Clinical genitourinary cancer最新文献

{"title":"Are Urologists and/or Radiation Oncologists Biased when Reporting of Advantages and Disadvantages of Surgery versus Radiation in Consultations for Early-Stage Prostate Cancer?","authors":"Nadine A. Friedrich ,&nbsp;Michael Luu ,&nbsp;Rebecca Gale ,&nbsp;Antwon Chaplin ,&nbsp;Reva Polineni ,&nbsp;Alex Shiang ,&nbsp;Dong Shin ,&nbsp;Stephen J. Freedland ,&nbsp;Brennan Spiegel ,&nbsp;Leslie K. Ballas ,&nbsp;Paul Kokorowski ,&nbsp;Timothy J. Daskivich","doi":"10.1016/j.clgc.2025.102486","DOIUrl":"10.1016/j.clgc.2025.102486","url":null,"abstract":"<div><h3>Background</h3><div>Treatment choice for early-stage prostate cancer (PC) is strongly influenced by the counseling physician's specialty. Whether a physician’s specialty biases how treatment advantages and disadvantages are presented in consultations is unclear. To investigate this, we analyzed content discussed by urologists and radiation oncologists when comparing radical prostatectomy and radiation therapy in PC consultations.</div></div><div><h3>Methods</h3><div>Consultations of 39 men with nonmetastatic PC across 6 urologists and radiation oncologists were recorded and transcribed. Analysts thematically characterized statements comparing advantages and disadvantages of surgery versus radiation (and vice versa) using an open coding approach. Frequency of thematic content by specialty was reported at a consultation level. Themes exceeding 10% and differing by ≥ 25% between specialties were reported.</div></div><div><h3>Results</h3><div>Our dataset included 1171 statements from 28 Urology and 11 Radiation Oncology consults. Major themes discussed included side effects (90%), cancer control (84%), convenience (56%), salvage options (48%) and invasiveness (43%). Differences in content between specialties were observed for all themes except convenience. For side effects, radiation oncologists (vs. urologists) more often noted that radiation has better urinary (55% vs. 0%) and erectile side effects than surgery (37% vs. 0%). For salvage therapy, urologists more often mentioned inability to get radiation twice (32% vs. 0%) and difficulties with salvage prostatectomy (36% vs. 0%). For cancer control, urologists more often noted long-term data on surgery outcomes as an advantage of surgery (25% vs. 0%). For invasiveness, radiation oncologists more often described radiation as less invasive (36% vs. 11%).</div></div><div><h3>Conclusions</h3><div>While specialists acknowledge obvious limitations of their treatments, they selectively highlight advantages of their procedures and the disadvantages of competing treatments.</div></div>","PeriodicalId":10380,"journal":{"name":"Clinical genitourinary cancer","volume":"24 2","pages":"Article 102486"},"PeriodicalIF":2.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146015855","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":"Preferred Treatment Sequencing for Metastatic Urothelial Carcinoma (mUC) in the Era of Perioperative and First-Line (1L) Checkpoint Inhibitor: Results From a National Survey of Genitourinary Oncologists","authors":"Karine Tawagi ,&nbsp;Ali R. Khaki ,&nbsp;Priyanka V. Chablani ,&nbsp;Jeannie Hoffman-Censits ,&nbsp;Vadim S. Koshkin ,&nbsp;Elizabeth R. Plimack ,&nbsp;Matt D. Galsky ,&nbsp;Shilpa Gupta ,&nbsp;Jonathan E. Rosenberg ,&nbsp;Petros Grivas ,&nbsp;Peter H. O’Donnell","doi":"10.1016/j.clgc.2025.102487","DOIUrl":"10.1016/j.clgc.2025.102487","url":null,"abstract":"<div><h3>Background</h3><div>Immune checkpoint inhibitors (ICI) are commonly used in urothelial carcinoma. We sought to understand provider preferences for subsequent treatment of patients after prior ICI.</div></div><div><h3>Materials and Methods</h3><div>We comprised a group of 11 expert genitourinary medical oncologists in the United States and created a survey regarding treatment sequencing. We present the final responses to this survey, using descriptive statistics.