Clinical genitourinary cancer最新文献

{"title":"Real-World Survival Outcomes of Partial Versus Radical Nephrectomy: Cause-Specific and Time-Dependent Effects","authors":"Yuki Kohada ,&nbsp;Hiroyuki Shikuma ,&nbsp;Keisuke Goto ,&nbsp;Kosuke Akiyama ,&nbsp;Mitsuru Kajiwara ,&nbsp;Shinji Matsuzaki ,&nbsp;Akira Fujita ,&nbsp;Kensuke Nishida ,&nbsp;Ryo Tasaka ,&nbsp;Shunsuke Miyamoto ,&nbsp;Kohei Kobatake ,&nbsp;Yohei Sekino ,&nbsp;Hiroyuki Kitano ,&nbsp;Akihiro Goriki ,&nbsp;Keisuke Hieda ,&nbsp;Nobuyuki Hinata","doi":"10.1016/j.clgc.2025.102391","DOIUrl":"10.1016/j.clgc.2025.102391","url":null,"abstract":"<div><h3>Objectives</h3><div>To assess the prognosis of radical nephrectomy (RN) and partial nephrectomy (PN) in patients with localized renal cell carcinoma (RCC), with particular consideration of cause-specific mortality and time-dependent effects on real-world survival outcomes.</div></div><div><h3>Patients and Methods</h3><div>This multicenter, retrospective study included patients with localized RCC who underwent RN or PN; 1:1 propensity score matching was conducted to minimize selection bias in the nonrandom assignment of patients to the PN and RN groups. Overall survival (OS), cancer-specific mortality (CSM), and other-cause mortality (OCM) were evaluated in patients who underwent RN or PN using conditional survival (CS) analysis.</div></div><div><h3>Results</h3><div>In total, 802 patients were included in the RN and PN groups (401 patients in each). The RN group had a significantly poorer OS than the PN group (<em>P</em> = .031). CS analysis indicated that neither the RN nor the PN groups had significantly enhanced survival rates over extended survival periods. The CS rate was consistently higher in the PN group than in the RN group at all time points during follow-up. Only the conditional cumulative incidence of OCM in the RN group was consistently high during the follow-up period, but that of OCM in the PN group and CSM in these groups remained low, irrespective of the length of survival.</div></div><div><h3>Conclusion</h3><div>PN was associated with better OS than RN in patients with localized RCC. CS analysis revealed this was attributed to a consistently high rate of OCM in the RN group during the follow-up period.</div></div>","PeriodicalId":10380,"journal":{"name":"Clinical genitourinary cancer","volume":"23 5","pages":"Article 102391"},"PeriodicalIF":2.7,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144669113","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":"Radical Surgery Compared to Bladder-Preserving Approaches for Limited Stage Small-Cell Bladder Cancer: Systematic Review and Meta-Analysis","authors":"András Kubik ,&nbsp;Isabel Pinto Amorim das Virgens ,&nbsp;Nóra Varga ,&nbsp;Anett Szabó ,&nbsp;Attila Keszthelyi ,&nbsp;Péter Fehérvári ,&nbsp;Péter Hegyi ,&nbsp;Nándor Ács ,&nbsp;Péter Nyirády ,&nbsp;Tibor Szarvas","doi":"10.1016/j.clgc.2025.102389","DOIUrl":"10.1016/j.clgc.2025.102389","url":null,"abstract":"<div><h3>Background and Objective</h3><div>Small-cell bladder cancer (SCBC) is an aggressive and rare malignancy for which there is no clear optimal treatment strategy. This systematic review and meta-analysis aimed to compare the median overall survival (OS) of patients with limited-stage (LS) SCBC treated with either cystectomy-based multimodal therapy (CBMMT) or radiation-based multimodal therapy (RBMMT).</div></div><div><h3>Methods</h3><div>A comprehensive search of PUBMED, Embase, and Scopus databases was performed for studies published before January 2024 according to the PRISMA guidelines. Studies have assessed LS-SCBC disease and provided survival data for subgroups of patients undergoing radical surgery or bladder-preserving approaches to be deemed eligible. Data extraction and quality assessment were independently conducted by 2 authors.</div></div><div><h3>Key Findings and Limitations</h3><div>Five studies comprising 1041 patients were analyzed. The pooled median OS for patients receiving RBMMT was 34.6 months (95% CI, 25.5-43.7), compared to 29.7 months (95% CI, 18.2-41.1) for those undergoing CBMMT. The main limitations are the retrospective nature of the included studies and the potential bias.