Clinical genitourinary cancer最新文献

{"title":"Real-world Clinical Outcomes and Prognostic Factors in Neuroendocrine Prostate Cancer","authors":"Richard Gagnon ,&nbsp;Ealia Khosh Kish ,&nbsp;Sarah Cook ,&nbsp;Kosuke Takemura ,&nbsp;Brian Yu Chieh Cheng ,&nbsp;Kamiko Bressler ,&nbsp;Daniel Yick Chin Heng ,&nbsp;Nimira Alimohamed ,&nbsp;Dean Ruether ,&nbsp;Richard Marvin Lee-Ying ,&nbsp;Pinaki Bose ,&nbsp;Michael Paul Kolinsky ,&nbsp;Catalina Vasquez ,&nbsp;Divya Samuel ,&nbsp;John Lewis ,&nbsp;Rehan Faridi ,&nbsp;Minal Borkar ,&nbsp;Adrian Fairey ,&nbsp;Tarek Bismar ,&nbsp;Steven Yip","doi":"10.1016/j.clgc.2024.102274","DOIUrl":"10.1016/j.clgc.2024.102274","url":null,"abstract":"<div><h3>Background</h3><div>Neuroendocrine prostate cancer (NEPC) encompasses pure NEPC and tumors with mixed adenocarcinoma and neuroendocrine histology. While NEPC is thought to confer a poor prognosis, outcome data are sparse, making risk stratification and treatment decisions difficult for clinicians.</div></div><div><h3>Methods</h3><div>This retrospective study identified patients with morphological and/or immunohistochemical NEPC features on pathological review of high-grade prostate cancer cases. Median overall survival (OS) was calculated by stage and castration sensitivity. Prognostic factors were assessed via multivariate analysis. OS and progression-free survival on first-line metastatic systemic treatment were also evaluated.</div></div><div><h3>Results</h3><div>Of 135 NEPC cases, 25.9% had NEPC documented in the original pathological report. Mixed pathology was found in 91.9% of cases. Median OS from NEPC diagnosis was 59.2, 42.3, 14.3, 17.6 and 9.6 months for localized, nonmetastatic castration-sensitive, nonmetastatic castration-resistant, metastatic castration-sensitive and metastatic castration-resistant prostate cancer, respectively. Anemia (hazard ratio [HR]: 1.66; 95% CI 1.05-2.16; <em>P = .</em>031) and elevated neutrophil-lymphocyte ratio (NLR) (HR: 1.51; 95% CI 1.01-2.52; <em>P = .</em>045), were associated with increased risk of death on multivariate analysis. 67 patients received first-line metastatic treatment beyond androgen deprivation, with a median progression-free survival of 5.2 months and OS of 15 months. Of these, 50.7% received more than 1 line of systemic treatment.</div></div><div><h3>Conclusion</h3><div>We observed underdiagnosis of NEPC in pathology specimens. NEPC is associated with poorer prognosis than would be expected in pure adenocarcinoma populations, with rapid progression on first-line metastatic treatment and sharp drop-off between subsequent treatment lines. Anemia and elevated NLR were associated with poor survival.</div></div>","PeriodicalId":10380,"journal":{"name":"Clinical genitourinary cancer","volume":"23 1","pages":"Article 102274"},"PeriodicalIF":2.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142848703","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":"Development and Validation of Prognostic Model for Metastatic Castration-Resistant Prostate Cancer Patients Treated With First-Line Abiraterone or Enzalutamide","authors":"Orazio Caffo ,&nbsp;Umberto Basso ,&nbsp;Carlo Cattrini ,&nbsp;Paola Ermacora ,&nbsp;Marco Maruzzo ,&nbsp;Martina Alberti ,&nbsp;Cecilia Anesi ,&nbsp;Davide Bimbatti ,&nbsp;Massimiliano Cani ,&nbsp;Veronica Crespi ,&nbsp;Giovanni Farinea ,&nbsp;Dzenete Kadrija ,&nbsp;Stefania Kinspergher ,&nbsp;Eleonora Lai ,&nbsp;Ludovica Lay ,&nbsp;Francesca Maines ,&nbsp;Alessia Mennitto ,&nbsp;Francesco Pierantoni ,&nbsp;Alessandro Samuelly ,&nbsp;Susanna Urban ,&nbsp;Antonello Veccia","doi":"10.1016/j.clgc.2024.102265","DOIUrl":"10.1016/j.clgc.2024.102265","url":null,"abstract":"<div><h3>Introduction</h3><div>Over the years, several prognostic models were developed in patients receiving chemotherapy for metastatic castration resistant prostate cancer (mCRPC), while data on androgen-receptor signaling inhibitors (ARSI) in a real-world setting are limited.