</div></div><div><h3>Results</h3><div>We received 78 responses (34%) from 227 genitourinary oncologists between May and August 2024; most were practicing for &gt;5 years (62%) and were seeing &gt;25 patients with metastatic urothelial carcinoma (mUC) yearly (72%). For patients with progression while receiving adjuvant ICI, 51% of respondents were somewhat/very likely to use enfortumab vedotin/pembrolizumab (EVP) as next therapy line. For patients with progression after prior ICI, 1/3 of respondents would consider first-line (1L) EVP irrespective of the interval from prior ICI completion. For ICI given in nonmuscle invasive bladder cancer and muscle-invasive bladder cancer, 43% and 45%, respectively would consider EVP &gt; 6 months post-ICI completion. After progression on EVP, 77% were somewhat/very likely to give platinum-based chemotherapy, and most would not include combination or switch maintenance ICI. Similarly, 80% were somewhat/very likely to recommend non-ICI clinical trials in the second-line setting after EVP, and 87% were somewhat/very likely to offer erdafitinib for susceptible <em>FGFR3</em> alterations.</div></div><div><h3>Conclusion</h3><div>Survey-based opinions can effectively capture treatment selection preferences for mUC and could inform future clinical trial design. Additional data, including the impact of residual toxicity from 1L EVP, are needed to better understand real-world treatment sequencing patterns.</div></div>","PeriodicalId":10380,"journal":{"name":"Clinical genitourinary cancer","volume":"24 2","pages":"Article 102487"},"PeriodicalIF":2.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146047558","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":"Metastatic Prostate Cancer with Low-Volume Primary Tumors – A National Cancer Database Analysis on Metastasis Profile and Survival Outcomes","authors":"Mohamed Javid Raja Iyub ,&nbsp;Pushan Prabhakar ,&nbsp;Deerush Kannan Sakthivel ,&nbsp;Aditi Chandrasekaran ,&nbsp;Rohan Garje ,&nbsp;Murugesan Manoharan","doi":"10.1016/j.clgc.2025.102494","DOIUrl":"10.1016/j.clgc.2025.102494","url":null,"abstract":"<div><h3>Introduction</h3><div>A tumor confined within the prostate gland is termed localized prostate cancer (PCa). However, metastasis could rarely develop in such low-volume primary tumors. The nature of these metastatic prostate cancers with low-volume primary tumors is largely underexplored. The objective of our study was to analyze the baseline characteristics, metastatic patterns, and survival outcomes of this condition from the National Cancer Database (NCDB).</div></div><div><h3>Methods</h3><div>Data from patients diagnosed with metastatic prostate cancer with low-volume primary tumors between 2004 and 2021 were analyzed for patient characteristics, metastatic trends, variations by histopathology type, and survival outcomes. Multivariable logistic regression was used to identify various factors associated with this condition. Survival outcomes were evaluated using the Kaplan–Meier analysis.</div></div><div><h3>Results</h3><div>A total of 1,613,004 individuals diagnosed with clinically localized PCa were analyzed. Among them, 45,010 patients had distant metastasis. The most common site of metastasis was bone, followed by lung, liver, and brain. The most common histopathology type was adenocarcinoma (94.3%). The median overall survival (OS) of metastatic prostate cancer with low-volume primary tumors was 37.13 (95% Confidence Interval (CI), 36.57-37.68) months. The best OS in single-site metastasis was seen in lung metastasis (median OS: 54.34 [95% CI, 42.10-66.58] months), and the worst was seen in liver metastasis (median OS: 18.17 [95% CI, 12.70-23.63] months). Adenocarcinoma had a better prognosis (median OS: 38.51 [95% CI, 37.91-39.10] months) than non-adenocarcinoma (median OS: 17.58 [95% CI, 16.40-18.75] months). All results had a <em>P</em>-value less than .001.