In January 2025, the AUA, in partnership with the Pfizer-Astellas Alliance, issued a competitive request for proposals (RFP) to support innovative quality improvement (QI) projects in the care of patients with advanced prostate cancer (APC). With $1.5 million in funding, the initiative aimed to close critical gaps in care delivery, promote equity, improve guideline adherence, and integrate genomics and advanced imaging into prostate cancer management.

Following a rigorous review by the AUA’s Expert Review Committee, 7 winning proposals were selected in May. These projects span academic centers and community practices across the US, focusing on issues like rural access, artificial intelligence–enhanced care coordination, genomic disparities, and optimized use of next-generation sequencing testing. Together, these efforts exemplify the AUA’s commitment to its National Quality Agenda and its strategy to elevate standards of care across diverse practice settings.

To learn more about the initiative and what it means for the future of prostate cancer care, Adam Weiner spoke with Dr Randy Vince, Chair of the AUA Expert Review Committee, about the goals, significance, and transformative potential of these newly funded projects.

Adam Weiner, MD: Can you tell us about the motivation behind this RFP and why the AUA prioritized QI in APC at this time?

Randy Vince, MD: In today’s quickly changing landscape of research funding, one principle remains unchanged: the unwavering commitment to ensuring every patient, regardless of race, geographic location, or financial status, has access to high-quality care. As disparities in care delivery persist, it is more important than ever to implement innovative solutions that elevate both access and quality. This RFP is driven by that very mission and underscores the AUA’s commitment to advancing QI efforts. In particular, it aims to address critical gaps in care for patients with APC—those who often face the greatest barriers and the highest stakes. Through this initiative, we reaffirm our belief that excellence in care should not be a privilege for some but a standard for all.

Weiner: How does this initiative fit into the broader goals of the AUA’s National Quality Agenda and Strategies for Urologic Practice?

Vince: This initiative aligns seamlessly with the AUA’s National Quality Agenda and its Strategies for Urologic Practice. It directly addresses several of the agenda’s core priorities, including reducing disparities and promoting equitable access to urological care, enhancing patient safety, promoting patient-centered care, and delivering greater value in care. These guiding principles were front and center during the project selection process. Importantly, every funded project aligns with a priority of the Quality Agenda, reinforcing the AUA’s commitment to evidence-based, equity-driven, and patient-centered improvements in urological care. This initiative doesn’t just reflect the AUA’s mission—it advances it in a meaningful and measurable way.

Weiner: What were some of the most pressing gaps in APC care that the AUA and Pfizer-Astellas hoped to address through these grants?

Vince: The main focus of this initiative has been on enhancing access to high-quality standard-of-care treatment for patients with APC. As you know, significant disparities still exist in this area: from differences in treatment received to underutilization of genetic testing. These gaps were a primary concern during the process of selecting projects. Each funded study was chosen not only for its scientific excellence but also for its potential to directly address these disparities and improve patient outcomes. This emphasis ensures that our funding choices support the broader goal of providing equitable, evidence-based care for all patients.

Weiner: Were there any common themes or innovative approaches across the selected projects that stood out to you?

Vince: A common theme across many of the selected projects is their strong focus on patients. Whether through personalized counseling to help patients understand and pursue essential testing or by bringing health care services directly to people in underserved areas, these projects aim to make access to care easier. This approach is especially important for patients with APC, who often need complex, multispecialty care that isn’t always available locally. By improving access and meeting patients where they are, these initiatives can significantly enhance both outcomes and experiences. In short, these are not just research projects—they are patient-first solutions created to close gaps in care and make a real difference where it’s needed most.

Weiner: Several projects focused on genomic testing. Why is this such a critical area for QI in APC right now?

Vince: Whether we’re talking about genomic or genetic testing, both play a critical role in guiding treatment decisions and informing patients—and their families—about inherited risks. These tests not only help identify the most effective therapies based on a patient’s unique tumor biology but also uncover germline mutations that can be passed down across generations.