</div></div><div><h3>Conclusions and Clinical Implications</h3><div>This meta-analysis indicates that RBMMT may provide comparable outcomes to CBMMT in LS-SCBC patients, supporting the consideration of bladder-preserving approaches in selected cases. RBMMT may offer a potential clinical benefit in terms of organ preservation for appropriately selected patients, although survival differences were not statistically significant.</div></div>","PeriodicalId":10380,"journal":{"name":"Clinical genitourinary cancer","volume":"23 5","pages":"Article 102389"},"PeriodicalIF":2.7,"publicationDate":"2025-06-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144644380","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":"Evaluation of the Effects of Enzalutamide and Abiraterone Acetate on Sarcopenia in Metastatic Castration-Sensitive Prostate Cancer","authors":"Cevat İlteriş Kıkılı ,&nbsp;Maide Müreva ,&nbsp;Caner Kapar ,&nbsp;Bahadır Köylü ,&nbsp;Fatih Kemik ,&nbsp;Feyyaz Hazar Yağmur ,&nbsp;Fatih Selçukbiricik ,&nbsp;Ercan İnci ,&nbsp;Deniz Tural","doi":"10.1016/j.clgc.2025.102388","DOIUrl":"10.1016/j.clgc.2025.102388","url":null,"abstract":"<div><h3>Background</h3><div>Sarcopenia is associated with worse prognosis and higher mortality in various solid tumors. We aim to evaluate the impact of enzalutamide and abiraterone acetate on sarcopenia in patients with metastatic castration-sensitive prostate cancer.</div></div><div><h3>Materials and Methods</h3><div>The skeletal muscle indexes (SMI, cm²/m²) were calculated from pre-treatment and 12th-month CT scans. Patients were categorized into sarcopenic and non-sarcopenic groups based on the predefined SMI and body mass index cut-off values. Baseline and 12th-month SMI values together with percentages of sarcopenic patients were compared between the enzalutamide and abiraterone acetate groups. Radiological progression-free survival (rPFS) and overall survival (OS) were also compared between sarcopenic and non-sarcopenic patients.</div></div><div><h3>Results</h3><div>We included 19 patients receiving enzalutamide and 30 patients receiving abiraterone acetate. In the enzalutamide group, SMI decreased significantly from pre-treatment to the 12th month (median ΔSMI: −3.1 cm²/m², <em>P</em> = .004). In the abiraterone acetate group, SMI declined significantly over the same period (median ΔSMI: −4.1 cm²/m², <em>P</em> = .001). There were no significant differences in SMI changes and sarcopenia rates between two groups. Median rPFS was 29 months in the pre-treatment sarcopenic group and 37 months in the non-sarcopenic group (HR = 2.38 [95% CI, 0.54-10.41], <em>P</em> = .24). Median OS was 33 months in the sarcopenic group and 47 months in the non-sarcopenic group (HR = 1.94 [95% CI, 0.42-9.03], <em>P</em> = .38).</div></div><div><h3>Conclusion</h3><div>Both enzalutamide and abiraterone acetate significantly reduces SMI values following a 12-month treatment period. Despite a trend toward shorter rPFS and OS in sarcopenic patients, the differences did not reach statistical significance.</div></div>","PeriodicalId":10380,"journal":{"name":"Clinical genitourinary cancer","volume":"23 5","pages":"Article 102388"},"PeriodicalIF":2.3,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144663159","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":"Does Size Predict Aggressiveness?: Exploring Sporadic Multifocal Tumors in a 10-Year Retrospective Analysis","authors":"Felicia L. Pasadyn ,&nbsp;Dongling Wu ,&nbsp;Shavy Nagpal ,&nbsp;Fang-Ming Deng ,&nbsp;Rozalba Gogaj ,&nbsp;William C. Huang","doi":"10.1016/j.clgc.2025.102387","DOIUrl":"10.1016/j.clgc.2025.102387","url":null,"abstract":"<div><h3>Introduction and Objective</h3><div>For localized kidney tumors, size and growth kinetics generally predict malignant potential. Thus, for patients with multifocal renal masses, treatment priority often revolves around the largest or index tumor first. We reviewed our kidney surgery database to examine histologic concordance of sporadic multifocal renal tumors and to determine if size is also the greatest determinant of tumor aggressiveness.