</div></div><div><h3>Conclusion</h3><div>This comprehensive analysis reveals that metastatic prostate cancer with low-volume primary tumors is relatively uncommon (2.8% of ≤ T2 disease), with bone being the most common metastatic site. Isolated metastasis in the lungs and adenocarcinoma had better OS among the metastasis sites and histopathology type, respectively.</div></div>","PeriodicalId":10380,"journal":{"name":"Clinical genitourinary cancer","volume":"24 2","pages":"Article 102494"},"PeriodicalIF":2.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146026254","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 Outcomes of Targeted Therapies Following HIF-2α Inhibition in Metastatic Renal Cell Carcinoma: A Real-World Analysis","authors":"Patricia Rioja ,&nbsp;Macarena Rey-Cárdenas ,&nbsp;Jorge Esteban-Villarrubia ,&nbsp;David Plata ,&nbsp;Ileana Sparagna ,&nbsp;Fábio Schütz ,&nbsp;Ray Manneh ,&nbsp;Roberto Iacovelli ,&nbsp;Ronan Flippot ,&nbsp;Guillermo de Velasco","doi":"10.1016/j.clgc.2025.102498","DOIUrl":"10.1016/j.clgc.2025.102498","url":null,"abstract":"<div><h3>Introduction</h3><div>Belzutifan, a HIF-2α inhibitor, represents a new therapeutic option for patients with advanced clear-cell renal cell carcinoma (ccRCC); however, data regarding optimal postprogression treatment strategies is limited. With an expanding role of HIF-2α inhibitors, this study aimed to assess the activity of targeted therapies (TT) following belzutifan failure.</div></div><div><h3>Methods</h3><div>We conducted a multicenter retrospective study including patients with ccRCC treated with belzutifan-based regimens who subsequently received further TT. The primary endpoint were time to treatment failure (TTF) and objective response rate (ORR). Secondary endpoints were progression-free survival (PFS), and overall survival (OS).</div></div><div><h3>Results</h3><div>Thirty-five patients were included. Most (79%) received vascular endothelial growth factor receptor tyrosine kinase inhibitor (VEGFR-TKI) after belzutifan, primarily in the third-line setting or beyond. The most frequently used agents were cabozantinib (46%), axitinib (29%), and everolimus (14%), the latter representing a mechanistically distinct agent as a mammalian target of rapamycin (mTOR) inhibitor. The median TTF for subsequent TT was 6.13 months (mo) (95% CI, 3.44-11.28). ORR was 20% and a median PFS was 6.13 mo (95% CI, 5.02-12.2). The median OS was 11.28 mo (95% CI, 6.89-NR), with a 1-year survival rate of 49% (95% CI = 31-65).</div></div><div><h3>Conclusions</h3><div>Despite extensive prior treatment, patients experienced clinical benefit from TT, particularly VEGFR-TKIs, after progression on belzutifan. These findings support the feasibility of sequencing TT following belzutifan-based regimens in advanced ccRCC, and highlight the need to further define optimal therapeutic sequencing strategies.</div></div>","PeriodicalId":10380,"journal":{"name":"Clinical genitourinary cancer","volume":"24 2","pages":"Article 102498"},"PeriodicalIF":2.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146115078","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 Patients With Baseline Neuropathy and/or Diabetes Mellitus Receiving Enfortumab Vedotin-Based Regimens for Advanced Urothelial Carcinoma in the UNITE Database","authors":"Albert Jang ,&nbsp;Tanya Jindal ,&nbsp;Ali Raza Khaki ,&nbsp;Cindy Y. Jiang ,&nbsp;Omar Alhalabi ,&nbsp;Charles B. Nguyen ,&nbsp;Irene Tsung ,&nbsp;Eugene Oh ,&nbsp;Ilana Epstein ,&nbsp;Dimitra Rafailia Bakaloudi ,&nbsp;Salvador Jaime-Casas ,&nbsp;Amanda Nizam ,&nbsp;Michael Glover ,&nbsp;Hannah Mabey ,&nbsp;Amy Taylor ,&nbsp;Sean Evans ,&nbsp;Denny Shin ,&nbsp;Cameron Pywell ,&nbsp;Bashar Abuqayas ,&nbsp;Pedro C. Barata ,&nbsp;Jason R. Brown","doi":"10.1016/j.clgc.2026.102501","DOIUrl":"10.1016/j.clgc.2026.102501","url":null,"abstract":"<div><h3>Introduction</h3><div>Enfortumab vedotin (EV)-based regimens have become standard treatments for advanced urothelial carcinoma (aUC). However, clinical trials excluded clinically significant peripheral neuropathy or uncontrolled diabetes mellitus. Therefore, we characterized real-world outcomes of patients with aUC and pre-existing peripheral neuropathy and/or diabetes mellitus receiving EV-based therapies.