Clinical genitourinary cancer最新文献

{"title":"Safety and Efficacy of 177Lu-PSMA Therapy Following 223Radium Treatment: A Retrospective Multinational Real-World Analysis","authors":"Giulia Giannini ,&nbsp;Mona Kafka ,&nbsp;Hannes Neuwirt ,&nbsp;Nastasiia Artamonova ,&nbsp;Gianpaolo di Santo ,&nbsp;Irene Virgolini ,&nbsp;Robert Dotzauer ,&nbsp;Emil Deiss ,&nbsp;Pia Paffenholz ,&nbsp;Axel Heidenreich ,&nbsp;Sazan Rasul ,&nbsp;Igor Tsaur ,&nbsp;Steffen Rausch ,&nbsp;Holger Einspieler ,&nbsp;Christian la Fougère ,&nbsp;Nils F. Trautwein ,&nbsp;Fabio Zattoni ,&nbsp;Matteo Sepulcri ,&nbsp;Isabel Heidegger","doi":"10.1016/j.clgc.2024.102260","DOIUrl":"10.1016/j.clgc.2024.102260","url":null,"abstract":"<div><h3>Background</h3><div>¹⁷⁷Lu PSMA therapy is increasingly used for metastatic castration-resistant prostate cancer (mCRPC) treatment. However, data on its efficacy and safety in patients previously treated with ²²³Ra remain limited.</div></div><div><h3>Methods</h3><div>This retrospective, multicenter study evaluated 233 mCRPC patients treated with ¹⁷⁷Lu PSMA at 5 European centers. The cohort included 27 patients previously treated with ²²³Ra and 206 Radium-naive patients. Statistical analyses, including Chi-squared, Mann-Whitney U tests, and multivariate logistic regression, were used to assess response and mortality. Predictors of response and mortality were identified using multivariate models.</div></div><div><h3>Results</h3><div>Patients who experienced a longer interval between castration resistance and the initiation of ¹⁷⁷Lu PSMA therapy demonstrated better responses (median 17 months in responders vs. 8.5 months in progressors, <em>P</em> = .001). Platelet counts were significantly lower in the progressive group compared to the responsive group (<em>P</em> = .01). Multivariate regression confirmed lower platelet levels as a predictor of poor response (<em>P</em> = .029). The overall response rate to ¹⁷⁷Lu PSMA was 54%, similar between the ²²³Ra-pretreated and Radium-naive groups. However, mortality was significantly higher in the ²²³Ra-pretreated group (86%) compared to the Radium-naive group (51%, <em>P</em> = .003). ECOG performance status (<em>P</em> = .004) and ALP levels (<em>P</em> = .030) were significant predictors of mortality, while CRP showed a trend towards significance (<em>P</em> = .064). Tolerability of ¹⁷⁷Lu PSMA was comparable to the safety profile reported in the literature, with 44% of ²²³Ra-pretreated patients experiencing AEs and 22% experiencing severe AEs (Grade ≥ 3).</div></div><div><h3>Conclusions</h3><div>¹⁷⁷Lu PSMA therapy is effective and well-tolerated in mCRPC patients pretreated with ²²³Ra. However, higher mortality was observed in the ²²³Ra-pretreated group. ECOG PS, ALP, and platelet counts were significant predictors of response and mortality, and a longer interval between therapies was associated with better outcomes. These findings underscore the importance of treatment sequencing and monitoring prognostic markers.</div></div>","PeriodicalId":10380,"journal":{"name":"Clinical genitourinary cancer","volume":"23 1","pages":"Article 102260"},"PeriodicalIF":2.3,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142721625","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":"Transcriptome-Based Network Analysis Related to Histone Deacetylase Genes and Identified EMP1 as a Potential Biomarker for Prognosis in Bladder Cancer","authors":"Qiong Bao ,&nbsp;Yan Li ,&nbsp;Yu Chen ,&nbsp;Ji Zheng ,&nbsp;Jiang Zhao ,&nbsp;Ting Hu","doi":"10.1016/j.clgc.2024.102262","DOIUrl":"10.1016/j.clgc.2024.102262","url":null,"abstract":"<div><h3>Background</h3><div>Abnormal expression and function of histone deacetylases (HDACs) are closely associated with the development of bladder cancer (BCa). Systematic elucidation of the role of HDACs in BCa is expected to improve BCa prognosis and treatment strategies.