Clinical genitourinary cancer最新文献

{"title":"Reassessing the Evidence: Is Intensified Therapy Justified in Older Patients with Metastatic Hormone-Sensitive Prostate Cancer?","authors":"Lorenzo Dottorini ,&nbsp;Italo Sarno ,&nbsp;Alessandro Iaculli ,&nbsp;Giandomenico Di Menna ,&nbsp;Yasser Hussein ,&nbsp;Ivano Vavassori ,&nbsp;Mauro Rossitto ,&nbsp;Andrea Luciani ,&nbsp;Fausto Petrelli","doi":"10.1016/j.clgc.2025.102410","DOIUrl":"10.1016/j.clgc.2025.102410","url":null,"abstract":"<div><div>To assess the comparative efficacy of intensified systemic treatments in older patients (≥ 65 years) with metastatic hormone-sensitive prostate cancer (mHSPC) through a network meta-analysis (NMA), and evaluate whether routine use of intensified regimens is justified in this population. A systematic literature search of MEDLINE, Embase, and Cochrane Library databases identified randomized controlled trials published between 2000 and 2024 evaluating first-line systemic therapies in mHSPC. Eligible studies combined androgen deprivation therapy (ADT) with docetaxel, abiraterone, enzalutamide, apalutamide, darolutamide, or antiandrogens. The primary endpoint was overall survival (OS). Bayesian NMA was conducted using a consistency model and Markov chain Monte Carlo simulations. SUCRA values were used to estimate treatment rankings. Subgroup data for older patients were extracted where available. Eleven were included in the analysis. Compared to ADT alone, none of the intensified regimens showed statistically significant superiority in OS in older subgroups. ADT + docetaxel + darolutamide had the highest probability of being the most effective treatment (SUCRA 87.8%), followed by ADT + abiraterone + enzalutamide (SUCRA 80.9%). In older patients with mHSPC, intensified systemic regimens demonstrate trends toward improved OS but fail to achieve clear statistical superiority over ADT alone. The substantial heterogeneity across studies and absence of older-specific subgroup data limit definitive conclusions. Treatment decisions in this population should be individualized using geriatric assessment, considering patient fitness, comorbidities, life expectancy, and treatment goals. Further dedicated trials in older and frail patients are warranted to guide optimal therapeutic strategies.</div></div>","PeriodicalId":10380,"journal":{"name":"Clinical genitourinary cancer","volume":"23 5","pages":"Article 102410"},"PeriodicalIF":2.7,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144908294","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":"Is Active Surveillance a Suitable Approach for Bilateral Multifocal Renal Oncocytomas? The 20-Year National Cancer Institute Experience","authors":"Aditi Chaurasia ,&nbsp;Shiva Singh ,&nbsp;Noah Pinson ,&nbsp;Nikhil Gopal ,&nbsp;Jessica Hsueh ,&nbsp;Daniel Nethala ,&nbsp;Rabindra Gautam ,&nbsp;Christopher J. Ricketts ,&nbsp;Cathy D. Vocke ,&nbsp;Laura S. Schmidt ,&nbsp;Maria J. Merino ,&nbsp;Ashkan A. Malayeri ,&nbsp;W. Marston Linehan ,&nbsp;Mark W. Ball","doi":"10.1016/j.clgc.2025.102401","DOIUrl":"10.1016/j.clgc.2025.102401","url":null,"abstract":"<div><h3>Objectives</h3><div>To investigate the clinical characteristics, tumor growth rate, oncologic and renal function outcomes in patients with bilateral, multifocal renal oncocytoma managed with active surveillance and/or surgery.</div></div><div><h3>Materials and Methods</h3><div>Bilateral, multifocal renal oncocytoma patients were evaluated using clinical, cross-sectional imaging and pathologic records. The cohort was divided into 3 groups: those under active surveillance only, those who underwent surgery in combination with active surveillance, and those who underwent multiple interventions. Growth rate, metastases and renal function outcomes were compared between the 3 groups.