Clinical genitourinary cancer最新文献

{"title":"Letter to the Editor: Transperineal Versus Transrectal Prostate Biopsy: A Systematic Review and Meta-Analysis of Randomized Controlled Trials","authors":"Pedro Henrique Souza Brito","doi":"10.1016/j.clgc.2025.102488","DOIUrl":"10.1016/j.clgc.2025.102488","url":null,"abstract":"","PeriodicalId":10380,"journal":{"name":"Clinical genitourinary cancer","volume":"24 2","pages":"Article 102488"},"PeriodicalIF":2.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146020970","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Main Genomic Findings in Penile Cancer: An Update","authors":"Herney Andrés García-Perdomo ,&nbsp;Scott Tagawa","doi":"10.1016/j.clgc.2025.102493","DOIUrl":"10.1016/j.clgc.2025.102493","url":null,"abstract":"<div><div>Penile squamous cell carcinoma (PSCC) is a rare but highly heterogeneous malignancy accounting for over 95% of penile cancers. While it is more prevalent in regions such as South America, parts of Africa, and South Asia, its global rarity has historically limited molecular research. Recent advances in high-throughput sequencing have enabled the detailed genomic and epigenomic characterization of HPV-associated and HPV-independent carcinogenesis, unveiling critical differences between these two processes. These discoveries are reshaping classification, prognosis, and therapeutic decision-making in PSCC</div></div>","PeriodicalId":10380,"journal":{"name":"Clinical genitourinary cancer","volume":"24 2","pages":"Article 102493"},"PeriodicalIF":2.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146015856","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy and Safety of Immune Checkpoint Blockade in Locally Advanced or Metastatic Penile Cancer: A Systematic Review and Meta-Analysis","authors":"Mariana Macambira Noronha ,&nbsp;Luiz Felipe Costa de Almeida ,&nbsp;Pedro Robson Costa Passos ,&nbsp;Luís Felipe Leite da Silva ,&nbsp;Anelise Poluboiarinov Cappellaro ,&nbsp;Valbert Oliveira Costa Filho ,&nbsp;Leonardo-Gil Santana ,&nbsp;Changsu Lawrence Park ,&nbsp;Erick Figueiredo Saldanha","doi":"10.1016/j.clgc.2025.102491","DOIUrl":"10.1016/j.clgc.2025.102491","url":null,"abstract":"<div><div>Locally advanced or metastatic penile cancer (LA/mPC) is an aggressive and rare malignancy with limited treatment options. While promising, the role of Immune Checkpoint Blockade (ICB) in LA/mPC remains controversial. We performed a systematic review and meta-analysis to evaluate the efficacy and safety of ICB in patients with LA/mPC. A literature search was conducted in PubMed, Embase, and Cochrane (up to June 2025). The analysis was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines (CRD420251070583). Proportional outcomes were pooled using a random-effects proportional meta-analysis, and hazard ratios (HR) were pooled using a random-effects model. We used the available Kaplan-Meier curves to recreate time-to-event data from the studies considered. Heterogeneity between studies was evaluated using the I² metric and Cochran's Q test. A total of 12 cohorts (488 patients) were included in the analysis. The pooled Objective Response Rate in patients treated with ICB was 34.13% (95% CI, 20.62%-56.48%). Subgroup analysis demonstrated marked variability by treatment strategy, with an ORR of 60.7% for ICB plus chemotherapy versus 16.7% for ICB monotherapy (<em>P</em> &lt; .01). At 12 months, pooled Progression-Free Survival (PFS) and Overall Survival (OS) rates were 62.64% (95% CI, 55.55%-70.63%) and 80.21% (95% CI, 74.11%-86.83%), respectively. The median PFS and OS were 5.7 months and 13.6 months, respectively. The pooled incidence of Immune-related Adverse Events was 40.36% (95% CI, 26.82%-60.74%) for any grade and 13.79% (95% CI, 7.67%-24.80%) for grade ≥ 3 events. ICB, particularly when combined with chemotherapy, shows signals of clinical activity in LA/mPC. However, due to high inter-study variability and the single-arm nature of the analysis, these findings are hypothesis-generating and require prospective, randomized, biomarker-driven validation.