</div></div><div><h3>Methods</h3><div>We explored the correlation and expression patterns of HDAC family genes in BCa. Consensus clustering was employed to categorize BCa into subtypes based on HDAC expression profiles. Differential analysis, pathway enrichment analysis, and drug responsiveness evaluation were conducted to characterize HDAC subtypes. Then, a prognostic model based on HDAC cluster related genes was constructed and validated across multiple cohorts.</div></div><div><h3>Results</h3><div>We identified distinct HDAC expression patterns and correlations with immune cell infiltration and enrichment of pathways in cancer, highlighting their role in BCa. Consensus clustering revealed 2 HDAC gene subtypes. Gene cluster 1 showed worse survival, higher clinical stage, and lower immune cell infiltration compared to gene cluster 2. Additionally, pathway enrichment analysis revealed differences in tumor-promoting pathways between the clusters. Moreover, gene cluster 1 exhibited higher resistance to Rho kinase inhibitor drugs. Multi-omic analysis unveiled unique mutation and CNV profiles between the clusters, indicating distinct molecular features. Furthermore, a HDAC gene-related prognostic model demonstrated robust predictive accuracy and identified EMP1 as a key prognostic gene associated with poor survival and enriched metastatic pathways.</div></div><div><h3>Conclusion</h3><div>Our study provides comprehensive insights into the landscape of HDACs in BCa, elucidating their roles in tumor heterogeneity, immune modulation, drug responsiveness, and molecular features. EMP1 is a potential therapeutic target and prognostic marker for BCa.</div></div>","PeriodicalId":10380,"journal":{"name":"Clinical genitourinary cancer","volume":"23 1","pages":"Article 102262"},"PeriodicalIF":2.3,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142721643","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":"Reevaluating the Role of Extended Pelvic Lymphadenectomy in Muscle-Invasive Bladder Cancer: Insights From SWOG S1011 and LEA AB 25-02 Trials","authors":"Caio Vinícius Suartz ,&nbsp;Vincent Fradet ,&nbsp;Paul Toren ,&nbsp;Leopoldo Alves Ribeiro-Filho ,&nbsp;Daher Chade ,&nbsp;Fernando Korkes","doi":"10.1016/j.clgc.2024.102249","DOIUrl":"10.1016/j.clgc.2024.102249","url":null,"abstract":"","PeriodicalId":10380,"journal":{"name":"Clinical genitourinary cancer","volume":"23 1","pages":"Article 102249"},"PeriodicalIF":2.3,"publicationDate":"2024-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142703918","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":"Dose Per Body Weight Predicts Incidence and Severity of Apalutamide-Related Skin Rash in Metastatic Castration-Sensitive Prostate Cancer","authors":"Kotaro Suzuki,&nbsp;Yusuke Shiraishi,&nbsp;Yasuyoshi Okamura,&nbsp;Yukari Bando,&nbsp;Takuto Hara,&nbsp;Keisuke Okada,&nbsp;Tomoaki Terakawa,&nbsp;Yoji Hyodo,&nbsp;Koji Chiba,&nbsp;Jun Teishima,&nbsp;Yuzo Nakano,&nbsp;Hideaki Miyake","doi":"10.1016/j.clgc.2024.102250","DOIUrl":"10.1016/j.clgc.2024.102250","url":null,"abstract":"<div><h3>Background</h3><div>A survival advantage with apalutamide (APA) combined with androgen deprivation therapy for metastatic castration-sensitive prostate cancer (mCSPC) has been demonstrated in the clinical trial, irrespective of race. However, the incidence of APA-induced skin rash in the Japanese subpopulation is higher than that in the global population. In the present study, we investigated the predictive value of APA dose per body weight for the incidence of skin rash.</div></div><div><h3>Methods</h3><div>A total of 128 patients with mCSPC treated with APA between January 2018 and December 2022 were retrospectively reviewed. A receiver operating characteristic analysis was performed to identify the optimal APA cutoff dose. In addition to comparing the status of APA-induced skin rash, the progression-free survival (PFS) was compared after propensity score matching.