</div></div><div><h3>Methods</h3><div>We conducted a retrospective chart review at a tertiary referral center of 1983 patients undergoing nephrectomy (radical and partial) from January 2010 to December 2019. We identified 138 patients with multifocal renal masses (<em>n</em> = 138). Surgical pathology parameters, including tumor size, TNM grading, and staging, were collected through electronic medical records. Patients with syndromic diseases were excluded (<em>n</em> = 10), resulting in a total sample of 128 patients with sporadic multifocal tumors. Overall, the sample included 307 tumors total, with a mean number of 2.4 lesions per patient.</div></div><div><h3>Results</h3><div>About 128 patients (6.45%) had sporadic multifocal renal tumors. Among these, 82 out of 128 (64%) had concordant histologic subtypes, while 46 out of 128 (36%) had discordant histology. In 99 patients (77.3%), the index tumor demonstrated a more aggressive histology. There were 29 patients (22.6%) with a benign or less aggressive index tumor. Among those, 21 patients (16%) had a benign index tumor, 5 (24%) of which had a malignant secondary tumor.</div></div><div><h3>Conclusion</h3><div>Multifocal tumors frequently have discordant histology. While size tends to predict oncologic risk, many patients harbor more aggressive disease in nonindex lesions, highlighting the limitations of relying on size alone for managing sporadic multifocal RCC.</div></div>","PeriodicalId":10380,"journal":{"name":"Clinical genitourinary cancer","volume":"23 5","pages":"Article 102387"},"PeriodicalIF":2.3,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144596517","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 Treatment Patterns and Survival in People With Metastatic Castration-Resistant Prostate Cancer Following Metastatic Hormone-Sensitive Disease Between 2020 and 2023 in the United States","authors":"Amit D. Raval ,&nbsp;Guifang Chen ,&nbsp;Matthew J. Korn ,&nbsp;Andreas Bernthaler ,&nbsp;Niculae Constantinovici ,&nbsp;Stephen J. Freedland","doi":"10.1016/j.clgc.2025.102386","DOIUrl":"10.1016/j.clgc.2025.102386","url":null,"abstract":"<div><h3>Purpose</h3><div>To examine treatment patterns and survival in people with metastatic castration-resistant prostate cancer (mCRPC) previously progressing from metastatic hormone-sensitive prostate cancer (mHSPC) in the United States.</div></div><div><h3>Methods</h3><div>People diagnosed with mCRPC between January 1, 2020–June 30, 2023 were retrospectively identified in the ConcertAI NLP360™ electronic medical records (EMR) database. Inclusion criteria were prior diagnosis of mHSPC and ≥1 EMR encounter ≥12 months pre-mCRPC and ≥6 months post-mCRPC.</div></div><div><h3>Results</h3><div>Among 609 people identified, the most common prior treatment for mHSPC was androgen deprivation therapy (ADT) alone (53%); others included ADT plus abiraterone (ABI; 19%), ADT plus a non-ABI androgen receptor pathway inhibitor (ARPI; 18%) and ADT plus docetaxel (10%). Overall, the most common first-line (1L) therapies for mCRPC were a non-ABI ARPI (37%; most commonly enzalutamide [24%]), ABI (25%), and chemotherapy (22%). These were also the most common 1L mCRPC therapies for those receiving ADT alone or ADT plus docetaxel for mHSPC. Among those who received ADT plus ABI or a non-ABI ARPI for mHSPC, 50% and 40%, respectively, also received an ARPI 1L for mCRPC. 1L chemotherapy for mCRPC was more common following ADT combination regimens (24%–41%) than ADT alone (12%) for mHSPC. Median real-world overall survival was 27.2 months from mCRPC diagnosis and 20.8 months from 1L therapy.</div></div><div><h3>Conclusion</h3><div>Back-to-back ARPI use from mHSPC to mCRPC is common in current clinical practice and survival remains &lt;3 years. Alternative mCRPC treatments, such as intensified combination regimens beyond androgen receptor targeting, require exploration to improve survival in mCRPC.