</div></div><div><h3>Patients and methods</h3><div>We compared a consecutive series of 565 mCRPC patients receiving first-line ARSI at 4 high-volume Italian Centers (development set) to an external series of 180 patients receiving the same treatment at another Italian high-volume Center (training set), between 2011 and 2022.</div><div>Sixteen clinical and baseline laboratory variables were selected to develop a prognostic model. Patients were categorized into risk groups according to the number of independent factors positively associated with overall survival (OS).</div></div><div><h3>Results</h3><div>In the development cohort, after a median follow-up of 21.1 months, the median OS was 30.4 months (95% CI 27.5-33.4). At the multivariate analysis, 7 variables [age, prostate specific antigen (PSA) doubling time, baseline levels of hemoglobin, PSA, time to castration resistance, ECOG PS and bone metastases number) were included into the final model.</div><div>The median OS was 13.4, 25.7 and 46.4 months in poor (0-2 factors), intermediate (3-4 factors) and good (≥ 5 factors) prognosis group, respectively.</div><div>The application of the model to the validation set confirmed its ability to prognosticate for OS. The model c-indexes were 0.68 (95% CI 0.64-0.72) and 0.75 (95% CI 0.68-0.81) in the development and validation cohort, respectively.</div></div><div><h3>Conclusions</h3><div>Our model, based on clinical and laboratory variables readily assessable in clinical practice, might prognosticate the OS of mCRPC patients receiving first-line ARSI.</div></div>","PeriodicalId":10380,"journal":{"name":"Clinical genitourinary cancer","volume":"23 1","pages":"Article 102265"},"PeriodicalIF":2.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142815282","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":"Complex Decision Making for Individual Patients With Penile Cancer: Benchmarking Divergent Practices in European High-Volume Reference Centers: Results From eUROGEN Survey","authors":"Laura Elst ,&nbsp;Darren Shilhan ,&nbsp;Michelle Battye ,&nbsp;Jure Murgić ,&nbsp;Ana Frӧbe ,&nbsp;Maarten Albersen ,&nbsp;Marija Miletić","doi":"10.1016/j.clgc.2024.102275","DOIUrl":"10.1016/j.clgc.2024.102275","url":null,"abstract":"<div><h3>Background and objectives</h3><div>Penile cancer (PeCa) remains a challenge due to its rarity and the lack of prospective studies, leading to treatment challenges and controversies. Guidelines offer recommendations, but discrepancies with clinical practice persist. This study analyzed treatment practices among specialists managing high-risk PeCa in European reference centers.</div></div><div><h3>Methods</h3><div>A cross-sectional survey included 39 PeCa specialists from 13 European countries representing high-volume centers. Descriptive analysis assessed (neo)adjuvant therapy preferences, systemic regimen choices, immunotherapy use, and next-generation sequencing (NGS) integration.</div></div><div><h3>Key findings and limitations</h3><div>Variations in managing high-risk PeCa, especially in (neo)adjuvant therapy utilization, were noted among participants. The differences highlight the influence of professional backgrounds and variations in treatment approaches between participants. Systemic regimen preferences and immunotherapy utilization also varied. Limited NGS integration indicated gaps in precision medicine adoption. Limitations included sample size, self-reported data, and cross-sectional design.