</div></div><div><h3>Results</h3><div>The optimal cutoff dose predicting the occurrence of skin rash was 3.33 mg/kg. Our cutoff value significantly stratified the 2 groups in time to occurrence of APA-induced skin rash and discontinuation of APA due to skin rash (<em>P</em> = .005 and <em>P</em> = .009, respectively). The incidence of a ≥G3 skin rash in patients receiving ≥3.33 mg/kg was significantly higher than in others (6.5% vs. 19.7%, <em>P</em> = .037). There was no significant difference in the PFS between patients administered &lt;3.33 mg/kg and those administered ≥3.33 mg/kg.</div></div><div><h3>Conclusions</h3><div>Our data suggest that the drug dosage per body weight may predict the incidence and severity of APA-induced skin rash. Further large-scale prospective studies are needed to validate the predictive value of drug dosage per body weight and identify the optimal cutoff value.</div></div>","PeriodicalId":10380,"journal":{"name":"Clinical genitourinary cancer","volume":"23 1","pages":"Article 102250"},"PeriodicalIF":2.3,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142690143","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 of Inpatient, Evidence-Based Tobacco Use Treatment of Patients With Bladder Cancer After Radical Cystectomy","authors":"Hersh Trivedi ,&nbsp;Hannah Kay ,&nbsp;Katy Reines ,&nbsp;Julie Hartzell ,&nbsp;Eiman Newcomer ,&nbsp;Shannon Myers ,&nbsp;Richard S. Matulewicz ,&nbsp;Adam O. Goldstein ,&nbsp;Kimberly A. Shoenbill ,&nbsp;Marc A. Bjurlin","doi":"10.1016/j.clgc.2024.102252","DOIUrl":"10.1016/j.clgc.2024.102252","url":null,"abstract":"<div><h3>Purpose</h3><div>Despite a 3-fold increase in risks of bladder cancer (BC) among current smokers, smoking cessation therapy for patients undergoing treatment is significantly underutilized. Inpatient admission after surgery provides a teachable moment to pursue tobacco treatment. We conducted a 12-month prospective quality improvement initiative to increase tobacco treatment program (TTP) consultations with BC patients who smoke and underwent radical cystectomy (RC).</div></div><div><h3>Materials and Methods</h3><div>From 6/2022 to 6/2023, patients admitted after RC for BC who were identified to be current smokers were referred to our institution's inpatient TTP. A baseline standardized assessment of tobacco dependence was conducted postoperatively, and nicotine replacement therapy (NRT) was prescribed both inpatient and upon discharge. Study endpoints included the percentage of patients receiving inpatient TTP consultation, inpatient and 1-month NRT prescription fill rates, tobacco usage, cessation rates, quit attempts, and patient and provider satisfaction. Postintervention outcomes were compared to historical controls.</div></div><div><h3>Results</h3><div>Of the 16 inpatients (of 63 RCs) who smoked and received a TTP referral, 15 accepted. Referrals to TTP increased from 20% at baseline to 100% after implementation of the intervention (<em>P</em> = .01). NRT was prescribed for 40% of inpatients, and 60% of patients filled NRT after discharge. At 1-month follow-up, a significant decrease occurred in cigarette use (12.6 cigarettes/day to 6.8 cigarettes/day; <em>P</em> = .001). The majority, 86%, reported attempts to quit, and 29% reported that they successfully quit smoking. Patients reported high levels of stress reduction, confidence to quit, desire to quit, and willingness to use NRT. Most (83%) providers were very satisfied with the TTP and felt recommendations were easy to implement.</div></div><div><h3>Conclusions</h3><div>This study successfully increased the use of inpatient TTP in patients with BC who smoked and were undergoing RC. The positive outcomes, including high acceptability among patients, increased rates of TTP consultations, reduced cigarette usage postintervention, and notable satisfaction among healthcare providers, suggest that these strategies can be readily adopted by urologic care teams.