</div></div>","PeriodicalId":10380,"journal":{"name":"Clinical genitourinary cancer","volume":"24 2","pages":"Article 102491"},"PeriodicalIF":2.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146032076","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Deterioration in Physical Fitness and Changes in Body Composition After Cisplatin-Based Chemotherapy for Metastatic Testicular Cancer","authors":"Helene F.S. Negaard ,&nbsp;Hege S. Haugnes ,&nbsp;Sophie D. Fosså ,&nbsp;Gunhild M. Gjerset ,&nbsp;Elisabeth Edvardsen ,&nbsp;Karl-Otto Larsen ,&nbsp;Torgrim Tandstad ,&nbsp;Truls Raastad ,&nbsp;Torbjørn Wisløff ,&nbsp;Lene Thorsen","doi":"10.1016/j.clgc.2026.102507","DOIUrl":"10.1016/j.clgc.2026.102507","url":null,"abstract":"<div><h3>Introduction</h3><div>Cisplatin-based chemotherapy (CBCT) is standard treatment for most men with metastatic testicular cancer (TC). The main objective was to evaluate changes in physical fitness and body composition from before to immediately after CBCT and 3 months after completion of CBCT.</div></div><div><h3>Patients and Materials</h3><div>The assessments included cardiorespiratory fitness (peak oxygen uptake [VO₂ peak]), muscle strength (1 repetition maximum [1RM]) and muscular endurance in leg- and chest press, body composition (dual-energy X-ray absorptiometry), physical activity (PA) levels, and patient-reported outcomes (functional scales, global quality of life [QoL], mental health and fatigue). Twenty-eight patients were included, most with low-volume metastatic disease and all within the good prognosis risk group.</div></div><div><h3>Results</h3><div>From before the start of CBCT to immediately after the last CBCT cycle, there were significant reductions in VO₂ peak by 24% (<em>P</em> &lt; .001)<em>,</em> 1RM leg press by 8% (<em>P</em> = .004), 1RM chest press by 17% (<em>P</em> = .001), chest press endurance by 22% (<em>P</em> = .005), total lean body mass by 2.2 kg (<em>P</em> &lt; .001), PA level, physical-, role-, cognitive- and social functioning, and QoL; and significant increases in total and physical fatigue and symptoms of depression. There was a good correlation between reductions in VO₂ peak and QoL during CBCT (<em>r</em> = 0.54, <em>P</em> = .016), whereas no correlation between reductions in VO₂ peak and PA levels. Twelve weeks after CBCT, all variables had returned to baseline values except for PA levels and physical functioning.</div></div><div><h3>Conclusion</h3><div>TC patients should be prepared for reductions in physical fitness and QoL during CBCT. The reduction in cardiovascular fitness is possibly independent of the PA level.</div></div>","PeriodicalId":10380,"journal":{"name":"Clinical genitourinary cancer","volume":"24 2","pages":"Article 102507"},"PeriodicalIF":2.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146133815","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of PD-L1 and PD-1 Expression With Clinicopathological Characteristics and Prognosis in Upper Tract Urothelial Carcinoma","authors":"Peng Li ,&nbsp;Xiaolei Zhang ,&nbsp;Xiao Yang ,&nbsp;Hai Li ,&nbsp;Guoxin Song ,&nbsp;Qiang Lu ,&nbsp;Li Pengchao","doi":"10.1016/j.clgc.2025.102497","DOIUrl":"10.1016/j.clgc.2025.102497","url":null,"abstract":"<div><h3>Introduction</h3><div>To investigate the expression of PD-L1/PD-1 in tumor cells and tumor-infiltrating immune cells (TIICs) and their association with clinicopathologic characteristics and prognosis in UTUC.