</div></div><div><h3>Patients and Methods</h3><div>In the multicenter retrospective UNITE database, patients with documented baseline neuropathy and diabetes mellitus were identified. Observed response rate (ORR) and duration of response (DOR) were compared using Fisher’s exact test. Progression-free survival (PFS) and overall survival (OS) were estimated by Kaplan–Meier method. Multivariable Cox models were used to adjust for confounding variables, including treatment duration.</div></div><div><h3>Results</h3><div>Comparing 268 patients with baseline neuropathy to 586 patients without neuropathy, median PFS was 7.2 versus 6.3 months (HR 0.87 [0.73-1.04]; <em>P</em> = .11), and median OS 14.4 versus 13.0 months (HR 0.88 [0.73-1.07]; <em>P</em> = .21), Although discontinuation rate due to intolerance was significantly higher for patients with baseline neuropathy (26% vs. 18%; <em>P</em> = .008), these patients did not have shorter survival. Comparing 157 patients with baseline diabetes mellitus to 697 patients without diabetes mellitus, median PFS was 5.3 versus 6.7 months (HR 1.24 [1.01-1.52]; <em>P</em> = .04), and median OS 13.7 versus 13.3 months (HR 1.06 [0.84-1.34]; <em>P</em> = .62).</div></div><div><h3>Conclusion</h3><div>Patients with known baseline neuropathy and/or diabetes mellitus did not have worse survival outcomes receiving EV-based regimens. Patients with baseline neuropathy who discontinued EV early due to intolerance also did not exhibit worse survival. Our findings suggest despite these relevant underlying comorbidities, patients with aUC can derive benefit from EV-containing regimens, with very close monitoring.</div></div>","PeriodicalId":10380,"journal":{"name":"Clinical genitourinary cancer","volume":"24 2","pages":"Article 102501"},"PeriodicalIF":2.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146127917","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":"Outcomes for Patients With SPOP Mutated Castration-Resistant Prostate Cancer (CRPC) Treated With an Androgen Receptor Pathway Inhibitor (ARPI)","authors":"Joseph J. Park ,&nbsp;Lauren E. Howard ,&nbsp;Stamatina Fragkogianni ,&nbsp;Daniel J. George ,&nbsp;Andrew J. Armstrong","doi":"10.1016/j.clgc.2026.102502","DOIUrl":"10.1016/j.clgc.2026.102502","url":null,"abstract":"<div><h3>Introduction</h3><div>Inactivating missense mutations in the <em>SPOP</em> gene increase the transcriptional activity of the androgen receptor and sensitivity to hormonal therapies in patients with hormone sensitive prostate cancer (HSPC). However, the relationship of <em>SPOP</em> alterations with differential outcomes by race, particularly in patients with castration-resistant prostate cancer (CRPC), remains unclear.</div></div><div><h3>Patients and Methods</h3><div>We conducted a retrospective case-control analysis of 78 <em>SPOP</em>-mutated (SPOPmut) patients matched to 223 <em>SPOP</em> wild-type (SPOPwt) patients who received first-line ARPI therapy in the CRPC setting. All patients had somatic gene profiling using the Tempus xT or xF NGS assays. We compared PSA declines, time to treatment failure (TTF), progression-free survival (PFS), and overall survival (OS) with ARPI treatment by race and <em>SPOP</em> status.