Clinical genitourinary cancer最新文献

{"title":"mRNA-Based Urine Test Performance in High and Very-High Risk Non–Muscle-Invasive Bladder Cancer Patients Undergoing Contextual Endoscopic Follow-up (VERNAL: Vesical Tumor Early Monitoring: mRNA-Based Follow-up)","authors":"Alberto Macchi ,&nbsp;Martina Bruniera ,&nbsp;Sebastiano Nazzani ,&nbsp;Tommaso Ceccato ,&nbsp;Claudia Colbacchini ,&nbsp;Alessandra Taverna ,&nbsp;Giuseppe Aiello ,&nbsp;Valentina Bernasconi ,&nbsp;Mario Catanzaro ,&nbsp;Tullio Torelli ,&nbsp;Davide Biasoni ,&nbsp;Silvia Stagni ,&nbsp;Antonio Tesone ,&nbsp;Carlo Silvani ,&nbsp;Melanie Claps ,&nbsp;Patrizia Giannatempo ,&nbsp;Matteo Zimatore ,&nbsp;Chiara Bonini ,&nbsp;Daniele Morelli ,&nbsp;Nicola Nicolai","doi":"10.1016/j.clgc.2025.102333","DOIUrl":"10.1016/j.clgc.2025.102333","url":null,"abstract":"<div><h3>Introduction and Objectives</h3><div>Non–muscle-invasive bladder cancer (NMIBC) patients need a strict follow-up with cystoscopy (UCS) and voided urinary cytology (vUC) due to high rate of recurrence and progression. To reduce invasiveness and costs, a new diagnostic biomarker, namely Xpert Monitor BC^Ⓡ—detecting 5 mRNAs in voided urine—, has been proposed. We test Xpert Monitor BC^Ⓡ ability to detect tumor recurrence at an early point during follow-up of high risk (HR) or very high risk (VHR) NMIBC patients, aiming at evaluating reliability of this test as a single procedure.</div></div><div><h3>Materials and Methods</h3><div>Between September 2022 and July 2023 included, 80 HR or VHR NMIBC patients were prospectively enrolled. Both naïve and previously treated patients (including Bacillus Calmette-Guérin—BCG—and/or systemic immunotherapy) were admitted. Patients with known upper urinary tract urothelial carcinoma (UTUC) were excluded. Xpert Monitor BC^Ⓡ test was carried out on precystoscopy voided urine samples. In case of suspicious urethra-cystoscopy (UCS), a transurethral resection (TURB) or a biopsy was indicated. vUC was usually prescribed to be performed prior to UCS. Negative predictive value (NVP), positive predictive value (PPV), sensitivity (SE) and specificity (SP) of Xpert Monitor BC^Ⓡ and vUC, were assessed and compared with UCS and secondarily with histology at TURB/bladder biopsy.</div><div>Patients who proceeded with follow-up underwent a second evaluation with Xpert Monitor BC^Ⓡ test.</div></div><div><h3>Results</h3><div>Seventy-six patients were evaluable. Median age was 70 years (interquartile range [IQR] 65-78) and 62 (81.6%) patients were male. VHR patients were 14 (18.4%), 47 (61.8%) had a history of carcinoma in situ (CIS) and 37 (49.3%) had multifocal disease while 51 patients (67.1%) had recurrent bladder cancer (BC).</div><div>BC recurred in 15 patients (19.7%): in 3 of them as a muscle-invasive bladder cancer (MIBC). Xpert Monitor BC^Ⓡ showed a NPV, PPV, SE, SP of 95.3% (41/43), 57.6% (19/33), 90.5% (19/21) and 74.5% (41/55) respectively. When available, vUC displayed a NPV of 78.9% (30/38), a PPV of 75% (3/4), a SE of 27.3% (3/11) and a SP of 96.7% (30/31). Twenty patients underwent a subsequent Xpert Monitor BC^Ⓡ test and UCS during their follow-up, and 3 had a bladder cancer recurrence. Of note Xpert Monitor BC^Ⓡ was positive in all those 3 patients who previously tested positive despite a negative UC.</div></div><div><h3>Conclusions</h3><div>High NPV and SE of Xpert Monitor BC^Ⓡ are confirmed in our HR and VHR NMIBC series. Apparent false positive tests may be regarded as suspicious for persistent/recurrent disease. Implementation of Xpert Monitor BC^Ⓡ aiming at improving cancer detection is supported by these findings, and a single test based follow-up may be explored.