</div></div>","PeriodicalId":10380,"journal":{"name":"Clinical genitourinary cancer","volume":"23 1","pages":"Article 102252"},"PeriodicalIF":2.3,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142694006","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 by Retrospective Eligibility for Maintenance Therapy of Patients With Advanced Urothelial Carcinoma: Post Hoc Analysis of the Phase 3 KEYNOTE-361 Trial","authors":"Ronac Mamtani ,&nbsp;Nobuaki Matsubara ,&nbsp;Alvaro Montesa Pino ,&nbsp;Urbano Anido Herranz ,&nbsp;Mehmet A． N. Şendur ,&nbsp;Gwenaelle Gravis ,&nbsp;Olivier Huillard ,&nbsp;Hyo Jin Lee ,&nbsp;Rustem Gafanov ,&nbsp;Florence Joly ,&nbsp;Jens Bedke ,&nbsp;Avishay Sella ,&nbsp;Yen-Hwa Chang ,&nbsp;Kentaro Imai ,&nbsp;Blanca Homet Moreno ,&nbsp;Jin Zhi Xu ,&nbsp;Ajjai Alva ,&nbsp;Thomas Powles","doi":"10.1016/j.clgc.2024.102248","DOIUrl":"10.1016/j.clgc.2024.102248","url":null,"abstract":"<div><h3>Introduction</h3><div>The phase 3 KEYNOTE-361 trial of first-line pembrolizumab with or without chemotherapy versus chemotherapy alone in patients with locally advanced or metastatic urothelial carcinoma (la/mUC) completed enrollment before the approval of postchemotherapy maintenance avelumab for patients without progressive disease. This post hoc analysis evaluated the outcomes of patients who received chemotherapy alone in KEYNOTE-361 by retrospective eligibility for subsequent maintenance therapy.</div></div><div><h3>Patients and Methods</h3><div>Patients in the chemotherapy alone arm were retrospectively categorized as maintenance eligible (received ≥4 cycles of chemotherapy and did not die or experience disease progression within 10 weeks of chemotherapy completion), maintenance ineligible (received &lt;4 cycles of chemotherapy or had progressive disease or died within 0-10 weeks after completion of ≥4 cycles of chemotherapy), and indeterminate eligibility for maintenance therapy (if neither maintenance eligible or ineligible). End points included progression-free survival per Response Evaluation Criteria in Solid Tumors version 1.1 by blinded independent central review and overall survival from randomization (start of chemotherapy).</div></div><div><h3>Results</h3><div>Median follow-up was 31.7 months (range, 22.0-42.3). Among 342 patients who received chemotherapy alone, 172 (50.3%) were maintenance eligible, 108 (31.6%) were maintenance ineligible, and 62 (18.1%) had indeterminate eligibility for maintenance therapy. The median progression-free survival was 9.0 months (95% CI 8.4-10.4) in maintenance-eligible patients, 5.1 months (4.2-6.0) in maintenance-ineligible patients, and 2.3 months (1.9-3.8) in the indeterminate group; median overall survival was 23.3 months (95% CI 19.4-26.1), 10.2 months (9.1-11.6), and 5.5 months (3.7-8.5), respectively.</div></div><div><h3>Conclusion</h3><div>This post hoc analysis suggests that a majority of patients with untreated la/mUC who initiated chemotherapy in a clinical trial may have been considered eligible for maintenance therapy and had favorable survival outcomes compared with those considered maintenance ineligible.</div></div>","PeriodicalId":10380,"journal":{"name":"Clinical genitourinary cancer","volume":"23 1","pages":"Article 102248"},"PeriodicalIF":2.3,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142696149","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The role of Cabazitaxel in Patients With Castration-Resistant and Osseous Metastases Prostate Cancer. A Hellenic Cooperative Oncology Group Phase II Study","authors":"Michalis Liontos ,&nbsp;Anna Goussia ,&nbsp;Nikolaos Korfiatis ,&nbsp;Kyriaki Papadopoulou ,&nbsp;Georgios Kanellis ,&nbsp;Anastasios Visvikis ,&nbsp;Georgios Petrakis ,&nbsp;Marinos Tsiatas ,&nbsp;Elena Fountzilas ,&nbsp;Epaminontas Samantas ,&nbsp;George Fountzilas ,&nbsp;Eleni Efstathiou","doi":"10.1016/j.clgc.2024.102253","DOIUrl":"10.1016/j.clgc.2024.102253","url":null,"abstract":"<div><h3>Background</h3><div>Cabazitaxel is an effective treatment in metastatic castration-resistant prostate cancer (mCRPC) patients previously exposed to docetaxel and novel hormonal treatments. Understanding the molecular biology of mCRPC disease and taking into account the several approved treatment options, biomarkers are needed to guide decision making including cabazitaxel treatment.