</div></div><div><h3>Results</h3><div>We identified <em>SPOP</em> mutations in 29% of Black men (<em>n</em> = 10/34) and 20% of White men (<em>n</em> = 30/150). After adjusting for race, visceral metastases, PSA, and M1 at diagnosis, there was no significant difference in TTF (HR 0.80, 95% CI, 0.56-1.15, <em>P</em> = .2), PFS (HR 0.81, 95% CI, 0.58-1.12, <em>P</em> = .2) or OS (HR 0.81, 95% CI, 0.55-1.19, <em>P</em> = .3) by <em>SPOP</em> status. Black men had improved OS with first line ARPI in the CRPC setting (HR 0.44, 95% CI, 0.24-0.79, <em>P</em> = .006) irrespective of <em>SPOP</em> status. PSA declines were more common in SPOPmut patients, with a PSA90 decline in 51% versus 31% (OR 2.35, 95% CI, 1.09-5.12). <em>SPOP</em> mutations were associated with <em>AR</em> ligand-binding domain mutations<em>, APC</em>, and <em>CDKN1B</em> alterations in CRPC.</div></div><div><h3>Conclusion</h3><div>In this exploratory analysis, we found that Black men have improved survival in the first line mCRPC setting with ARPI therapy, but that <em>SPOP</em> mutations do not explain these differential outcomes despite improved short term PSA declines. Thus, other factors may explain the disparity in outcomes we confirmed in men with CRPC.</div></div>","PeriodicalId":10380,"journal":{"name":"Clinical genitourinary cancer","volume":"24 2","pages":"Article 102502"},"PeriodicalIF":2.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146159584","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":"Prostate Cancer Incidence by Age and Clinicopathological Characteristics: A Population-Based Study in Girona, Spain, 2010 to 2021","authors":"Arantza Sanvisens ,&nbsp;Jan Trallero ,&nbsp;Aina Romaguera ,&nbsp;Montse Puigdemont ,&nbsp;Anna Vidal-Vila ,&nbsp;Josep Comet-Batlle ,&nbsp;Rafael Marcos-Gragera ,&nbsp;Bernat Carles Serdà-Ferrer","doi":"10.1016/j.clgc.2025.102492","DOIUrl":"10.1016/j.clgc.2025.102492","url":null,"abstract":"<div><h3>Purpose</h3><div>The aim of this study is to determine the incidence of prostate cancer (PC) and its trends according to the age, Gleason grade (GG) and stage.</div></div><div><h3>Methods</h3><div>Population-based study of PC cases diagnosed in Girona, Spain, from 2010 to 2021. Age at diagnosis, date and method of diagnosis, histology, Gleason score, and stage at diagnosis were collected. Poisson and negative binomial generalized linear models were used to estimate incidence trends and incidence rate ratios (IRRs), respectively.</div></div><div><h3>Results</h3><div>Five thousand three hundred nine cases were included, with a median age of 70 years (IQR:64-77). The age standardized rates according to GG ranged from 12.8 cases per 100,000 men-year (m-y) for GG 5 to 36.6 cases for GG 2 and from 19.9 to 52.6 cases per 100,000 m-y for stages IV and II, respectively. Overall, there was a decline between 2010 and 2014, with an annual percentage change (APC) of <span><math><mrow><mo>−</mo><mspace></mspace></mrow></math></span>6.1% (95% CI, <span><math><mrow><mo>−</mo><mspace></mspace></mrow></math></span>9.0, <span><math><mrow><mo>−</mo><mspace></mspace></mrow></math></span>3.1), followed by stabilisation (APC: <span><math><mo>−</mo></math></span>0.3% [95% CI, <span><math><mrow><mo>−</mo><mspace></mspace></mrow></math></span>2.1, 1.5]). Adjusted IRRs for GG 3, 4, and 5 were lower than GG 1 and IRRs for stages III and IV were lower than stage I; however, the IRR for stage II was higher (IRR = 1.53 [95% CI, 1.40, 1.67]).</div></div><div><h3>Conclusions</h3><div>Although the overall incidence of PC has remained stable since 2014, there has been an increase in cases with the worst prognosis. These cases usually involve elderly patients, who are the most vulnerable.</div></div>","PeriodicalId":10380,"journal":{"name":"Clinical genitourinary cancer","volume":"24 2","pages":"Article 102492"},"PeriodicalIF":2.