</div></div>","PeriodicalId":10380,"journal":{"name":"Clinical genitourinary cancer","volume":"23 3","pages":"Article 102333"},"PeriodicalIF":2.3,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143791569","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":"Characterization of Exceptional Responses in Patients With Metastatic Castration-Resistant Prostate Cancer Treated With Cabozantinib and Immune Checkpoint Inhibitors","authors":"Teja Ganta ,&nbsp;Jonathan F. Anker ,&nbsp;Eric Miller ,&nbsp;Himanshu Joshi ,&nbsp;Che-Kai Tsao ,&nbsp;William K. Oh","doi":"10.1016/j.clgc.2025.102336","DOIUrl":"10.1016/j.clgc.2025.102336","url":null,"abstract":"<div><div><ul><li><span>•</span><span><div>Immune checkpoint inhibitors (ICIs) have been shown to have limited efficacy in unselected populations of patients with metastatic castration-resistant prostate cancer (mCRPC). In the phase III clinical trial CONTACT-02, a novel regimen combining cabozantinib and ICI improved progression-free survival in patients with mCRPC; however, due to its lack of survival benefit, it has not yet gained regulatory approval. In this retrospective series of patients with mCRPC without high tumor mutational burden or microsatellite instability treated with cabozantinib and ICI, the data indicate that a subpopulation exists with an exceptional long-term response, including some patients maintained on therapy for more than 30 months. The study further characterizes this subpopulation and can guide treatment selections for patients with limited options as oncologists and regulatory bodies continue to evaluate the risks and benefits of widespread adoption of this regimen.</div></span></li></ul></div></div>","PeriodicalId":10380,"journal":{"name":"Clinical genitourinary cancer","volume":"23 3","pages":"Article 102336"},"PeriodicalIF":2.3,"publicationDate":"2025-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143820338","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":"Off-Label Use of First-Line Immunotherapy for Metastatic Renal Cell Carcinoma","authors":"Hannah D McManus ,&nbsp;Jessica B Long ,&nbsp;Sarah J Westvold ,&nbsp;Michael S Leapman ,&nbsp;Michael E Hurwitz ,&nbsp;Aaron P Mitchell ,&nbsp;Craig Evan Pollack ,&nbsp;Cary P Gross ,&nbsp;Michaela A Dinan","doi":"10.1016/j.clgc.2025.102330","DOIUrl":"10.1016/j.clgc.2025.102330","url":null,"abstract":"<div><h3>Introduction</h3><div>Immune checkpoint inhibitors (ICI) were approved by the Food and Drug Administration (FDA) for patients with metastatic renal cell carcinoma (mRCC) in the second- line setting in 2015 and the first-line (1L) in 2018. Little is known about 1 L ICI use in the off-label (before FDA indication-specific approval) and postapproval settings.</div></div><div><h3>Patients and Methods</h3><div>We retrospectively analyzed off-label and post-FDA-approval 1 L ICI receipt in a cohort of Medicare beneficiaries ≥66 years old diagnosed with mRCC from 2015 to 2019. Off-label and postapproval 1 L ICI were defined as before or on/after 4/16/2018 (1L ipilimumab/nivolumab approval). Associations between demographic characteristics and 1 L ICI receipt in the off-label and postapproval periods were examined using multivariable logistic regression.</div></div><div><h3>Results</h3><div>We identified 23,469 patients, of which 368 (2.4%) off-label and 1,663 (21%) postapproval received 1 L ICI. In the off-label period, patients with co-morbid conditions were more likely to receive 1 L ICI compared to patients with no co-morbidities (3+ conditions, OR = 2.00; 95% CL, 1.31-3.05). In the postapproval period, older patients were less likely to receive 1 L ICI (81+ vs. 66-70, OR = 0.60; 95% CL, 0.52-0.69), and patients who were frail were less likely to receive 1 L ICI (OR = 0.77; 95% CL, 0.69-0.87). There were not significant differences in 1 L ICI receipt based on race/ethnicity.</div></div><div><h3>Conclusion</h3><div>Older patients and patients with more comorbidities were more likely to receive 1 L ICI off-label, but these differences did not persist after FDA approval. After 1 L ipilimumab/nivolumab approval, patients receiving 1 L ICI were more likely younger, healthy, and receiving dual-ICI regimens.