</div></div>","PeriodicalId":10380,"journal":{"name":"Clinical genitourinary cancer","volume":"23 5","pages":"Article 102386"},"PeriodicalIF":2.7,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144651524","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 Patients With Metastatic Prostate Cancer With Microsatellite Instability Treated With Pembrolizumab","authors":"Nicholas Lambert ,&nbsp;Casey Moore ,&nbsp;Julia Klavon ,&nbsp;Waddah Arafat ,&nbsp;Jue Wang ,&nbsp;Tian Zhang ,&nbsp;Kevin Courtney","doi":"10.1016/j.clgc.2025.102384","DOIUrl":"10.1016/j.clgc.2025.102384","url":null,"abstract":"<div><div>MSI-H prostate cancer is rarely encountered in clinical practice. When it is identified, pembrolizumab is a standard of care therapeutic option in the metastatic castration-resistant setting based on KEYNOTE-158, which included very few prostate cancer patients. A few previously published case series have shown encouraging clinical outcomes for patients with MSI-H mCRPC treated with pembrolizumab, however, there is still a paucity of real-world data.</div><div>Here we report an institutional case series of 13 patients with MSI-H metastatic prostate cancer identified by next generation sequencing of tumor tissue or ctDNA who were treated with pembrolizumab between October 2019 and December 2024. 12 patients had mCRPC and one patient had mCSPC. Among the mCRPC cohort, patients had received on average 2.7 prior lines of therapy and had a median PSA of 19.8 ng/mL. Sites of disease involvement were nodal (83.3%), bone (75%), bladder (25%), liver (16.7%), and rectum (8.3%).</div><div>9 of the 12 (75%) patients with mCRPC achieved PSA50 while on therapy, including 7 patients (58.3%) who achieved a complete biochemical response with undetectable PSA. Radiographically, overall response rate among the 7 patients with evaluable disease by RECIST 1.1 or PCWG3 was 57.1% with 2 complete responses and 2 partial responses. As of the data cutoff, 7 patients were alive, and 2 patients remained on treatment. After a median follow-up period of 14.4 months, median PFS and OS were not reached. The mCSPC patient, who is reported separately, achieved a complete biochemical and radiographic response.</div><div>Treatment with pembrolizumab led to a significant rate of biochemical and radiographic response in a heavily pre-treated cohort of MSI-H metastatic prostate cancer patients, and multiple patients achieved a durable complete response. Somatic mutation testing results were analyzed for all patients. Out of 7 patients who achieved a complete biochemical response, 6 had a homologous recombination repair (HRR) gene mutation, and all 3 patients with <em>PTCH1</em> mutations had a complete biochemical response, raising questions regarding potential predictive biomarkers for pembrolizumab therapy. The unique cases of the patient with mCSPC and another patient who was re-challenged with pembrolizumab after late progression are reported and highlight the need for more investigation into the optimal sequencing and duration of pembrolizumab in MSI-H prostate cancer, respectively.</div></div>","PeriodicalId":10380,"journal":{"name":"Clinical genitourinary cancer","volume":"23 5","pages":"Article 102384"},"PeriodicalIF":2.3,"publicationDate":"2025-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144679894","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":"Comorbidity Burden and Effectiveness of Immunotherapy in Metastatic Renal Cell Carcinoma","authors":"Emre Yekedüz ,&nbsp;Martin Zarba ,&nbsp;Eddy Saad ,&nbsp;Razane El Hajj Chehade ,&nbsp;Marc Eid ,&nbsp;Renee Maria Saliby ,&nbsp;Clara Steiner ,&nbsp;Marc Machaalani ,&nbsp;Rashad Nawfal ,&nbsp;Karl Semaan ,&nbsp;Yüksel Ürün ,&nbsp;Daniel Y.C. Heng ,&nbsp;Toni K. Choueiri","doi":"10.1016/j.clgc.2025.102385","DOIUrl":"10.1016/j.clgc.2025.102385","url":null,"abstract":"<div><h3>Background</h3><div>Comorbid conditions complicate the care of patients with cancer and frequently cause exclusion of patients from clinical trials.</div></div><div><h3>Methods</h3><div>Data from patients with metastatic renal cell carcinoma (mRCC) treated with immune checkpoint inhibitor (ICI)-based combinations in the first line setting were collected. The comorbidity burden was assessed at baseline by using the age-adjusted Charlson Comorbidity Index (CCI). Patients were stratified into 2 groups to predict overall survival (OS) through maximally selected rank statistics. The primary outcomes were time to treatment failure (TTF) and OS. The secondary outcome was the rate of adverse events (AEs) leading to dose reduction or treatment discontinuation.