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146013789","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 Discontinuation in Metastatic Castration-Resistant Prostate Cancer (mCRPC) Patients Treated With Lutetium-177 (177Lu)–PSMA-617: A Retrospective Real-World Study","authors":"Mohammad Hadi Samadi ,&nbsp;Amirreza Shamshirgaran ,&nbsp;Pegah Sahafi ,&nbsp;Haniye Elahifard ,&nbsp;Ghasemali Divband ,&nbsp;Kamran Aryana ,&nbsp;Emran Askari","doi":"10.1016/j.clgc.2025.102499","DOIUrl":"10.1016/j.clgc.2025.102499","url":null,"abstract":"<div><h3>Background</h3><div>Despite the efficacy of Lutetium-177 (¹⁷⁷Lu)–PSMA-617 in Metastatic Castration-Resistant Prostate Cancer (mCRPC), high discontinuation rates limit its therapeutic potential. This study aimed to characterize discontinuation reasons, timing, predictive factors, and survival impact in a real-world cohort.</div></div><div><h3>Methods</h3><div>We retrospectively analyzed 208 mCRPC patients treated with ¹⁷⁷Lu-PSMA-617 between 2017 and 2024. Discontinuation was defined as cessation before 6 cycles. Reasons were categorized as disease progression, serious adverse events, patient-related factors, physician decision, death, or miscellaneous. Early discontinuation was defined as &lt; 3 cycles. Logistic regression and Cox models identified predictors of discontinuation and overall survival (OS).</div></div><div><h3>Results</h3><div>Median cycles received were 3 (IQR 2-5); 169 patients (81.2%) discontinued, with 92 (44.2%) early discontinuation. Disease progression (43.8%) and serious adverse events (21.9%) were leading causes. Multivariate analysis revealed baseline creatinine (OR 5.50, <em>P</em> = .050) and ALP (per 100 U/L; OR 1.12, <em>P</em> = .032) predicted overall discontinuation, while Gleason score (OR 2.11, <em>P</em> = .009), hemoglobin (OR 0.62, <em>P</em> &lt; .001), and platelet counts (OR 0.54, <em>P</em> = .004) predicted early discontinuation. Median OS was 13 months overall, 11 months in discontinuers versus 22 months in completers (<em>P</em> &lt; .001), and 5 vs. 20 months in early vs. nonearly groups (<em>P</em> &lt; .001). Treatment discontinuation (HR 1.95, <em>P</em> = .001) and hemoglobin (HR 0.68, <em>P</em> &lt; .001) independently predicted OS.</div></div><div><h3>Conclusion</h3><div>Over 80% of mCRPC patients discontinued ¹⁷⁷Lu-PSMA-617, driven by progression and toxicity, with early discontinuation linked to aggressive disease and poor hematologic reserve. Discontinuation independently worsens survival, emphasizing the need for careful selection and supportive interventions to improve adherence and outcomes.</div></div>","PeriodicalId":10380,"journal":{"name":"Clinical genitourinary cancer","volume":"24 2","pages":"Article 102499"},"PeriodicalIF":2.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146097747","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":"Predicting Patient-Reported Outcomes Following Treatment for Localized Prostate Cancer: Model Development and Evaluation in an International Cohort Study","authors":"Adam B. Weiner ,&nbsp;Shannon C. Martin ,&nbsp;Holly Wilhalme ,&nbsp;Anissa V. Bailey ,&nbsp;Lorna Kwan ,&nbsp;Bashir Al Hussein Al Awamlh ,&nbsp;Zhiguo Zhao ,&nbsp;Paolo Verze ,&nbsp;Juliet Ippolito ,&nbsp;Roberto La Rocca ,&nbsp;Nora Tabea Sibert ,&nbsp;Daniel A. Barocas ,&nbsp;Thomas R. Belin ,&nbsp;David Elashoff ,&nbsp;Christoph Kowalski ,&nbsp;Claire Foster ,&nbsp;Caroline Moore ,&nbsp;Mark S. Litwin ,&nbsp;True North Global Registry","doi":"10.1016/j.clgc.2026.102504","DOIUrl":"10.1016/j.clgc.2026.102504","url":null,"abstract":"<div><h3>Background and objective</h3><div>Shared decision-making for localized prostate cancer (PCa) requires understanding how baseline factors predict patient-reported outcomes (PROs) after treatment. Most prior predictive models are limited by small, single-region cohorts. We sought to develop and evaluate models predicting 12-month PROs using the large, multi-national Movember True North Global Registry (TNGR).