</div></div>","PeriodicalId":10380,"journal":{"name":"Clinical genitourinary cancer","volume":"23 3","pages":"Article 102330"},"PeriodicalIF":2.3,"publicationDate":"2025-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143769210","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":"Preliminary Assessment of Cone Beam CT Guided Percutaneous Cryoablation for CT1A Renal Cell Carcinoma: A Relatively Novel and Underutilized Technique","authors":"M. Duijn ,&nbsp;A.E.C. Ruiter ,&nbsp;A.D. Montauban van Swijndregt ,&nbsp;V.P.M. van der Hulst ,&nbsp;B.W. Lagerveld","doi":"10.1016/j.clgc.2025.102329","DOIUrl":"10.1016/j.clgc.2025.102329","url":null,"abstract":"<div><h3>Introduction</h3><div>To assess the efficacy and safety of cone beam CT guided percutaneous cryoablation (CBCT guided PCA) for the treatment of cT1a renal tumors by evaluating oncological outcomes and postoperative complication risk, in comparison to conventional CTguided PCA and laparoscopic cryoablation (LCA) using long-term follow-up data from a single-center cohort.</div></div><div><h3>Methods</h3><div>A retrospective analysis of 3 cryoablation (CA) techniques was conducted at our institution from December 2006 to February 2023. A total of 77 (32.6%) patients underwent CBCT guided PCA, 34 (14.4%) received CT guided PCA, and 125 (53%) were treated with LCA. Primary outcomes included recurrence-free survival (RFS) and overall complication rate (OCR). RFS was calculated using the Kaplan-Meier method. Univariate and multivariate Cox proportional hazards analyses assessed the impact of specific baseline characteristics on recurrence risk.</div></div><div><h3>Results</h3><div>19 (8.1%) patients exhibited local disease recurrence during follow-up. Recurrence occurred in 7 (9.1%), 4 (11.8%), and 8 (6.4%) patients in the CBCT guided PCA, CT guided PCA, and LCA group, respectively (<em>P</em> = .549). The overall RFS was 90.1%, 88.2%, and 93.6% for CBCT guided PCA, CT guided PCA, and LCA, respectively. RFS did not differ significantly between the 3 groups (Log-rank for trend: <em>P</em> = .083). No significant difference in overall recurrence (OCR) was observed among the groups (<em>P</em> = .200).</div></div><div><h3>Conclusion</h3><div>CBCT guided PCA shows higher overall RFS in comparison to CT guided PCA and thereby is an effective and safe alternative for the treatment of small renal masses.</div></div>","PeriodicalId":10380,"journal":{"name":"Clinical genitourinary cancer","volume":"23 3","pages":"Article 102329"},"PeriodicalIF":2.3,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143739922","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":"Pathological Complete Response in Metastatic Renal Cell Carcinoma Patients Treated With Cabozantinib Plus Nivolumab. Case Series and Literature Review","authors":"Marco Stellato MD ,&nbsp;Simone Rota MD ,&nbsp;Melanie Claps MD ,&nbsp;Valentina Guadalupi MD ,&nbsp;Alessandro Rametta MD ,&nbsp;Giuseppe Fotia MD ,&nbsp;Marco Barella MD ,&nbsp;Elena Verzoni MD ,&nbsp;Giuseppe Procopio MD","doi":"10.1016/j.clgc.2025.102328","DOIUrl":"10.1016/j.clgc.2025.102328","url":null,"abstract":"<div><div><ul><li><span>•</span><span><div>Cabozantinib plus nivolumab could be safe and effective in metastatic Renal Cell Carcinoma patients with oligometastatic disease and primary in site.</div></span></li><li><span>•</span><span><div>IO-TKI is associated to high response rate that sometimes includes pathological Complete Response.</div></span></li><li><span>•</span><span><div>Cytoreductive Nephrectomy should be considered in multidisciplinary team as an option for selected patients with low disease burden, fit for surgery, especially following a favorable response to systemic treatment.</div></span></li></ul></div></div>","PeriodicalId":10380,"journal":{"name":"Clinical genitourinary cancer","volume":"23 3","pages":"Article 102328"},"PeriodicalIF":2.3,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143714236","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":"Lymphovascular Invasion Predicts Cancer-specific Mortality in Penile Localized Squamous Cell Carcinoma","authors":"Natali Rodriguez Peñaranda ,&nbsp;Letizia Maria Ippolita Jannello ,&nbsp;Francesco Di Bello ,&nbsp;Carolin Siech ,&nbsp;Mario de Angelis ,&nbsp;Jordan A. Goyal ,&nbsp;Zhe Tian ,&nbsp;Fred Saad ,&nbsp;Shahrokh F. Shariat ,&nbsp;Nicola Longo ,&nbsp;Felix K.H. Chun ,&nbsp;Alberto Briganti ,&nbsp;Ottavio de Cobelli ,&nbsp;Stefano Di Bari ,&nbsp;Stefano Puliatti ,&nbsp;Salvatore Micali ,&nbsp;Pierre I. Karakiewicz","doi":"10.1016/j.clgc.2025.102320","DOIUrl":"10.1016/j.clgc.2025.102320","url":null,"abstract":"<div><h3>Introduction</h3><div>Lymphovascular invasion (LVI) is a predictor of unfavorable stage at presentation in squamous cell carcinoma of the penis (SCCP). However, it is unknown if LVI may also predict cancer-specific mortality (CSM), especially in patients with localized SCCP in whom important differences in the treated natural history may exist. We addressed this knowledge gap in localized (T1b-T2N0M0) SCCP patients treated with penectomy.</div></div><div><h3>Methods</h3><div>Within the Surveillance, Epidemiology, and End Results database (SEER 2010-2021), we identified localized SCCP patients treated with penectomy in whom LVI status was available. Kaplan-Meier analyses and multivariable Cox regression models (CRM) addressed CSM. Covariates consisted of age at diagnosis, T stage, penectomy type, and race/ethnicity.</div></div><div><h3>Results</h3><div>Of 685 localized SCCP patients, 144 (21%) were LVI-positive. At three-years of follow-up CSM-free survival rates were 85% versus 69% in respectively LVI-negative versus LVI-positive patients (<em>P</em> &lt; 0.001), which resulted in a univariable hazard ratio [HR] of 2.5 (<em>P</em> &lt; 0.01). After multivariable adjustment in Cox regression models, LVI-positive status independently predicted a 2.6-fold higher CSM (<em>P</em> &lt; 0.001). In subgroup analyses, LVI also independently predicted higher CSM in T1b (HR = 3.0; <em>P</em> = 0.01), as well as in T2 (HR= 2.5; <em>P</em> &lt; 0.001) SCCP patients.</div></div><div><h3>Conclusion</h3><div>In localized SCCP patients, LVI is a highly significant independent predictor of higher CSM in both T1b and T2 stages and may warrant consideration for use in clinical practice.</div></div>","PeriodicalId":10380,"journal":{"name":"Clinical genitourinary cancer","volume":"23 3","pages":"Article 102320"},"PeriodicalIF":2.3,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143641960","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":"CDK4/6 Inhibition With Abemaciclib in Patients With Previously Treated Advanced Renal Cell Carcinoma","authors":"Bradley A. McGregor ,&nbsp;Wanling Xie ,&nbsp;Stephanie A. Berg ,&nbsp;Wenxin Xu ,&nbsp;Srinivas R. Viswanathan ,&nbsp;David McDermott ,&nbsp;Sabina Signoretti ,&nbsp;William G Kaelin Jr ,&nbsp;Toni K. Choueiri","doi":"10.1016/j.clgc.2025.102318","DOIUrl":"10.1016/j.clgc.2025.102318","url":null,"abstract":"<div><h3>Background</h3><div>Preclincal data provide a rationale for cyclin-dependent kinases 4 and 6 (CDK4/6) inhibitors alone and in combination with HIF-2α inhibitors in treatment of clear cell renal cell carcinoma (ccRCC), with randomized phase 2 clinical trials currently open exploring the combination of palbociclib with belzutifan vs belzutifan in treatment resistant ccRCC (NCT05468697). However, single agent activity for CDK4/6 inhibitors in ccRCC has not been reported. In this multi-center phase 1b clinical trial (<span><span>NCT04627064</span><svg><path></path></svg></span>), we investigated the safety and efficacy of monotherapy with abemaciclib, an oral CDK4/6 inhibitor in patients with advanced pretreated RCC.</div></div><div><h3>Methods</h3><div>Adult patients with advanced RCC with a clear cell component and ECOG status of ≤ 2 progressing after at least 1 prior regimen including immunotherapy and a VEGFR TKI received abemaciclib 200 mg twice daily in 4-week cycles until progression or unacceptable toxicity. The primary objective was to evaluate the objective response rate (ORR) of abemaciclib with a secondary endpoint of safety. First imaging was performed after 8 weeks or 2 cycles. Response was assessed per RECIST 1.1 and toxicity graded per CTCAE v5.0.