</div></div><div><h3>Results</h3><div>A total of 304 patients were included. Most patients were male (73%), had clear cell RCC (91.4%), and were treated with nivolumab + ipilimumab (53.6%). The most common comorbidities were diabetes (18.4%), followed by previous myocardial infarction (12.8%), chronic kidney disease (6.6%), and chronic pulmonary disease (5.6%). After adjusting for baseline prognostic factors in mRCC including the International mRCC Database Consortium (IMDC) risk, TTF (Hazard Ratio [HR], 1.51, 95% Confidence Interval [CI], 1.09-2.10, <em>P</em> <em>=</em> .013) and OS (HR: 1.98, 95% CI, 1.33-2.94, <em>P</em> <em>=</em> .001) were worse in the CCI-high group vs. the CCI-low group. The rates of AEs leading to dose reduction or treatment discontinuation were comparable between the 2 groups.</div></div><div><h3>Conclusions</h3><div>Despite similar rates of AEs leading to dose reduction or treatment discontinuation, a high comorbidity burden is associated with worse outcomes in patients with mRCC treated with first-line ICI-based therapies. Our study underscores the necessity for a multidimensional approach to assess the comorbidity burden in patients with mRCC receiving ICI-based combinations.</div></div>","PeriodicalId":10380,"journal":{"name":"Clinical genitourinary cancer","volume":"23 4","pages":"Article 102385"},"PeriodicalIF":2.3,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144565564","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of Gleason, Stage and Age on Surgery and Radiotherapy in Prostate Cancer Patients in Northern Italy","authors":"Lucia Mangone ,&nbsp;Francesco Marinelli ,&nbsp;Isabella Bisceglia ,&nbsp;Angelina Filice ,&nbsp;Maria Barbara Braghiroli ,&nbsp;Francesca Roncaglia ,&nbsp;Andrea Palicelli ,&nbsp;Fortunato Morabito ,&nbsp;Antonino Neri ,&nbsp;Roberto Sabbatini ,&nbsp;Cinzia Iotti ,&nbsp;Carmine Pinto","doi":"10.1016/j.clgc.2025.102383","DOIUrl":"10.1016/j.clgc.2025.102383","url":null,"abstract":"<div><h3>Background</h3><div>The incidence of prostate cancer is increasing due to the aging and early diagnosis. This study aims to evaluate the influence of Gleason, stage and age on surgery and radiotherapy.</div></div><div><h3>Methods</h3><div>In a province of northern Italy were analyzed 1381 prostate cancers diagnosed between 2018 and 2022, focusing on trends in age, stage, Gleason and treatment.</div></div><div><h3>Results</h3><div>Over the study period, there was slight a decline in stage I (39%, 42%, 36%, 28%, 38%) and Gleason 6 (26%, 28%, 28%, 18%, 26%), along with an increase in stage IV (13%, 13%, 15%, 20%, 16%) and Gleason 8-10 (20%, 21%, 21%, 26%, and 28%). Surgery and radiation therapy remained constant at 34% and 40%, respectively. The likelihood of receiving surgery decreased in patients aged 70-79 [OR 0.35; 0.21-0.58] and 80+ [OR 0.03; 0.02-0.07] and increased in Gleason 7 [OR 1.83; 1.27-2.65] and stage II [OR 3.89; 2.74-5.51] and III [OR 9.77; 6.34-15.05]. The possibility of receiving radiotherapy increases in patients aged 70-79 [OR 2.85; 1.75-4.65] and 80+ [OR 2.11; 1.24-3.60] and in patients with Gleason 7 [OR 1.95; 1.42-2.68] and 8-10 [OR 2.95; 1.96-4.46].</div></div><div><h3>Conclusions</h3><div>During the period there was a slight shift toward more aggressive prostate cancers, but treatments remained stable.</div></div>","PeriodicalId":10380,"journal":{"name":"Clinical genitourinary cancer","volume":"23 4","pages":"Article 102383"},"PeriodicalIF":2.3,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144556995","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":"Cabozantinib in the First-Line Treatment of Patients With Metastatic Renal Cell Carcinoma, Real-World Data From the Czech Republic and Poland: ICARO-RC Project","authors":"Jakub Kucharz ,&nbsp;Alexandr Poprach ,&nbsp;Bożena Sikora-Kupis ,&nbsp;Marta Darewicz ,&nbsp;Piotr Domański ,&nbsp;Monika Bezděková ,&nbsp;Ivana Koloušková ,&nbsp;Eva Kolaríková ,&nbsp;Jindrich Kopecky ,&nbsp;Hana Studentova ,&nbsp;Ondrej Fiala ,&nbsp;Igor Richter ,&nbsp;Michal Lacek ,&nbsp;Tomas Buchler ,&nbsp;Alvaro Pinto","doi":"10.1016/j.clgc.2025.102382","DOIUrl":"10.1016/j.clgc.2025.102382","url":null,"abstract":"<div><h3>Introduction</h3><div>The treatment of metastatic renal cell carcinoma (RCC) has changed dramatically in the last few years, with different options being available, and with no data