</div></div><div><h3>Patients and Methods</h3><div>Immunohistochemistry (IHC) was performed to detect the expression of PD-L1 and PD-1 in 124 formalin-fixed paraffin embedded tumor specimens in UTUC. Clinicopathological variables and overall survival (OS) were documented. Association between PD-L1, PD1 with clinicopathologic characteristics and OS were evaluated using binary logistic regression or Cox regression. Statistical significance was considered at 0.05.</div></div><div><h3>Results</h3><div>Of 113 eligible patients (11 excluded due to insufficient tissue), 31.9% (36/113) showed PD-L1⁺ tumor cells, and 28.8% (29/101) had PD-L1⁺ TIICs. PD-1⁺ TIICs were observed in 58.4% (59/101). PD-L1 expression in tumor cells correlated significantly with high tumor grade (<em>P</em> = .029). PD-L1⁺ tumor cells predicted reduced OS in univariate (HR = 1.83, <em>P</em> = .025) and multivariable analyses (HR = 2.15, <em>P</em> = .007). PD-1⁺ TIICs associated with early-stage disease (<em>P</em> = .005) but not OS (<em>P</em> = .166). PD-L1⁺ TIICs also showed no OS association (<em>P</em> = .644).</div></div><div><h3>Conclusions</h3><div>PD-L1 is expressed in 31.9% of UTUC tumors and 28.8% of TIICs, while PD-1 is detected in 58.4% of TIICs. Tumor cell PD-L1 positivity independently predicts poor survival and may drive UTUC progression. PD-1⁺ TIICs correlate with early-stage disease but lack prognostic value for OS. These findings highlight PD-L1 as a potential biomarker for risk stratification in UTUC.</div></div>","PeriodicalId":10380,"journal":{"name":"Clinical genitourinary cancer","volume":"24 2","pages":"Article 102497"},"PeriodicalIF":2.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146026255","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of Proton Pump Inhibitor Use on the Efficacy of IO–IO Versus IO–TKI Therapy in Metastatic Renal Cell Carcinoma","authors":"Lan Inoki ,&nbsp;Shingo Toyoda ,&nbsp;Wataru Fukuokaya ,&nbsp;Takafumi Yanagisawa ,&nbsp;Teruo Inamoto ,&nbsp;Takuhisa Nukaya ,&nbsp;Kiyoshi Takahara ,&nbsp;Takuya Tsujino ,&nbsp;Ryoichi Maenosono ,&nbsp;Kazumasa Komura ,&nbsp;Kensuke Bekku ,&nbsp;Motoo Araki ,&nbsp;Takehiro Iwata ,&nbsp;Kazutoshi Fujita ,&nbsp;JK-FOOT study group","doi":"10.1016/j.clgc.2025.102500","DOIUrl":"10.1016/j.clgc.2025.102500","url":null,"abstract":"<div><h3>Basckground</h3><div>Immune checkpoint inhibitor (ICI)-based combination therapies have become the standard first-line treatment for metastatic renal cell carcinoma (mRCC). Proton-pump inhibitors (PPIs), frequently used to treat gastrointestinal conditions, have been implicated in modulating ICI efficacy, potentially through gut microbiome dysbiosis. However, the impact of PPIs on ICI-based therapies for mRCC remains unclear.</div></div><div><h3>Methods</h3><div>This multicenter retrospective cohort study analyzed 427 patients with mRCC classified as intermediate or poor risk according to the IMDC criteria treated with first-line IO-IO (ipilimumab plus nivolumab) or IO-TKI (ICI plus tyrosine kinase inhibitor) therapies. Patients were stratified by PPI use during the 30 days before and including the day of ICI initiation. Overall survival (OS), progression-free survival (PFS), and objective response rate (ORR) were compared between PPI users and nonusers.</div></div><div><h3>Results</h3><div>PPI use was significantly associated with shorter OS in patients receiving IO-IO therapy (median OS, 23.34 months vs. not reached; <em>P</em> = .002), but not in those receiving IO-TKI therapy (<em>P</em> = .909). Multivariate analysis confirmed PPIs as an independent prognostic factor for OS in the IO-IO group (HR, 1.647; 95% CI, 1.007-2.693; <em>P</em> = .046). No significant differences in PFS or ORR were observed between PPI users and nonusers in either group, although the complete response rate was notably lower in PPI users treated with IO-IO (1.6% vs. 10.3%; <em>P</em> = .025).