</div></div><div><h3>Results</h3><div>Eleven patients were enrolled between December 31, 2020 and October 03, 2023. Median age was 62 years (range 54-68); 73% (<em>n</em> = 8) had IMDC intermediate risk disease and 1 patient had translocation RCC with a clear cell component. Median number of prior therapies was 4 (range 1-9). ORR was 0% (0/11; 8 progressive disease, 1 stable disease stopping for clinical progression, 2 not evaluable with clinical progression). About 27% (<em>n</em> = 3) experienced grade ≥3 treatment-related adverse events (diarrhea <em>n</em> = 1, nausea <em>n</em> = 1, neutropenia <em>n</em> = 1).</div></div><div><h3>Conclusion</h3><div>In patients with heavily pretreated metastatic RCC, abemaciclib monotherapy had no clinically meaningful activity without new toxicity signals. This data will offer important insight into interpretation of results for ongoing trials exploring CDK4/6 inhibition in combination with HIF-2α inhibitors and immunotherapy.</div></div>","PeriodicalId":10380,"journal":{"name":"Clinical genitourinary cancer","volume":"23 3","pages":"Article 102318"},"PeriodicalIF":2.3,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143600725","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":"Effect of NSAID Consumption on Renal Cell Carcinoma Prognosis: A Population-Based Study","authors":"Ilkka Kemppinen,&nbsp;Antti Pöyhönen,&nbsp;Priit Veskimäe,&nbsp;Thea Veitonmäki,&nbsp;Teuvo Tammela,&nbsp;Teemu J. Murtola","doi":"10.1016/j.clgc.2025.102311","DOIUrl":"10.1016/j.clgc.2025.102311","url":null,"abstract":"<div><h3>Objective</h3><div>The objective is to study the effect of NSAID consumption on renal cell carcinoma prognosis.</div></div><div><h3>Methods</h3><div>In retrospective cohort study patients diagnosed with renal cell carcinoma (RCC) between 1995 and 2015 (<em>n</em> = 7492) were divided into subgroups based on their NSAID use. Multivariate adjusted analyses were performed using cox's regression model to evaluate hazard ratio for RCC mortality. Analyses were conducted separately for acetylsalicylic acid (ASA), COX-2 selective inhibitor (COXIB), and NSAID (including ASA and COXIB) users.</div></div><div><h3>Results</h3><div>Any NSAID consumption prior to the diagnosis of RCC exhibits a slightly elevated mortality rate compared to individuals who do not consume NSAIDs (HR 1.08, 95% CI 1.00-1.16). Pre- and postdiagnostic ASA and KOKSIB use, as well as postdiagnostic NSAID, ASA, and COXIB use, weren't associated with RCC mortality. Among women, NSAID use elevated RCC mortality both prior to the diagnosis (HR 1.21, 95% CI 1.08-1.36, <em>P</em> = .005) and after the diagnosis (HR 1.15, 95% CI 1.05-1.29, <em>P</em> = .046).</div></div><div><h3>Conclusion</h3><div>Prediagnostic NSAID consumption slightly elevated RCC mortality. Among women, both pre- and postdiagnostic NSAID use is associated with heightened RCC mortality.</div></div>","PeriodicalId":10380,"journal":{"name":"Clinical genitourinary cancer","volume":"23 3","pages":"Article 102311"},"PeriodicalIF":2.3,"publicationDate":"2025-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143548452","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":"Isolated Urinary Tract Persistence or Progression in Patients Treated With Immunotherapy for Advanced Urothelial Carcinoma","authors":"Pierre-Etienne Gabriel ,&nbsp;Hélène Gauthier ,&nbsp;Evanguelos Xylinas ,&nbsp;Jean-François Hermieu ,&nbsp;François Desgrandchamps ,&nbsp;Christophe Hennequin ,&nbsp;Stéphane Culine ,&nbsp;Alexandra Masson-Lecomte ,&nbsp;Clément Dumont","doi":"10.1016/j.clgc.2025.102312","DOIUrl":"10.1016/j.clgc.2025.102312","url":null,"abstract":"<div><h3>Purpose</h3><div>Emerging therapies including anti-PD-(L)1 immunotherapy have changed paradigms of treatment and improved oncological outcomes of advanced/metastatic urothelial carcinoma (mUC) patients. An emerging challenge in this setting is the management of isolated urinary tract persistence or progression (IUTP) of primary urothelial tumor despite stability or response of metastatic disease to immunotherapy.</div></div><div><h3>Methods</h3><div>This retrospective monocentric study included all patients treated with single-agent anti-PD-(L)1 for mUC between August 2015 and October 2023. Patients were divided in cohorts of interest depending on primary UC site (lower or upper tract) and previous surgery at the time of immunotherapy initiation. Incidence of IUTP was analyzed in a competitive-risk fashion.