</div></div><div><h3>Methods</h3><div>Cababone was a phase II translational study that attempted to identify predictors of cabazitaxel efficacy. mCRPC with documented bone metastases were enrolled prospectively and treated with cabazitaxel 25mg/m² every 3 weeks. Prostate cancer biopsies, bone marrow aspirates and blood samples were collected for translational research.</div></div><div><h3>Results</h3><div>Sixty patients were enrolled and 59 received treatment according to protocol. Six-month progression free survival (PFS) rate was 47% (95% CI: 33% - 59%) and 12-month Overall Survival (OS) rate was 70% (95% CI: 56% - 80%). Patients with reactive hematopoiesis had improved PFS and OS with cabazitaxel treatment. Mutations in HRR genes were detected in 7 patients.</div></div><div><h3>Conclusions</h3><div>No differences in cabazitaxel efficacy were noted according to mutational status of HRR genes analyzed. No new safety issues were detected. In conclusion, CabaBone confirmed efficacy of cabazitaxel in mCRPC patients including the subgroup of patients with HRR mutations. Reactive hematopoiesis in bone marrow biopsies was related to improved survival warranting further investigation of bone biomarkers as predictors of cabazitaxel efficacy.</div></div>","PeriodicalId":10380,"journal":{"name":"Clinical genitourinary cancer","volume":"23 1","pages":"Article 102253"},"PeriodicalIF":2.3,"publicationDate":"2024-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142694042","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":"Central Nervous System Toxicity in Prostate Cancer Patients Treated with Androgen Receptor Signaling Inhibitors: A Systematic Review, Meta-analysis, and Network Meta-analysis","authors":"Akihiro Matsukawa ,&nbsp;Takafumi Yanagisawa ,&nbsp;Pawel Rajwa ,&nbsp;Tamás Fazekas ,&nbsp;Marcin Miszczyk ,&nbsp;Ichiro Tsuboi ,&nbsp;Mehdi Kardoust Parizi ,&nbsp;Ekaterina Laukhtina ,&nbsp;Jakob Klemm ,&nbsp;Sever Chiujdea ,&nbsp;Stefano Mancon ,&nbsp;Keiichiro Mori ,&nbsp;Shoji Kimura ,&nbsp;Pierre I. Karakiewicz ,&nbsp;Jun Miki ,&nbsp;Takahiro Kimura ,&nbsp;Shahrokh F. Shariat","doi":"10.1016/j.clgc.2024.102251","DOIUrl":"10.1016/j.clgc.2024.102251","url":null,"abstract":"<div><h3>Background</h3><div>Androgen-receptor signaling inhibitors (ARSIs) significantly improve survival in systemic therapy for advanced/metastatic prostate cancer (PCa) patients; however possible central nervous system (CNS) toxicity is an unaddressed concern. We aimed to assess and compare the incidence of CNS-related adverse events (AEs) secondary to the treatment of PCa patients with different ARSIs.</div></div><div><h3>Materials</h3><div>In August 2023, a comprehensive seach was conducted in three databases for randomized controlled trials (RCTs) of PCa patients receiving ARSIs plus ADT. The primary endpoints included mental impairment, cognitive impairment, seizure, fatigue, and falls.</div></div><div><h3>Results</h3><div>Twenty-six RCTs, comprising 20,328 patients, were included in meta-analyses and network meta-analyses (NMAs). ARSIs increased the risk of mental impairment (RR: 1.72; 95% CI, 1.09-2.71), cognitive impairment (RR: 2.25; 95% CI, 1.78-2.86), seizure (RR: 2.20, 95% CI, 1.09-4.45), fatigue (RR: 1.31, 95% CI, 1.20-1.43), and falls (RR: 2.07, 95% CI, 1.60-2.67) compared to standard of care (SOC). Based on NMAs, Enzalutamide showed a significant increase in risk for all assessed CNS-related AEs, while Abiraterone demonstrated significant risk increases in cognitive impairment, fatigue, and falls. Conversely, Darolutamide did not exhibit significant increases in risk for any CNS-related AEs, except for fatigue.