</div></div><div><h3>Conclusions</h3><div>PPI use was associated with inferior survival in mRCC patients receiving IO-IO therapy, potentially through microbiome modulation and other immunologic or clinical mechanisms; however, these findings are based on retrospective data and should be regarded as hypothesis-generating. Caution is advised when prescribing PPIs to patients undergoing ICI-based therapy, particularly IO-IO regimens, and prospective studies are needed to confirm whether avoiding unnecessary PPI use can improve clinical outcomes.</div></div>","PeriodicalId":10380,"journal":{"name":"Clinical genitourinary cancer","volume":"24 2","pages":"Article 102500"},"PeriodicalIF":2.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146076086","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative Analysis of Signet Ring and Non-Signet Ring Urachal Adenocarcinomas: A National Cancer Database Study","authors":"Deerush Kannan Sakthivel,&nbsp;Pushan Prabhakar,&nbsp;Mohamed Javid Raja Iyub,&nbsp;Rohan Garje,&nbsp;Murugesan Manoharan","doi":"10.1016/j.clgc.2025.102495","DOIUrl":"10.1016/j.clgc.2025.102495","url":null,"abstract":"<div><h3>Introduction</h3><div>Primary urachal adenocarcinomas are rare and histologically diverse. Signet ring cell carcinoma (SRCC), a poorly cohesive and aggressive variant, is associated with poor prognosis compared to non-signet ring urachal adenocarcinoma (UA). This study aims to compare the clinicopathologic features, treatment patterns, and survival outcomes between SRCC and UA.</div></div><div><h3>Methods</h3><div>We retrospectively analyzed data from the National Cancer Database (2004-2020), including patients aged ≥ 18 with SRCC or non-signet ring UA located at the bladder dome. Demographics, staging, treatment modalities, and overall survival (OS) were compared using chi-square tests and Kaplan–Meier analysis.</div></div><div><h3>Results</h3><div>Among 550 patients, 60 had SRCC and 490 had non-signet ring UA. Baseline characteristics were comparable, though SRCC cases showed more frequent under-staging and treatment at community centers. Median OS was significantly shorter for SRCC (29.6 vs. 79.0 months, <em>P</em> &lt; .001). Partial cystectomy conferred better survival than radical cystectomy in both groups. Chemotherapy did not improve outcomes in SRCC and was associated with worse survival in UA, likely due to selection bias.</div></div><div><h3>Conclusion</h3><div>SRCC of the urachus is a biologically distinct subtype with significantly worse outcomes than non-signet ring UA, regardless of surgical approach. Histology-specific strategies are needed to improve survival in this rare, aggressive cancer.</div></div>","PeriodicalId":10380,"journal":{"name":"Clinical genitourinary cancer","volume":"24 2","pages":"Article 102495"},"PeriodicalIF":2.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146076073","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Does Physician Documentation of Patients’ Prostate-Specific Antigen Doubling Time Affect Treatment Decisions in High-Risk Biochemically Recurrent Prostate Cancer?","authors":"Alicia K. Morgans ,&nbsp;Maelys Touya ,&nbsp;Nader El-Chaar ,&nbsp;Dina ElSouda ,&nbsp;Lisa Mucha ,&nbsp;Krishnan Ramaswamy ,&nbsp;Kelechi L. Adejumo ,&nbsp;Tammy Schuler ,&nbsp;Jason Sharpe ,&nbsp;Bruce Feinberg ,&nbsp;Parisa Asgarisabet ,&nbsp;Prathamesh Pathak ,&nbsp;Stephen J. Freedland","doi":"10.1016/j.clgc.2025.102496","DOIUrl":"10.1016/j.clgc.2025.102496","url":null,"abstract":"<div><h3>Introduction</h3><div>Nearly half of patients with prostate cancer experience biochemical recurrence (BCR) within 10 years after definitive treatment. Among them, patients with high-risk BCR are those who have a prostate-specific antigen (PSA) doubling time (PSADT) of ≤ 9 months, which is one of the strongest predictors of poor outcomes. This study aimed to define characteristics and treatment patterns among patients whose PSADT was documented or undocumented by treating physicians at the time of high-risk BCR diagnosis.