</div></div><div><h3>Results</h3><div>Sixty-two patients (median age 64 years (IQR 57.5-69), 49 men) were identified with 10 patients (16.1%) having a known family history of bilateral, multifocal oncocytoma. Overall, the combined median growth rate of primary tumors across all 3 groups was 0.25 cm/year (IQR 0.1-0.4). Comparing between all 3 groups identified a statistically significant difference in age of diagnosis (<em>P</em> = .01), whereas no difference was noted for age at death. No distant metastasis was observed. A statistically significant difference in median tumor size at the time of last follow-up (<em>P</em> = .02) was reported among the 3 groups. No statistically significant differences were seen in primary tumor growth rate (<em>P</em> = .50), initial eGFR (<em>P</em> = .35), final eGFR (<em>P</em> = .26) and change in eGFR levels over time (<em>P</em> = .10) among all 3 groups.</div></div><div><h3>Conclusion</h3><div>Disease-specific outcomes and renal function outcomes do not differ significantly among the patients managed with active surveillance and/or surgery.</div></div>","PeriodicalId":10380,"journal":{"name":"Clinical genitourinary cancer","volume":"23 5","pages":"Article 102401"},"PeriodicalIF":2.7,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144982389","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 HRR Gene Subclass on Clinical Outcomes of PARP Inhibitors in Metastatic Castration-Resistant Prostate Cancer","authors":"George Dimitrov ,&nbsp;Elenko Popov","doi":"10.1016/j.clgc.2025.102411","DOIUrl":"10.1016/j.clgc.2025.102411","url":null,"abstract":"<div><h3>Objective</h3><div>This retrospective study evaluates the clinical significance of mutations in effector genes (<em>BRCA1, BRCA2, PALB2, RAD51, FANCD2</em>) versus sensor genes (<em>ATM, ATR, CHEK1, CHEK2, NBS1</em>) in patients with metastatic castration-resistant prostate cancer (mCRPC) classified as homologous recombination deficiency (HRD)-positive. The study assesses their predictive value for response to poly(ADP-ribose) polymerase inhibitors (PARPi) combined with androgen receptor signaling inhibitors (ARSi).</div></div><div><h3>Design</h3><div>A multicenter, retrospective real-world study conducted across 6 oncology hospitals in Bulgaria. Patient data were obtained through a formal request to the Ministry of Health’s United Information Portal, an electronic health records repository. The analysis included mCRPC patients treated with olaparib plus abiraterone who underwent next-generation sequencing (NGS) between January 1, 2022, and January 1, 2025, conducted in a certified national reference laboratory, with a median follow-up of 16 months. The primary endpoints were overall survival (OS) and progression-free survival (PFS).</div></div><div><h3>Results</h3><div>Of the 210 mCRPC patients screened via NGS, 28% (<em>n</em> = 58) harbored mutations in at least one HRR gene, classified as sensor (<em>n</em> = 27) or effector (<em>n</em> = 31). Patients with effector mutations demonstrated a statistically significant improvement in PFS compared to those with sensor mutations (median PFS: 20 vs. 14 months, HR = 0.48, 95% CI: 0.252–0.914, <em>P</em> = .0294). Similarly, overall survival (OS) was significantly prolonged in the effector group. While the median OS for the sensor group was 19 months, the effector group had not yet reached median OS at the time of analysis (HR = 0.38, 95% CI, 0.154-0.945, <em>P</em> = .0373). Logistic regression analysis and PSM supported findings.</div></div><div><h3>Conclusion</h3><div>Patients with mCRPC harboring effector HRR mutations derive greater clinical benefit from PARPi plus ARSi than those with sensor mutations. These findings highlight the heterogeneous predictive value of HRR gene alterations and suggest that mutation sub-class should guide treatment decisions in HRD-positive mCRPC.