For instance, while genetic testing is recommended for men with APC, adoption rates remain disappointingly low. This is despite the well-established fact that a substantial number of these men carry hereditary mutations that could affect their children and relatives. Failing to act on this knowledge is a missed opportunity—not only for treatment optimization but for preventive care in families at risk.

That’s why projects aimed at increasing the use of genomic and genetic testing are so vital. They empower patients, guide precision treatment, and extend the benefits of modern medicine far beyond the individual to entire families and future generations.

Weiner: Rural care delivery and digital health solutions were also prominent. Can you comment on the importance of expanding access in underserved areas?

Vince: Yes, as you know, even though I’m still early in my career, I’ve devoted my work to serving all people, particularly those in underserved communities. This has been a guiding principle for me personally and professionally, and it remains a core focus for our committee.

I firmly believe that as physicians, and more importantly, as human beings, we have a duty to ensure everyone receives the highest standard of care, regardless of race, gender, sexual orientation, income, or zip code. For me, this isn’t just a professional obligation; it’s a moral necessity.

As we’ve discussed before, communities that lack robust resources often experience the most severe health disparities. This makes our focus on these areas not just important, but urgent. And this work is not a zero-sum game. We can—and must—improve care for those most in need while continuing to maintain high standards across the board.

By leveraging innovative, community-based strategies to bring care directly to underserved populations, we have an opportunity to close long-standing gaps in health care access, quality, and outcomes. That’s how we begin to build a more equitable system, where every life is valued, and every patient is empowered to thrive.

Weiner: What role do you think multidisciplinary teams (including genetic counselors, advanced practice providers, etc) will play in improving APC outcomes?

Vince: Absolutely—this is crucial. The reality is simple: multidisciplinary care teams consistently lead to better patient outcomes, regardless of the disease. Whether we’re talking about managing diabetes, treating biliary tract cancers, or addressing APC, the value of a collaborative, team-based approach is undeniable.

Multidisciplinary teams bring together diverse expertise, including that of urologists, oncologists, advanced practice providers, genetic counselors, social workers, and patient navigators. This collective approach ensures that patients receive comprehensive, coordinated care that addresses both clinical and nonclinical needs. It not only improves survival and treatment adherence but also helps patients navigate a complex health care system with greater ease.

When it comes to men with APC, they often encounter significant barriers to receiving timely and appropriate care, and multidisciplinary teams are especially crucial. These teams are better equipped to bridge gaps, streamline treatment pathways, and personalize care in ways that truly matter. Therefore, in my opinion, multidisciplinary care isn’t just advantageous; it’s essential.

Weiner: How can clinicians outside of these selected institutions benefit from the knowledge and findings that come out of this initiative?

Vince: We recognize that these projects will not solve every challenge. However, they will provide clinicians and health systems with clear examples of approaches that work and practical methods for tackling many of the issues we’ve discussed.

At the very least, these projects generate valuable insights and key takeaways that can be scaled and refined. And as we move forward, we do so with one constant priority: improving the lives of patients and their families. That is the true measure of success and the driving force behind every effort we pursue.

Weiner: What excites you most about the potential impact of this initiative?

Vince: I might sound like the eternal optimist here, but I truly believe that no man should die from prostate cancer. And the reality is, those who are dying from this disease all have APC. Men with early-stage localized disease are not the ones losing their lives to prostate cancer.

As we work to reduce unnecessary deaths and suffering, initiatives like this are absolutely vital. If there’s one thing that excites me most, it’s the potential to drive large-scale change. The findings from this initiative won’t just inform best practices—they could reshape how we care for men with APC across the country, and that’s powerful and why this work matters.

Weiner: For urologists looking to engage in QI work, what advice would you offer?

Vince: Identify a need—and pursue it relentlessly. Be bold enough to try new, creative approaches. Not every initiative will lead to immediate change and that’s okay. Even in those moments, there is invaluable insight to be gained.

Ultimately, the only way to genuinely improve our patients’ lives is through unwavering commitment. We must stay dedicated in our efforts, even when the outcomes don’t meet our expectations. Progress is often built on persistence, and real impact comes from those who refuse to give up.

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