</div></div><div><h3>Patients and Methods</h3><div>Participating physicians from the United States Cardinal Health Oncology Provider Extended Network abstracted medical record data of patients with high-risk BCR into electronic case report forms (index: 2018-2020; follow-up through 2022). Physicians reported PSADT values at index using labs, clinical judgment, or online calculation. If not provided, PSADT was retrospectively calculated using PSA data from the case report forms. Baseline characteristics and treatment patterns were compared between patients with documented versus undocumented PSADT.</div></div><div><h3>Results</h3><div>Among 284 patients, PSADT was not documented by treating physicians in 180 patients (63%) at the time of high-risk BCR diagnosis. For the 104 patients (37%) for whom PSADT was documented, physicians often overestimated PSADT compared with retrospective calculations based on validated tools, underestimating progression risk. Notably, patients with documented PSADT had a significantly shorter median time to treatment than those with undocumented PSADT (1.0 vs. 6.7 months; hazard ratio: 3.4; 95% confidence interval: 2.6-4.4; <em>P</em> &lt; .0001).</div></div><div><h3>Conclusion</h3><div>Many patients with high-risk BCR may be unidentified in practice despite widespread availability of PSADT calculators to characterize risk. Physicians that document PSADT are more likely to prescribe treatment early, despite underestimating progression risk (ie, overestimating PSADT). Efforts should be made to improve consistent, accurate PSADT calculation and documentation by physicians to inform treatment decision-making for management of high-risk BCR.</div></div>","PeriodicalId":10380,"journal":{"name":"Clinical genitourinary cancer","volume":"24 2","pages":"Article 102496"},"PeriodicalIF":2.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146076085","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Real-World Outcomes of First-Line Immune-Based Combination Therapies in Bone-Metastatic Clear Cell Renal Cell Carcinoma","authors":"Alia Harba ,&nbsp;Fabien Moinard-Butot ,&nbsp;Edouard Auclin ,&nbsp;Philippe Barthélémy ,&nbsp;Johanna Noel ,&nbsp;Clément Dumont ,&nbsp;Hélène Gauthier ,&nbsp;Olivier Huillard ,&nbsp;Loïc Jaffrelot ,&nbsp;Thomas Seisen ,&nbsp;Charlotte Joly ,&nbsp;Christophe Tournigand ,&nbsp;Mostefa Bennamoun ,&nbsp;Matthieu Roulleaux-Dugage ,&nbsp;Mathilde Cancel ,&nbsp;Victor Heurtier ,&nbsp;Hamid Lardjani ,&nbsp;Stéphane Oudard ,&nbsp;Constance Thibault","doi":"10.1016/j.clgc.2026.102506","DOIUrl":"10.1016/j.clgc.2026.102506","url":null,"abstract":"<div><h3>Background</h3><div>Bone metastases occur in one third of patients with metastatic clear cell renal cell carcinoma (mccRCC) and are associated with poor prognosis. Optimal first-line treatment for this subgroup of patients remains undefined.</div></div><div><h3>Methods</h3><div>We conducted a multicenter retrospective study of patients with bone-metastatic (BM+) mccRCC treated with first-line immune checkpoint inhibitor (ICI)-based combinations between January 2015 and February 2024 across 8 French centers. The primary endpoint was time to next treatment (TTNT). Secondary endpoints included overall survival (OS), bone progression-free survival (bPFS), incidence of skeletal-related events (SREs) and changes in bone pain.