</div></div>","PeriodicalId":10380,"journal":{"name":"Clinical genitourinary cancer","volume":"23 5","pages":"Article 102411"},"PeriodicalIF":2.7,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144982446","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":"Treatment Patterns and Outcomes in Lymph-Node-Positive (pN1) Prostate Cancer: A National Cancer Database Study","authors":"Andrea Piccolini ,&nbsp;Stephan M. Korn ,&nbsp;Zhiyu Qian ,&nbsp;Pietro Brin ,&nbsp;Klara Pohl ,&nbsp;Hanna Zurl ,&nbsp;Boyuan Xiao ,&nbsp;Giovanni Lughezzani ,&nbsp;Nicolò M. Buffi ,&nbsp;Paul L. Nguyen ,&nbsp;Mutlay Sayan ,&nbsp;Quoc-Dien Trinh ,&nbsp;Alexander P. Cole","doi":"10.1016/j.clgc.2025.102413","DOIUrl":"10.1016/j.clgc.2025.102413","url":null,"abstract":"<div><h3>Introduction</h3><div>Lymph node involvement after radical prostatectomy (pN1) is associated with worse oncologic outcomes, yet its optimal management remains controversial. We evaluated oncologic outcomes and treatment patterns in pN1 prostate cancer.</div></div><div><h3>Patients and Methods</h3><div>We analyzed data from the National Cancer Database (NCDB) on men undergoing radical pN1 between 2010 and 2020. Exclusion criteria included distant metastases and delayed androgen-deprivation therapy (ADT) or adjuvant radiotherapy (aRT) beyond 1 year from surgery. The primary outcome was overall survival (OS). Multinomial logistic regression identified demographic and clinical predictors of treatment selection. Inverse probability of treatment weighting (IPTW) was applied to adjust baseline characteristics and perform weighted survival analysis across treatment groups.</div></div><div><h3>Results</h3><div>Among 13,454 patients with pN1 disease, 51.2% were managed with observation, 17.8% received ADT alone, 26.9% ADT plus aRT, and 4.1% aRT alone. Median follow-up was 56.3 months (IQR:36-83). ISUP grade 4-5, pT3-4 disease, and increased nodal burden were associated with treatment intensification. Compared to Non-Hispanic Whites, Non-Hispanic Black patients had lower odds of receiving ADT plus aRT (aOR: 0.79, 95% CI, 0.69-0.91, <em>P</em> &lt; .001). ADT alone or aRT alone did not improve OS; ADT combined with aRT was significantly associated with improved OS (HR: 0.78, 95% CI, 0.68-0.89, <em>P</em> &lt; .001).</div></div><div><h3>Conclusion</h3><div>This national analysis revealed variability in postsurgical management for pN1 disease. Only less than a third of men received aRT, despite this treatment being associated with improved OS. Given the observed variability in treatment use and outcomes, our findings support the value of individualized management strategies and multidisciplinary decision-making.</div></div>","PeriodicalId":10380,"journal":{"name":"Clinical genitourinary cancer","volume":"23 5","pages":"Article 102413"},"PeriodicalIF":2.7,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144982359","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":"Neoadjuvant PD-1/PD-L1 Inhibitors for Muscle-Invasive Bladder Cancer: A Meta-Analysis","authors":"Lian Hu ,&nbsp;Jia-Wei Hu ,&nbsp;Chang-Quan Wang ,&nbsp;Rui-Ying Li ,&nbsp;Song Li","doi":"10.1016/j.clgc.2025.102408","DOIUrl":"10.1016/j.clgc.2025.102408","url":null,"abstract":"<div><div>Neoadjuvant immune checkpoint inhibitors have emerged as a potential treatment option for muscle-invasive bladder cancer (MIBC), but their comparative efficacy and safety remain unclear. This meta-analysis evaluated pathological outcomes and adverse events of neoadjuvant PD-(L)1 inhibitors across different therapeutic approaches. A systematic search was conducted across multiple databases (PubMed, Embase, Cochrane Library, China National Knowledge Infrastructure, and Wanfang databases), from their inception to December 21, 2024, for studies investigating neoadjuvant PD-(L)1 inhibitors in patients with MIBC. Primary outcomes included pathological complete