</div></div><div><h3>Conclusions and clinical implications</h3><div>This study offered insights into PeCa management by specialists in high-volume European reference centers, stressing the need for evidence-based recommendations, guideline adherence, and collaboration to enhance PeCa care.</div></div><div><h3>Patient summary</h3><div>Managing PeCa is complex due to its rarity and treatment controversies. This study examined practices among specialists in European reference centers, revealing treatment variations. The findings emphasize the importance of evidence-based care and collaboration in optimizing PeCa management.</div></div>","PeriodicalId":10380,"journal":{"name":"Clinical genitourinary cancer","volume":"23 1","pages":"Article 102275"},"PeriodicalIF":2.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142848700","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":"Eighty-Nine Cases of Primary Prostatic Signet Ring Cell Carcinoma—Systematic Review","authors":"Madison Boot ,&nbsp;Kenneth Keen Yip Chew ,&nbsp;Jack Archer ,&nbsp;Kirra Parks ,&nbsp;Katelyn Wilson ,&nbsp;Cameron Sowter ,&nbsp;Steven Sowter","doi":"10.1016/j.clgc.2024.102281","DOIUrl":"10.1016/j.clgc.2024.102281","url":null,"abstract":"<div><div>Signet ring cell adenocarcinoma is a rare subtype of mucinous adenocarcinoma that affects the gastrointestinal tract and the prostate. Prostatic signet ring cell carcinoma comprises 0.02% of all cases of prostate cancer and 0.4% of all signet ring cell cancers. The aim of this review was to summarize the existing literature on primary prostatic signet ring cell carcinoma by assessing patient demographics, clinical presentations, investigations, treatment methods, and survival outcomes. A systematic review was conducted in multiple databases, including 46 articles comprising 89 individual cases of primary prostatic signet ring cell carcinoma. Data was extracted and analyzed using descriptive statistics. The average age of patients with primary prostatic signet ring cell carcinoma was 68.5 years, and most cases were reported in Caucasian individuals. Clinical presentations varied, with lower urinary tract symptoms being the most common. Biochemical markers, such as prostate-specific antigen, were often elevated. Imaging modalities, including computed tomography and magnetic resonance imaging, were used for diagnosis, and it found that one-third had metastatic disease on diagnosis. Treatment options included radical prostatectomy, hormone therapy, radiation therapy, and chemotherapy. The prognosis for primary prostatic signet ring cell carcinoma was poor, with a 3-year survival rate of approximately 17%. Primary prostatic signet ring cell carcinoma is a rare and aggressive form of prostate cancer. The limited literature on this condition highlights the need for further research. These systematic review findings contribute to a better understanding of this disease and may guide future clinical management strategies.</div></div>","PeriodicalId":10380,"journal":{"name":"Clinical genitourinary cancer","volume":"23 1","pages":"Article 102281"},"PeriodicalIF":2.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142901154","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":"Activity of 177Lu-PSMA-617 in Patients With Advanced Prostate Cancer and Brain Metastases","authors":"Narmeen S. Rashid ,&nbsp;Avina Rami ,&nbsp;Min Lang ,&nbsp;Hailey Stoltenberg ,&nbsp;Andrew Wolanski ,&nbsp;Jolivette Ritzer ,&nbsp;Heather Jacene ,&nbsp;Praful Ravi","doi":"10.1016/j.clgc.2025.102309","DOIUrl":"10.1016/j.clgc.2025.102309","url":null,"abstract":"<div><div><ul><li><span>•</span><span><div>While 177Lu-PSMA-617 (LuPSMA) is a proven life-prolonging therapy in patients with metastatic castration-resistant prostate cancer (mCRPC), little is known about its efficacy in patients with central nervous system (CNS) metastasis.