</div></div><div><h3>Conclusions</h3><div>The addition of ARSIs to ADT increased all examined CNS-related AEs compared to SOC. Each ARSI is associated with a distinct profile of CNS-related AEs. Careful patient selection and monitoring for CNS sequelae is necessary to achieve the best quality of life in patients on ARSI + ADT for PCa.</div></div>","PeriodicalId":10380,"journal":{"name":"Clinical genitourinary cancer","volume":"23 1","pages":"Article 102251"},"PeriodicalIF":2.3,"publicationDate":"2024-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142690142","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Salvage Stereotactic Radiotherapy for Nodal Oligo-Recurrent Prostate Cancer: A Systematic Review and Meta-Analysis of Randomized Controlled Trials","authors":"Ayesha Aman ,&nbsp;Arfa Akram ,&nbsp;Bisma Akram ,&nbsp;Ali Husnain ,&nbsp;Aleena Akram ,&nbsp;Sania Akram ,&nbsp;Eeman Ahmad ,&nbsp;Arsalan Nadeem","doi":"10.1016/j.clgc.2024.102239","DOIUrl":"10.1016/j.clgc.2024.102239","url":null,"abstract":"<div><h3>Background</h3><div>Prostate cancer has a high frequency of relapse, and the relapse is usually associated with a nodal recurrence pattern spreading predominantly to fewer pelvic or extra-pelvic lymph nodes. This meta-analysis sought to determine the safety and survival outcomes of salvage body stereotactic radiotherapy (SBRT) in oligo-recurrent nodal prostate cancer patients.</div></div><div><h3>Methods</h3><div>We searched the Cochrane Central Register of Controlled Trials, PubMed, ClinicalTrials.gov, and Google Scholar to retrieve all the relevant randomized controlled trials (RCTs) from inception to May 2024. Dichotomous outcomes were pooled using risk ratios (RR) with a 95% confidence interval (CI), whereas survival outcomes were reported using hazard ratios (HR) with a 95% CI.</div></div><div><h3>Results</h3><div>Three RCTs with a total of 312 patients (median age range of &gt;18-79) were included. Of 312 patients, 135 received SBRT with medical therapy, while 122 underwent either observation, medical therapy, or elective nodal radiotherapy. SBRT significantly increased the biochemical recurrence-free survival (HR: 0.45; 95% CI, 0.28-0.73) with minimal inter-study heterogeneity (I2 = 0%). SBRT did not affect the grade 2 genitourinary (GU) toxicity levels (Common Terminology Criteria for Adverse Events [CTCAE] v4.0) (RR: 0.74; 95% CI, 0.32-1.70; (I2 = 0%) nor the grade 2 gastrointestinal (GI) toxicity levels (CTCAE v4.0) (RR: 1.05; 95% CI, 0.26-4.31; I2 = 0%). SBRT was not associated with any significant change in the grade 1 toxicity levels (CTCAE v4.0) (RR, 1.08; 95% CI, 0.62-1.89) with moderate heterogeneity (I2 = 63%).</div></div><div><h3>Conclusion</h3><div>SBRT improves biochemical recurrence-free survival in patients with oligo-recurrent prostate cancer without increasing grade 1 and grade 2 GU/GI toxicity levels.</div></div>","PeriodicalId":10380,"journal":{"name":"Clinical genitourinary cancer","volume":"22 6","pages":"Article 102239"},"PeriodicalIF":2.3,"publicationDate":"2024-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142678037","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":"Comments on PSMA use in the primary staging of prostate cancer","authors":"Ryan P. Smith ,&nbsp;Robert M. Turner ,&nbsp;Ronald M. Benoit","doi":"10.1016/j.clgc.2024.102246","DOIUrl":"10.1016/j.clgc.2024.102246","url":null,"abstract":"","PeriodicalId":10380,"journal":{"name":"Clinical genitourinary cancer","volume":"23 1","pages":"Article 102246"},"PeriodicalIF":2.3,"publicationDate":"2024-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142694001","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}