response (pCR), pathological partial response (pPR), downstaging (DS), and grade ≥3 immune-related adverse events (irAEs). Random-effects models were used to calculate pooled estimates, with subgroup analyses performed based on treatment strategy and inhibitor type. Twenty-nine studies were finally included, involving 33 treatment arms. The overall pooled pCR rate was 32.7% (95% confidence interval [CI]: 27.7%-37.7%), with PD-(L)1 inhibitors plus chemotherapy showing the highest rate (39.2%, 95% CI: 32.1%-46.3%), followed by dual checkpoint inhibition (27.6%, 95% CI: 15.5%-39.6%), and monotherapy (24.6%, 95% CI: 16.9%-32.3%). The overall pooled pPR was 45.3% (95% CI: 38.4%-52.2%), and DS rate was 62.9% (95% CI: 53.1%-72.8%). Grade ≥3 irAEs varied significantly by approach: 9.4% (95% CI: 6.0%-12.7%) for monotherapy, 24.9% (95% CI: 9.6%-40.2%) for dual checkpoint inhibition, and 14.2% (95% CI: 6.9%-21.5%) for combination with chemotherapy. Sensitivity analyses confirmed the robustness of these findings. Neoadjuvant PD-(L)1 inhibitors demonstrate promising efficacy in MIBC with acceptable toxicity profiles. Combination with chemotherapy provides the highest pathological response rates with moderate toxicity, while monotherapy offers a favorable safety profile that may benefit cisplatin-ineligible patients. These findings support the continued investigation of these approaches in ongoing Phase III trials.</div></div>","PeriodicalId":10380,"journal":{"name":"Clinical genitourinary cancer","volume":"23 5","pages":"Article 102408"},"PeriodicalIF":2.7,"publicationDate":"2025-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144920357","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":"The Prognostic Role of 68GA-PSMA-PET/CT in Metastatic Hormone-Sensitive Prostate Cancer: A Preliminary Analysis","authors":"Andrea Marchetti ,&nbsp;Veronica Mollica ,&nbsp;Andrea Farolfi ,&nbsp;Gianfilippo Bianciardi ,&nbsp;Matteo Rosellini ,&nbsp;Elisa Tassinari ,&nbsp;Linda Danielli ,&nbsp;Lorenzo Bianchi ,&nbsp;Riccardo Schiavina ,&nbsp;Stefano Fanti ,&nbsp;Francesco Massari","doi":"10.1016/j.clgc.2025.102406","DOIUrl":"10.1016/j.clgc.2025.102406","url":null,"abstract":"<div><h3>Background and objective</h3><div>In metastatic hormone-sensitive prostate cancer (mHSPC), to evaluate therapy response is currently used conventional imaging and PSA levels. Positron emission tomography with ⁶⁸Gallium Prostate-specific membrane antigen (⁶⁸Ga-PSMA-PET/CT) could be useful, although it is not recommended by international guidelines. Its prognostic utility has been already investigated in several works in the castration-resistant setting, but no sufficient efforts have been made to better define it in mHSPC.</div></div><div><h3>Methods</h3><div>Retrospective monocentric study to preliminary explore the value of ⁶⁸Ga-PSMA-PET/CT in this setting. We enrolled metastatic patients at the baseline ⁶⁸Ga-PSMA-PET/CT, treated with androgen deprivation therapy plus docetaxel or androgen receptor signaling inhibitors (ARSI) or both as first-line.</div></div><div><h3>Key findings and limitations</h3><div>The survival analysis indicated that a Major SUVmax exceeding the cut-off (<em>P</em> = .037) and a SUVmean above the cut-off (<em>P</em> = .025) were linked to improved progression-free survival (PFS) as compared to values ≤ cut-off. While several parameters were associated with undetectable PSA levels at any point after the initiation of first-line therapy, only low-volume disease (HR 7.64, <em>P</em> .002), MTV ≤ cut-off 3-months PSA (HR 5.36, <em>P</em> = .012) and SUVmean ≤ cut-off 3-months PSA (HR 38.6, <em>P</em> &lt; .001) were associated with a higher probability of reaching an undetectable value of PSA in the multivariate analysis. Limitations: retrospective nature, short follow-up time and lack of comparison with conventional imaging.