</div></span></li><li><span>•</span><span><div>In this case series, some CRPC patients with CNS disease had a partial or mixed intracranial response to LuPSMA, typically combined with brain-directed therapy, but others developed new brain metastasis or experienced neurological decline.</div></span></li><li><span>•</span><span><div>Though LuPSMA appears to have some intracranial activity, a multimodal approach with adjunctive use of local therapy is likely needed for patients with CNS disease.</div></span></li></ul></div></div>","PeriodicalId":10380,"journal":{"name":"Clinical genitourinary cancer","volume":"23 2","pages":"Article 102309"},"PeriodicalIF":2.3,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143479102","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":"Incidence of Significant Prostate Cancer in the Follow-Up of Patients With Suspicious Lesion on MRI and Negative Targeted and systematic Biopsies","authors":"Claire Siebert ,&nbsp;Truong-An Nguyen ,&nbsp;Alexandre Fourcade ,&nbsp;Audrey Zambon ,&nbsp;Kevin Saout ,&nbsp;Charles Deruelle ,&nbsp;Vincent Joulin ,&nbsp;Valentin Tissot ,&nbsp;Laurent Doucet ,&nbsp;Georges Fournier ,&nbsp;Antoine Valeri","doi":"10.1016/j.clgc.2025.102308","DOIUrl":"10.1016/j.clgc.2025.102308","url":null,"abstract":"<div><h3>Introduction</h3><div>Currently, there are no established guidelines for follow-up (FU) after negative prostate biopsies (PBx) despite the presence of a target on MRI. We aimed to evaluate the risk of clinically significant prostate cancer (csPCa) within 2 years (2y) and at final FU in such cases.</div></div><div><h3>Patients and Methods</h3><div>We analyzed 105 patients with negative systematic and targeted PBx despite positive mpMRI (PI-RADS ≥ 3) (median FU: 66.5 months [IQR: 40-83]). All patients underwent FU with serial PSA measurements, digital rectal examinations and, when indicated, FU-MRI and/or FU-PBx. Outcomes assessed csPCa occurrence (GGG /ISUP ≥ 2) at 2y and at final FU, and predictive factors for csPCa.</div></div><div><h3>Results</h3><div>At 2y, the csPCa detection rate (Det-R) was 7.6%, increasing to 15.2% at final FU. No significant differences were observed at 2y based on baseline PI-RADS status. The mean initial PSAD was significantly higher in patients with csPCa at 2y versus without: 0.20 ng/mL² (SD: 0.11) versus 0.13 ng/mL² (SD: 0.12) (<em>P</em> = .008). Patients with baseline PSAD &gt; 0.15 had a significantly higher 2y csPCa Det-R versus with PSAD &lt; 0.15: 18.2% (4/22) versus 3.7% (3/81) (<em>P</em> = .036). The combination of PSAD &lt; 0.15 and PI-RADS 3 at baseline was associated with a very low 2y csPCa Det-R (3%, 1/34), compared to PSAD &gt; 0.15 and PI-RADS ≥ 4 (23%, 3/13).</div><div>At final follow-up: 53% of patients with csPCa had an increasing PSAD (vs. 14% without, <em>P</em> = .003). A total of 41% (43/105) of patients underwent FU-MRI. Patients with csPCa were significantly more likely to have upgraded MRI findings (56% vs. 2.2%, <em>P</em> &lt; .001).</div></div><div><h3>Conclusion</h3><div>Following negative PBx despite a positive mpMRI, the risk of csPCa was low. However, careful monitoring is essential, particularly in cases of PSAD &gt; 0.15, and/or PI-RADS ≥ 4 at baseline. FU-PSAD and FU-MRI emerged as the most significant predictive factors, aiding to stratify the need for FU-PBx.