</div></div><div><h3>Results</h3><div>A total of 124 patients were included; 55% received ICI-ICI and 45% an ICI plus a tyrosine kinase inhibitor (TKI). Median follow-up was 36.8 months. Median TTNT was 11.7 months (95% CI, 8.38-20.0), OS 28.8 months (95% CI, 23.7-40.2) and bPFS 11.7 months (95% CI, 7.69-21.7). Median TTNT was numerically longer with ICI-TKI compared to ICI-ICI (17.9 vs. 8.5 months; <em>P</em> = .40), with no significant difference in OS or bPFS between treatment groups. SREs occurred in 32% of patients. Bone progression was observed in 48%, with a concomitant SRE in 54% mostly involving preexisting lesions (78%). Bone pain improved in 45% of evaluable patients. No significant differences were observed between treatment groups for SRE incidence or bone pain improvement. Hypercalcemia was associated with shorter OS and bPFS, while bone-only disease correlated with improved OS. Use of bone-targeting agents (BTAs) was independently associated with longer bPFS.</div></div><div><h3>Conclusion</h3><div>ICI-CI and ICI-TKI combinations showed comparable outcomes in BM+ mccRCC. Bone progression and SREs remained frequent and often involved preexisting bone lesions. These findings support early integration of local treatments as well as BTAs, which were independently associated with longer bPFS.</div></div>","PeriodicalId":10380,"journal":{"name":"Clinical genitourinary cancer","volume":"24 2","pages":"Article 102506"},"PeriodicalIF":2.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146138229","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"PSMA PET Imaging in the Postradiotherapy Setting: Implications for the Diagnosis of Recurrent Prostate Cancer","authors":"Victoria Vera Barragán ,&nbsp;Felipe Couñago ,&nbsp;Nieves Sicilia Pozo ,&nbsp;Patricia Willisch Santamaria ,&nbsp;Alai Goñi Ramírez ,&nbsp;Miren Gaztañaga Boronat ,&nbsp;Elías Gomis-Sellés ,&nbsp;Justo Serrano Vicente ,&nbsp;Fernando López Campos","doi":"10.1016/j.clgc.2026.102505","DOIUrl":"10.1016/j.clgc.2026.102505","url":null,"abstract":"<div><div>Prostate-specific membrane antigen (PSMA) PET/CT is a highly sensitive tool for detecting metastatic prostate cancer. While its role in staging and advanced disease is well established, its diagnostic role after local therapies—particularly radiotherapy (RT)—remains less defined. This review analyzes the use of PSMA PET/CT after RT in hormone-sensitive and oligometastatic patients treated with metastasis-directed radiotherapy (MDRT). A key challenge is the interpretation of uptake in irradiated regions—such as the prostate bed, lymph nodes, and bone—where inflammation or fibrosis may cause false positives. We also address the modulation of PSMA expression by RT and by androgen receptor inhibitors. Both can induce transient increases in tracer uptake (flare phenomenon) without true progression. The timing and clinical meaning of this effect remain uncertain in hormone-naïve disease. Finally, we review quantitative PET biomarkers such as SUVmax, SUVmean, PSMA-TV, PSMA-TL, and tumor asphericity (ASP). These metrics show prognostic potential but lack validated criteria in the post-RT setting. In summary, current evidence highlights the need to clarify the role of PSMA PET/CT after RT. A better definition of its diagnostic value is essential to guide treatment decisions and future clinical guideline.</div></div>","PeriodicalId":10380,"journal":{"name":"Clinical genitourinary cancer","volume":"24 2","pages":"Article 102505"},"PeriodicalIF":2.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146168494","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}