</div></div><div><h3>Conclusion and clinical implications</h3><div>Lower values of ⁶⁸Ga-PSMA-PET/CT derived-parameters at baseline are negative prognostic factor, in view of the correlation with lower PFS. This study could help oncologists in the management of mHSPC patients, although further investigations are needed to better understand the prognostic and predictive ⁶⁸Ga-PSMA-PET/CT role in this setting.</div></div>","PeriodicalId":10380,"journal":{"name":"Clinical genitourinary cancer","volume":"23 5","pages":"Article 102406"},"PeriodicalIF":2.7,"publicationDate":"2025-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144982414","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":"Clinical and Pathological Predictors for Occult Lymph Node Involvement in Patients With Clinical Node-Negative Bladder Cancer Undergoing Radical Cystectomy","authors":"Salvador Jaime-Casas ,&nbsp;Miguel Zugman ,&nbsp;Regina Barragan-Carrillo ,&nbsp;Hedyeh Ebrahimi ,&nbsp;Koral Shah ,&nbsp;Wesley Yip ,&nbsp;Cory M. Hugen ,&nbsp;Kevin G. Chan ,&nbsp;Clayton S. Lau ,&nbsp;Bertram E. Yuh ,&nbsp;Benjamin Mercier ,&nbsp;Nicholas J. Salgia ,&nbsp;Daniela V. Castro ,&nbsp;Xiaochen Li ,&nbsp;JoAnn Hsu ,&nbsp;Charles B. Nguyen ,&nbsp;Alexander Chehrazi-Raffle ,&nbsp;Sumanta K Pal ,&nbsp;Abhishek Tripathi","doi":"10.1016/j.clgc.2025.102405","DOIUrl":"10.1016/j.clgc.2025.102405","url":null,"abstract":"<div><h3>Background</h3><div>Occult pathological lymph node involvement in patients with clinical node-negative (cN0) bladder cancer (BC) remains a diagnostic challenge. We evaluate predictors of lymph node positivity (pN+) in patients with cT1-4N0M0 BC undergoing radical cystectomy and pelvic lymph node dissection (RC-PLND).</div></div><div><h3>Methods</h3><div>We included patients with cT1-4N0M0 BC undergoing RC-PLND from February 2004 through October 2020. Patients were classified as pN+ vs. pN0. Baseline characteristics were summarized using descriptive statistics. Logistic regression models and multivariable analysis estimated odds ratios (OR) for pN+ status. Kaplan Meier analysis and multivariable Cox proportional hazards models analyzed recurrence-free survival (RFS) and overall survival (OS).</div></div><div><h3>Results</h3><div>440 patients were evaluated, of which 81% (<em>n</em> = 359) had pN0 and 17% (<em>n</em> = 74) had pN+ disease. Most were male (80%), white (88%), and had a median age of 71 years. Most had clinical T2 (55%) and T1 (25%) disease. Lymphovascular invasion (LVI) on TURBT (OR 2.62, <em>P</em> = .04), positive surgical margins (OR 16.77, <em>P</em> &lt; .001), and ≥ cT2 disease (OR 1.89, <em>P</em> = .04) had higher odds of pN+ status. pN+ patients were more likely to suffer recurrence (HR 7.67, <em>P</em> &lt; .001) or death (HR 3.26, <em>P</em> &lt; .001) compared to pN0 patients. Preoperative hydronephrosis predicted worse RFS (HR 1.76, <em>P</em> = .011) and OS (HR 1.55, <em>P</em> = .007). Positive surgical margins (HR 2.34, <em>P</em> = .008) and preoperative renal function (HR 1.50, <em>P</em> = .004) predicted worse OS.</div></div><div><h3>Conclusion</h3><div>Positive surgical margins, LVI, and ≥ cT2 disease strongly predict pN+ findings in patients with cT1-4N0M0 BC. Preoperative variables can inform treatment for patients with a higher risk for positive lymph node findings at surgery.