</div></div>","PeriodicalId":10380,"journal":{"name":"Clinical genitourinary cancer","volume":"23 2","pages":"Article 102308"},"PeriodicalIF":2.3,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143510192","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":"Nonintravesical Interventions for Preventing Intravesical Recurrence in Patients With Nonmuscle-Invasive Bladder Cancer: A Systematic Review and Meta-Analysis","authors":"Ichiro Tsuboi ,&nbsp;Akihiro Matsukawa ,&nbsp;Mehdi Kardoust Parizi ,&nbsp;Robert J. Schulz ,&nbsp;Stefano Mancon ,&nbsp;Tamás Fazekas ,&nbsp;Marcin Miszczyk ,&nbsp;Anna Cadenar ,&nbsp;Ekaterina Laukhtina ,&nbsp;Pawel Rajwa ,&nbsp;Tatsushi Kawada ,&nbsp;Satoshi Katayama ,&nbsp;Takehiro Iwata ,&nbsp;Kensuke Bekku ,&nbsp;Takafumi Yanagisawa ,&nbsp;Jun Miki ,&nbsp;Takahiro Kimura ,&nbsp;Koichiro Wada ,&nbsp;Pierre I. Karakiewicz ,&nbsp;Piotr Chlosta ,&nbsp;Shahrokh F. Shariat","doi":"10.1016/j.clgc.2025.102306","DOIUrl":"10.1016/j.clgc.2025.102306","url":null,"abstract":"<div><div>Despite currently used intravesical therapies in non–muscle-invasive bladder cancer (NMIBC), the rate of intravesical recurrence remains very high. We aimed to evaluate the effectiveness of adding nonintravesical interventions to standard intravesical therapies to prevent intravesical recurrence. In April 2024, 3 databases were queried for prospective studies evaluating nonintravesical interventions in addition to standard intravesical therapies for NMIBC (CRD42024490988). The primary outcome was intravesical recurrence-free survival (iRFS). Standard pairwise meta-analyses were performed using hazard ratios (HR) and 95% confidence intervals (95% CI) with a random-effects model. We identified 18 eligible studies (14 RCTs and 4 prospective trials) comprising 4,593 NMIBC patients, which investigated pharmacological interventions (eg, selenium, vitamins, <em>Lactobacillus casei</em>, celecoxib, metformin, mistletoe lectin) and lifestyle modifications (diet). The addition of <em>Lactobacillus casei</em> significantly improved iRFS (HR: 0.50; 95% CI: 0.34-0.73; <em>P &lt; .</em>001). A high western diet pattern significantly worsened iRFS (HR:1.48, 95%CI:1.06-2.06, <em>P = .</em>03). The other nonintravesical interventions were not associated with iRFS. Our comprehensive review of the published literature highlights the need for further research into the efficacy of nonvesical interventions for NMIBC. While Lactobacillus was shown to improve iRFS in 2 RCTs, additional high-quality randomized studies are required to evaluate the effectiveness of other interventions.</div></div>","PeriodicalId":10380,"journal":{"name":"Clinical genitourinary cancer","volume":"23 2","pages":"Article 102306"},"PeriodicalIF":2.3,"publicationDate":"2025-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143426817","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":"Collecting Duct Carcinoma: Characteristics and Survival Outcomes From UroCCR Database (CDCSurv UroCCR n°141)","authors":"Louis-Pacôme Le Mével ,&nbsp;Jean-Christophe Bernhard ,&nbsp;Mokrane Yacoub ,&nbsp;Thibaut Waeckel ,&nbsp;Céline Bazille ,&nbsp;Cécile Champy ,&nbsp;Maria Mamodaly ,&nbsp;Karim Bensalah ,&nbsp;Nathalie Rioux-Leclercq ,&nbsp;Constance Michel ,&nbsp;Ilhem Hergli ,&nbsp;Louis Surlemont ,&nbsp;Julie Leclerc ,&nbsp;Morgan Roupret ,&nbsp;Franck Bruyere ,&nbsp;Gaëlle Fromont ,&nbsp;Thibaut Tricard ,&nbsp;Véronique Lindner ,&nbsp;Bastien PARIER ,&nbsp;Sophie Ferlicot ,&nbsp;Pierre Bigot","doi":"10.1016/j.clgc.2025.102305","DOIUrl":"10.1016/j.clgc.2025.102305","url":null,"abstract":"<div><h3>Objectives</h3><div>To describe characteristics and survival outcomes of patients with renal collecting duct carcinoma (RCDC).