Dr. Alexandre Zlotta

• 2026–present; Specialty Chief Editor of Urological Disorders, Frontiers in Medicine Journal
• 2024–present; Chair, Howard Sokolowski Chair in Uro-Oncological Research University of Toronto, Toronto
• 2015–present; Associate Editor, Bladder Cancer Journal
• 2013–present; Clinician Scientist, Mount Sinai Hospital, Sinai Health, Toronto
• 2007–present; Cross Appointment, Division of Urology, Department of Surgery, Women’s College Hospital, Canada  
• 2006–present; Professor, Urology, Surgery, University of Toronto, Toronto 
• 2006–present; Director, Urological Oncology, Division of Urology (Surgery), Murray Koffler Urologic Wellness Centre, Mount Sinai Hospital, Sinai Health, Toronto
• 2006–present; Associate Staff, Division of Urology (Surgical Oncology), Surgical Oncology, Urology, University Health Network (Princess Margaret Hospital and Toronto General Hospital), Toronto  

Former appointments 

• 2010–2017; Director, Uro-Oncology fellowship program, Society of Urologic Oncology (SUO) 
• 2004–2012; Associate Editor, European Urology
• 2004–2009; Board Member, European Society of Urologic Oncology (SUO)
• 2004–2006; Member, Royal College of Oncology, Belgium
• 2001–2022; Faculty, European School of Urology, Arnhem, Netherlands
• 2000–2008; Member, Scientific Committee of the European Association of Urology
• 2000–2006; Staff Urologist, University Clinics of Brussels, Belgium

• PhD, Immunology, Free Univesity of Brussels, Brussels, Belgium; 2007
• MD, Free University of Brussels, Brussels, Belgium; 1984–1989
• Urology, Free University of Brussels, Brussels, Belgium; 1989–1995

• 2025 – Best Abstract Award, European Association of Urology, Madrid, Spain
• 2023–2024 – Faculty Teaching Award, University of Toronto Uro-Oncology Fellowship, Toronto, Canada
• 2013–2014 – Faculty Postgraduate Teaching Award Clinical, University of Toronto, Department of Surgery, Division of Urology, Toronto, Canada
• 2012 – EAU Platinum Award 2012, European Association of Urology/European Urology, Paris, France
• 2000 – EAU 2000 Crystal Matula, European Association of Urology 

Radical cystectomy versus trimodality therapy for muscle-invasive bladder cancer: a multi-institutional propensity score matcher and weighted analysis

A landmark study conducted through a collaboration between Sinai Health, Princess Margaret Cancer Centre at University Health Network (UHN), Harvard Medical School and Massachusetts General Hospital and University of South California Los Angeles – and published in The Lancet Oncology – proved that a combination of surgery, radiation and low-dose chemotherapy can preserve the bladder for select patients while delivering the same survival outcomes as life-altering complete bladder removal. 

This work has already changed international treatment guidelines in urology and oncology. The study is now expanding across North America with extended follow-up and advanced analysis — a transformative advance that is sparing patients the trauma of bladder removal while offering the same chances of survival. 

The next goal is to understand how far the indications for safely preserving the bladder can be extended. With the collaboration of Dr. Laurent Briollais, statistician and senior investigator at the LTRI, we are using sophisticated and innovative statistical methods, such as pseudo-randomization, to provide the most scientifically robust evidence comparing bladder removal (cystectomy) and bladder preservation (trimodality therapy) in the absence of randomized study in this space. 

Read more about this research in the The Lancet Oncology. 

Genomic, transcriptomic and proteomic landscape of non-muscle invasive bladder cancer: predicting response or resistance to intravesical BCG 

In collaboration with Drs. Lilian Siu and Girish Kulkarni at UHN and Dr. Peter Black at the University of British Columbia, through a Marathon of Hope grant, we are correlating the genomic and transcriptomic landscape of high-risk non-muscle invasive bladder tumours (NMIBC) with disease outcomes in patients treated with adjuvant intravesical BCG immunotherapy. 

We are teaming with Drs. Kieran Campbell and Hartland Jackson at LTRI to add the spatial proteomic analysis to the RNAseq/DNAseq components. This will allow us to explore the use of these multi-omic platforms to predict resistance to therapy and to suggest a rapid switch in management. This work is poised to improve the management of patients affected by high-risk non-muscle invasive bladder cancer who are at risk of progression to potentially lethal muscle-invasive bladder cancer.  

Development and international evaluation of an artificial intelligence-based model (PROGRxN-BCa) using the World Health Organization 2004/2022 grading system to predict progression risk and improve substratification for non-muscle-invasive bladder cancer 

We are continuing a large, multi-institutional, international endeavour using artificial intelligence as a tool to predict the risk of recurrence and progression of non-muscle-invasive bladder cancer to more advanced, potentially life-threatening muscle-invasive disease. Indeed, current tools for non-muscle-invasive bladder cancer (NMIBC) perform sub-optimally in predicting progression risk to potentially lethal muscle-invasive disease. 

Through a very successful collaboration with many centres throughout Canada, UHN with Dr. Girish Kulkarni, MD Anderson in the US, and many centres affiliated with the European Association of Urology bladder group, we have recently published in the premier urology journal, European Urology, the largest cohort of non-muscle-invasive bladder cancer patients assembled (over 12,000). This study has shown that a new AI predictor outperformed current tools in the largest NMIBC cohort of its kind and has already led to a change in the guidelines.

Read more about this research in European Urology.

Artificial intelligence (AI) for bladder cancer diagnosis, grading and prognosis

With Drs. George Youssef, Ioannis Prassas, Fatemeh Zabihollahy and Neil Fleshner at UHN in collaboration with LTRI, we are using AI combined with RNA sequencing data and pathology to predict grade and stage of bladder cancer and improve our current tools. 

Development of a new AI tool for an early detection of the aggressive forms of prostate cancer at a localized and curable stage  

In partnership with Dr. Chris Wallis at Sinai Health, UHN, and collaborators from the University of Miami and Karolinska Institute in Stockholm as well as from Brussels, Shanghai, Tokyo, Seoul, Singapore and Kuala Lumpur, we have been awarded a large CIHR grant to develop an AI tool to detect aggressive prostate cancer earlier and more accurately. Using AI and biomarkers from close to 38,000 men, this project offers the potential for a major improvement over the traditional PSA blood test, which often produces false positives and cannot reliably distinguish slow-growing from potentially life-threatening cancers. 

This work is poised to save lives while reducing the anxiety and unnecessary procedures caused by current screening tools. Stemming from this large cohort of close to 40,000 patients, several sub-projects are underway: 

1. Studying the role of ancestry in the risk of being diagnosed with clinically significant prostate cancer (JNCCN).
2. Comparing clinically significant prostate cancer by PIRADS score worldwide.
3. Redefining the definition of clinically significant prostate cancer.
4. Assessing the usefulness of DRE as a diagnostic tool in the MRI setting. 

Using genetics and germline variants to improve current PSA testing and the early detection of aggressive potentially lethal prostate cancer

We have been awarded a large Movember TAG grant to study germline variants associated with metastatic prostate cancer. The overarching goal is to discover and validate genes associated with an increased risk of harbouring a lethal form of prostate cancer beyond the well-known BRCA1, BRCA2, ATM, CHEK genes. 

Secondary aims are:

1. Investigate the role of these variants on the progression risk of men managed by active surveillance.
2. Investigate the role of these variants on the response to various therapies in metastatic prostate cancer.