</div></div><div><h3>Methods</h3><div>We identified 27,499 men with localized PCa across 15 countries (2016-2022). Patients were randomly split into training (<em>n</em> = 18,332) and validation (<em>n</em> = 9,167) cohorts. Multivariable linear regressions incorporated baseline PROs, demographics, country, primary treatment (active surveillance, radical prostatectomy, external-beam radiotherapy ± androgen-deprivation therapy, or brachytherapy), and tumor characteristics (grade, stage, percent positive biopsy cores, PSA). Outcomes were changes from baseline to 12 months across 5 EPIC-26 domains.</div></div><div><h3>Results</h3><div>Baseline function, treatment modality, and tumor features were associated with 12-month changes across domains. When applied to the validation cohort, model performance explained 15%, 14%, 19%, 32%, and 28% of variance in urinary incontinence, irritative urinary, bowel, sexual, and hormonal function, respectively.</div></div><div><h3>Conclusions</h3><div>In this first global analysis of functional outcomes after PCa treatment, predictive accuracy was modest, reflecting substantial regional and practice heterogeneity. These findings underscore both the limits of universal prediction models and the value of large-scale international data for benchmarking outcomes. Future TNGR work will focus on region-specific and locally calibrated models to support more personalized counseling and quality-improvement initiatives.</div></div>","PeriodicalId":10380,"journal":{"name":"Clinical genitourinary cancer","volume":"24 2","pages":"Article 102504"},"PeriodicalIF":2.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146138208","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":"Integral Approach in the Follow-up of Prostate Cancer Patients: SOGUG Multidisciplinary Expert Panel Insights","authors":"María José Méndez-Vidal ,&nbsp;Enrique Gallardo ,&nbsp;Alfonso Gómez de Iturriaga ,&nbsp;Fernando López Campos ,&nbsp;Claudio Martínez Ballesteros ,&nbsp;Julia Ruiz Vozmediano ,&nbsp;Aránzazu González-del-Alba ,&nbsp;Jesús Muñoz-Rodríguez","doi":"10.1016/j.clgc.2025.102489","DOIUrl":"10.1016/j.clgc.2025.102489","url":null,"abstract":"<div><div>Prostate cancer (PCa) is the most common malignancy in men in the majority of countries globally and although most cases follow an indolent course, the disease is heterogeneous with some patients exhibiting an aggressive clinical course with progression and metastasis. Castration-resistant metastatic disease has an overall poor prognosis with most patients dying within 2 years of diagnosis. The diagnosis, treatment, and monitoring strategies of patients with PCa have experienced remarkable improvements due to advances in genetic biomarkers, novel imaging techniques, androgen receptor (AR) signaling targeting agents, next-generation chemotherapeutic drugs, bone-seeking agents, poly (ADP-ribose) polymerase (PARP) inhibitors and therapeutic radiopharmaceuticals. All these new therapeutic options are added to standard radiation therapy and radical surgical procedures. However, the treatment outcomes of PCa can be improved by understanding the current therapeutic options and their appropriate sequencing use. Hence, a panel of experts summarized the current challenges in optimizing management, monitoring patients and assessing treatment response across different risk groups and tumor stages. Treatment-decision making in the framework of multidisciplinary teams, better understanding of the patient journey, and identification of unmet needs for improving quality of life are essential considerations in the managing patients in the real-world setting.</div></div>","PeriodicalId":10380,"journal":{"name":"Clinical genitourinary cancer","volume":"24 2","pages":"Article 102489"},"PeriodicalIF":2.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146076074","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}