</div></div><div><h3>Methods</h3><div>We retrospectively analyzed data from patients treated for RCDC and included in the UroCCR database between 2007 and 2023. All tumors had a centralized pathological review by a CARARE network pathologist. Oncologic outcomes for cancer-specific survival (CSS) and progression-free survival (PFS) were estimated using the Kaplan-Meier method.</div></div><div><h3>Results</h3><div>A total of 29 patients with RCDC were included. The prevalence of RCDC in the UroCCR database was 0.18% (29/16133). The median age was 63 years (45-81). At diagnosis, 20 (69%) patients were symptomatic and 9 (31%) had a metastatic disease. Partial and radical nephrectomy were performed in respectively 8 (29.6%) and 19 (70.4%) cases. The median CSS were 21 months (95% CI 9.6-32) and median PFS was 7 months (95% CI 3.6-10.3). In the nonmetastatic group, the median CSS was 22 months (95% CI: 6.2-37), and median PFS was 12 months (95% CI: 0-39). Two years estimated PFS and CSS rates were respectively 29.7% and 38%. A localized disease (<em>P</em> = .012) and a tumor size inferior to 4 cm (<em>P</em> = .045) were associated with better oncological outcomes.</div></div><div><h3>Conclusion</h3><div>RCDC is a rare cancer with poor prognosis, and no treatment has demonstrated a significant improvement in survival. Recurrences are frequent and early. Management is heterogeneous and ineffective. These outcomes reinforce the need to better understand this tumor and evaluate alternative treatments.</div></div>","PeriodicalId":10380,"journal":{"name":"Clinical genitourinary cancer","volume":"23 2","pages":"Article 102305"},"PeriodicalIF":2.3,"publicationDate":"2025-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143479101","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":"Surgical Outcomes of Radical Nephrectomy and Inferior Vena Cava Thrombectomy Following Preoperative Systemic Immunotherapy: A Propensity Score Analysis","authors":"Zine-Eddine Khene ,&nbsp;Raj Bhanvadia ,&nbsp;Isamu Tachibana ,&nbsp;Wadih Issa ,&nbsp;William Graber ,&nbsp;Ivan Trevino ,&nbsp;Solomon L. Woldu ,&nbsp;Kris Gaston ,&nbsp;Affan Zafar ,&nbsp;Hans Hammers ,&nbsp;Suzanne Cole ,&nbsp;Tian Zhang ,&nbsp;Karim Bensalah ,&nbsp;Yair Lotan ,&nbsp;Vitaly Margulis","doi":"10.1016/j.clgc.2025.102307","DOIUrl":"10.1016/j.clgc.2025.102307","url":null,"abstract":"<div><h3>Introduction</h3><div>The impact of neoadjuvant immune checkpoint inhibitors (ICIs) on perioperative outcomes of radical nephrectomy (RN) with inferior vena cava (IVC) thrombectomy for renal cell carcinoma (RCC) remains unclear. This study aimed to assess the safety of preoperative immunotherapy prior to surgical resection of RCC with IVC tumor thrombus.</div></div><div><h3>Patients and Methods</h3><div>A retrospective review identified patients with RCC and IVC tumor thrombus who underwent concomitant nephrectomy and IVC thrombectomy. Patients were stratified based on preoperative ICI use. Inverse probability of treatment weighting (IPTW) was used to balance baseline characteristics. Intraoperative, postoperative, and oncological outcomes were evaluated using logistic, linear, and Cox proportional hazards regression models.</div></div><div><h3>Results</h3><div>A total of 101 patients were included in the study: 39 (39%) received preoperative ICI and 62 (61%) underwent upfront surgery. After IPTW adjustment, propensity score variables were well-balanced. Preoperative ICI was associated with longer operative time (+99.7 minutes, 95% CI: 38-172, <em>P =</em> .001), but no significant differences in intraoperative incidents, postoperative complications, or postoperative renal function (all p &gt; 0.05). With a median 19-month follow-up, exploratory analyses stratified by metastatic status revealed no significant differences in disease-free or overall survival between groups in both unweighted and IPTW-adjusted analyses (p &gt; 0.05).