:

Alright, good. And this is where I think patients really need to sort of be an active participant in those discussions. Like, if those side effects, getting one of those side effects is really, really so… they live in fear of that, then maybe you would sacrifice some oncologic control because you would have less risk of some of these complications. So, you know, just be vocal and make sure you share your concerns up front with your physicians when thinking about these different treatments.