</div></div>","PeriodicalId":10380,"journal":{"name":"Clinical genitourinary cancer","volume":"23 5","pages":"Article 102405"},"PeriodicalIF":2.7,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144982428","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":"Effectiveness and Safety of Cabozantinib Treatment in Patients with Advanced Renal Cell Carcinoma in Spanish and Portuguese Real-world Practice: The SOGUG-SPRWEC Study","authors":"Cristina Suárez ,&nbsp;Òscar Reig Torras ,&nbsp;Rafael Morales Barrera ,&nbsp;Ángel Rodríguez Sánchez ,&nbsp;Georgia Anguera Palacios ,&nbsp;André Miguel Branco Manshino ,&nbsp;Natalia Fernández Núñez ,&nbsp;María José Méndez Vidal ,&nbsp;Icíar García Carbonero ,&nbsp;Ovidio Fernández Calvo ,&nbsp;Regina Gironés Sarrió ,&nbsp;Guillermo Crespo Herrero ,&nbsp;Javier Afonso Afonso ,&nbsp;María José Juan Fita ,&nbsp;Josep Gumà Padró ,&nbsp;Martín Lázaro Quintela ,&nbsp;Alejo Rodriguez-Vida ,&nbsp;Carolina Hernández Pérez ,&nbsp;Ana Medina Colmenero ,&nbsp;Ricardo Collado Martín ,&nbsp;Enrique Gallardo","doi":"10.1016/j.clgc.2025.102402","DOIUrl":"10.1016/j.clgc.2025.102402","url":null,"abstract":"<div><h3>Background</h3><div>The SPRWEC study investigated cabozantinib effectiveness and safety in patients with advanced renal cell carcinoma (RCC) in real-world Spanish and Portuguese settings.</div></div><div><h3>Patients and methods</h3><div>Observational, ambispective, multicenter study including adult patients with advanced RCC receiving cabozantinib between October 2016 and May 2020 as second or subsequent treatment line. Primary endpoint was progression-free survival (PFS).</div></div><div><h3>Results</h3><div>About 258 patients (mean [SD] age 62.5 [11.0] years, 75.6% male) were included, 55.8% with prior immunotherapy. Median follow-up was 34.3 months. Median PFS was 7.63 months (95% CI, 6.64-8.72). Median overall survival (OS) was 15.36 months (95% CI, 11.58-19.11); objective response rate (ORR), 29.5% (95% CI, 24.0-35.4); median time to first response, 3.27 months (95% CI, 3.03-3.68); median duration of response, 9.77 months (95% CI, 7.24-12.63); median time to discontinuation, 6.97 months (95% CI, 5.79-8.42). Prior immunotherapy increased ORR (OR 2.132) and decreased OS (HR 1.529). ECOG 0-1 and dose reductions were associated with increased PFS (HR 0.470 and 0.558); poor and intermediate MSKCC (HR 3.861 and 1.681) and IMDC risks (HR 2.558 and 1.537) with decreased PFS. Most common AEs were diarrhea (41.9%), asthenia (34.9%), and anorexia (18.2%).</div></div><div><h3>Conclusion</h3><div>Cabozantinib’s effectiveness and safety as second or subsequent treatment line for advanced RCC in real-world settings are similar to those observed in clinical trials. This treatment after prior immunotherapy, the front-line standard of care, resulted in increased ORR and decreased OS, without changes in PFS.</div></div>","PeriodicalId":10380,"journal":{"name":"Clinical genitourinary cancer","volume":"23 5","pages":"Article 102402"},"PeriodicalIF":2.7,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144884456","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":"The Influence of the Introduction of PSMA-PET/CT in Danish Men Diagnosed with Prostate Cancer","authors":"Hein V. Stroomberg ,&nbsp;Klaus Brasso ,&nbsp;Andreas Røder","doi":"10.1016/j.clgc.2025.102404","DOIUrl":"10.1016/j.clgc.2025.102404","url":null,"abstract":"<div><h3>Background</h3><div>Conventional imaging in patients with newly diagnosed prostate cancer is gradually being replaced with PSMA-PET/CT. However, the possible impact of newer imaging modalities on stage migration is poorly understood. We have studied the effects of introducing PSMA-PET/CT on the incidence of newly diagnosed hormone-sensitive prostate cancer.</div></div><div><h3>Patients and methods</h3><div>This population-based nationwide study included all Danish men born between 1920 and 1970 and diagnosed with prostate cancer between 2010 and 2022 (<em>N</em> = 58,635). Information on prostate cancer diagnosis and diagnostic workup was retrieved from prospectively maintained nationwide registries. Cause of death was retrieved until the last date of follow-up (August 11, 2024). Multivariable linear regression, logistic regression, and Cause-specific Cox proportional hazards were utilized to obtain estimates.