</div></div><div><h3>Conclusions</h3><div>Preoperative immunotherapy appears safe and feasible for patients with RCC and IVC thrombus undergoing RN and thrombectomy, with no significant increase in postoperative morbidity despite longer operative times. Larger prospective studies with extended follow-up are needed to confirm these findings.</div></div>","PeriodicalId":10380,"journal":{"name":"Clinical genitourinary cancer","volume":"23 2","pages":"Article 102307"},"PeriodicalIF":2.3,"publicationDate":"2025-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143372836","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":"Comparison of Outcomes Between African American and European American Patients With Metastatic Clear Cell Renal Cell Carcinoma Receiving Immune Checkpoint Inhibitors","authors":"Jasmeet Kaur ,&nbsp;Jill S. Hasler ,&nbsp;Elizabeth A. Handorf ,&nbsp;Matthew R. Zibelman ,&nbsp;Fern Anari ,&nbsp;Daniel M. Geynisman ,&nbsp;Pooja Ghatalia","doi":"10.1016/j.clgc.2025.102304","DOIUrl":"10.1016/j.clgc.2025.102304","url":null,"abstract":"<div><h3>Background and Objective</h3><div>Immune checkpoint inhibitors (ICIs) and ICI/tyrosine kinase inhibitor (TKI) (ICI-based) combinations are standard first-line treatment (tx) options for patients with metastatic clear cell renal cell carcinoma (mRCC). However, only 1% of patients enrolled in trials studying these agents were Blacks.</div></div><div><h3>Methods</h3><div>Patients with mRCC who received front-line ICI-based tx or sunitinib after 2011 were included from the Flatiron Health electronic record-derived database. We analyzed progression-free survival in African American (Black) and European American (White) patients and tested the interaction between treatment type and race. Multivariable Cox proportional hazards models were used to assess associations with outcomes.</div></div><div><h3>Key Findings and Limitations</h3><div>Of 2,592 eligible pts, 2,379 (91.8%) were White, and 213 (8.2%) were Black. Of these, 1453 (56%) received ICI-based tx and 1139 (44%) received sunitinib. IMDC favorable, intermediate/poor and unknown risk was noted among 6%, 77.5% and 16.4% of White patients and 3.3%, 86.8% and 9.9% of Black patients. Median age was 64 years. There was no significant difference in PFS between Black and White patients receiving ICI-based treatment compared to sunitinib [hazard ratio (HR) for interaction between treatment type and race was 1.063 (0.78-1.45, <em>P</em> = .7)]. The interaction term between race and treatment type showed that there was no evidence of a differential treatment effect by race in the first 10 months (HR = 0.931 (0.79-1.10); <em>P</em> = .40), however significantly improved after 10 months (HR = 0.697 (0.56-0.87); <em>P</em> = .001). The retrospective nature of the study is a limitation</div></div><div><h3>Conclusions and Clinical Implications</h3><div>The study found no significant difference in treatment effects between White and Black patients receiving ICI-based first-line treatment and should be the standard of care for both Black and White patients.</div></div><div><h3>Patient Summary</h3><div>We reviewed Flatiron databases of patients with mRCC from both Black and White populations, finding that ICI-based therapy should be considered the standard of care for patients from both racial backgrounds.</div></div>","PeriodicalId":10380,"journal":{"name":"Clinical genitourinary cancer","volume":"23 2","pages":"Article 102304"},"PeriodicalIF":2.3,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143101028","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}