</div></div><div><h3>Results</h3><div>Overall,107 patients with mUC and no previous surgical treatment of primary tumor treated with immunotherapy were at risk of local progression. Among 65 mUC with an untreated bladder primary site, the cumulative incidence rate of IUTP in patients with nonprogressive metastatic disease on immunotherapy was 21.4% and 42.7% at 1 and 2 years, respectively. In responders, half of IUTP were nonmuscle invasive;5 patients, including all 3 with NMIBC, remained free of distant progression after a median follow-up of 12.7 (4.6-41.2) months. In mUTUC, 2 out of 18 patients (11.1%) experienced isolated primary site progression and underwent radical nephroureterectomy, with one patient remaining free of distant progression over 1 year.</div></div><div><h3>Conclusions</h3><div>These preliminary results show high incidence of IUTP as a progression pattern in mUC patients with clinical benefit of immunotherapy for mUC, highlighting the interest of monitoring the primary tumor and considering local treatment in selected cases, with promising oncological outcomes.</div></div>","PeriodicalId":10380,"journal":{"name":"Clinical genitourinary cancer","volume":"23 2","pages":"Article 102312"},"PeriodicalIF":2.3,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143520854","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 Pure Seminomas With Early Relapse: Prognostic Roles of High Dose Chemotherapy and Surgery of Residual Disease","authors":"Lucile Duval ,&nbsp;Benoît Allignet ,&nbsp;Christine Chevreau ,&nbsp;Gwenaelle Gravis ,&nbsp;Camille Mazza ,&nbsp;Marine Gross-Goupil ,&nbsp;Brigitte Laguerre ,&nbsp;Patrice Peyrat ,&nbsp;Floriane Izarn ,&nbsp;Anna Patrikidou ,&nbsp;Aude Fléchon","doi":"10.1016/j.clgc.2025.102310","DOIUrl":"10.1016/j.clgc.2025.102310","url":null,"abstract":"<div><h3>Introduction</h3><div>Metastatic seminomatous germ cell tumors (mSGCT) are a rare form of cancer. Few studies focused on early relapse (&lt;12 months) after first-line chemotherapy (ChT). We aimed to retrospectively evaluate the impact of salvage retroperitoneal lymph node dissection (RPLND) and high-dose ChT with hematopoietic stem cell transplantation (HDCT-HSCT) in mSGCT patients in a situation of early relapse.</div></div><div><h3>Methods</h3><div>Ninety-one mSGCT patients treated between 2005 and 2023 in 7 French expert centers for an early recurrence after an initial favorable response to first-line ChT were retrospectively included. Patient clinical characteristics, progression-free survival after first relapse (PFS) and overall survival (OS) were evaluated. We also assessed the role of HDCT-HSCT as first salvage treatment, and the impact of complementary RPLND after salvage ChT.</div></div><div><h3>Results</h3><div>After a median follow-up of 56 months, 3-year PFS and OS rates were 77.6% (95% CI, 68.3-88.1) and 88.4% (95% CI, 81.0-96.4), respectively. HDCT-HSCT was not associated with longer PFS or OS compared to standard-dose second-line ChT. In contrast, patients who underwent RPLND after salvage ChT demonstrated significantly longer PFS (at 3-years: 97.1% vs. 63%; HR 0.15; 95% CI, 0.03-0.65; <em>P</em> = .012) and a notable trend towards improved OS (at 3-years: 97.0% vs. 81.8%; HR 0.15; 95% CI, 0.02-1.23; <em>P</em> = .078).</div></div><div><h3>Conclusion</h3><div>RPLND after salvage treatment could be associated with improved PFS and OS in mSGCT patients with first-year relapse. However, the retrospective nature of the study limits causal inference, and prognostic factors influencing treatment selection should be further explored. Identifying subpopulations that might benefit from HDCT-HSCT is warranted.</div></div>","PeriodicalId":10380,"journal":{"name":"Clinical genitourinary cancer","volume":"23 2","pages":"Article 102310"},"PeriodicalIF":2.3,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143560335","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}