</div></div><div><h3>Results</h3><div>Each PSMA-PET/CT performed increased the number of metastatic diagnoses by 0.29 (95% confidence interval [CI]: 0.21-0.38, <em>P</em> &lt; .001), primarily driven by regions with a higher use of PSMA-PET/CT. Having PSMA-PET/CT performed increased the likelihood of having the therapies radiation to the prostate in an oligometastatic setting (Odds ratio: 4.1, 95% CI: 3.5-4.9) or chemotherapy (Odds ratio: 1.27, 95% CI: 1.04-1.56). Five-year prostate cancer-specific mortality in all men diagnosed with prostate cancer decreased only in areas with high PSMA-PET/CT usage, from 15% (95% CI: 14-16) when diagnosed in 2010 to 2014 to 13% (95% CI: 12-14) when diagnosed in 2019 to 2022.</div></div><div><h3>Conclusion</h3><div>Our data shows that the implementation of PSMA-PET/CT on a nationwide level led to prostate cancer stage migration, coinciding with a slight decrease in prostate cancer-specific mortality in regions with the highest usage of PSMA-PET/CT.</div></div>","PeriodicalId":10380,"journal":{"name":"Clinical genitourinary cancer","volume":"23 5","pages":"Article 102404"},"PeriodicalIF":2.7,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144860008","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":"Expression and Prognostic Significance of Different Antibody-Drug Conjugate Target Proteins in Urachal Carcinoma","authors":"Tian Han ,&nbsp;Honglei Cui ,&nbsp;Gan Du ,&nbsp;Youyan Guan ,&nbsp;Xingang Bi ,&nbsp;Lei Guo ,&nbsp;Hongzhe Shi ,&nbsp;Jianzhong Shou","doi":"10.1016/j.clgc.2025.102403","DOIUrl":"10.1016/j.clgc.2025.102403","url":null,"abstract":"<div><h3>Background</h3><div>Urachal carcinoma (UrC), a rare malignancy originating from urachal remnants, currently lacks standardized therapeutic options for advanced stages. While antibody-drug conjugate (ADC) therapy has emerged as a transformative approach in oncology, its clinical application in UrC remains investigational due to the paucity of data regarding target antigen expression profiles. This study systematically characterized the immunohistochemical landscape of UrC through the lens of established ADC targets and evaluated their prognostic implications, thereby informing future therapeutic development.</div></div><div><h3>Patients and Methods</h3><div>We retrospectively analyzed 41 histologically confirmed UrC specimens with complete clinical information. Immunohistochemical evaluation was performed for 6 therapeutic targets: HER2, Nectin-4, Claudin18.2, Trop2, Mesothelin, and PD-L1. Standardized scoring system was used to quantify the level of target expression and to determine the rate of high expression for each target. Survival outcomes were assessed through Kaplan–Meier method and Cox proportional hazards modeling.</div></div><div><h3>Results</h3><div>With a median follow-up of 99 months, the cohort exhibited a 5-year overall survival (OS) rate of 62.4% (95% CI, 48.5%-80.3%). Analysis of ADC target protein expression showed that Trop2 had the highest rate of high expression (58.5%), followed by Mesothelin (43.9%), Claudin18.2 (34.1%), Nectin-4 (24.4%), HER2 (9.8%), and PD-L1 (4.9%). Survival analysis demonstrated significantly reduced 5-year overall survival (OS) in the Trop2-high group (47.1% vs. 87.5%, <em>P</em> = 0.01). Multivariate Cox regression analysis identified both Trop2 and Sheldon stage as independent prognostic determinants.</div></div><div><h3>Conclusion</h3><div>Our findings confirm that UrC has the potential to be treated by ADC. Trop2 has the highest high expression rate in UrC and is associated with a worse prognosis, which may be a potential target for ADC therapy for UrC.</div></div>","PeriodicalId":10380,"journal":{"name":"Clinical genitourinary cancer","volume":"23 5","pages":"Article 102403"},"PeriodicalIF":2.7,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144851892","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}