comparing these new systemic therapies. Therefore, the value of real-world outcomes (RWO) becomes of great interest to understand the effectiveness of these treatments. Here we analyze the outcome of metastatic RCC patients treated with first-line cabozantinib in a retrospective cohort from the Czech Republic and Poland</div></div><div><h3>Methods</h3><div>Patients with metastatic RCC treated with first-line cabozantinib in the Czech Republic and Poland were included in a retrospective fashion. Data were collected regarding progression-free survival (PFS), overall survival (OS), response rate and toxicity, with a focus in several subgroups of interest.</div></div><div><h3>Results</h3><div>We identified 146 patients, the majority of them (80.8%) with clear cell RCC (ccRCC). The median OS was 14.7 months, and the median PFS 8.2 months, with a response rate of 30.3%. CTCAE v3.0 grade 3+4 toxicity was presented in 34.2% of patients. The efficacy of Cabozantinib was maintained regardless of histologic subtype and the presence of sarcomatoid component, although PFS and OS data were numerically better for nonclear cell RCC. Bone and liver metastases were confirmed as independent factor for poor survival in the multivariate analysis.</div></div><div><h3>Conclusions</h3><div>In our series, Cabozantinib demonstrated its activity in RCC patients in a RWO setting. Our data can be considered comparable with what has been seen in randomised clinical trials, considering the inherent bias present in RWO studies.</div></div>","PeriodicalId":10380,"journal":{"name":"Clinical genitourinary cancer","volume":"23 4","pages":"Article 102382"},"PeriodicalIF":2.3,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144489922","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":"Do Older Patients With Metastatic Hormone-Sensitive Prostate Cancer Benefit From Triplet or Doublet Therapy? A Network Meta-Analysis","authors":"Susu Zhou ,&nbsp;Parissa Alerasool ,&nbsp;Noriko Kishi ,&nbsp;Che-Kai Tsao","doi":"10.1016/j.clgc.2025.102380","DOIUrl":"10.1016/j.clgc.2025.102380","url":null,"abstract":"<div><h3>Introduction</h3><div>With the expanded approval of androgen receptor axis-targeted (ARAT) agents, clinicians now have more treatment options to offer patients with metastatic hormone-sensitive prostate cancer (mHSPC). Uncertainty remains as to whether older population could benefit similarly from these intensification treatment options.</div></div><div><h3>Patients and Methods</h3><div>A systematic database search was performed for randomized controlled trials (RCTs) evaluating the efficacy of androgen deprivation therapy (ADT) in combination with ARAT agents and/or docetaxel in older patients (aged ≥ 70 or 75 years) with mHSPC. The primary endpoint was overall survival (OS). Indirect comparisons of available treatment options were estimated using a random-effects network meta-analysis.</div></div><div><h3>Results</h3><div>A total of 11 RCTs were eligible. In comparison with ADT alone or ADT + docetaxel doublet, darolutamide + ADT + docetaxel showed a significant OS benefit, with hazard ratios (HRs) of 0.47 (95% confidence interval [CI]: 0.28-0.77) and 0.61 (95% CI, 0.40-0.93), respectively. However, another triplet (abiraterone + ADT + docetaxel) failed to demonstrate a statistically significant OS benefit, with HRs of 0.61 (95% CI, 0.37-1.02) and 0.80 (95% CI, 0.52-1.24), respectively. Triplet therapies comprising darolutamide and abiraterone ranked first and second, with <em>P</em> score of .90 and .67, respectively, followed by darolutamide + ADT (0.61), apalutamide + ADT (0.60), enzalutamide + ADT (0.56), ADT + docetaxel (0.40), abiraterone + ADT (0.20) and ADT alone (0.06). Furthermore, our data suggest an additional benefit from adding docetaxel as a component of doublet and triplet therapies for older men with mHSPC.</div></div><div><h3>Conclusion</h3><div>In older patients with mHSPC, triplet therapy comprising darolutamide, ADT, and docetaxel demonstrated the most pronounced OS benefit and ranked highest among currently available treatment options. Further studies are needed to explore the specific toxicities associated with the triplet regimen in this population to better balance oncologic benefits with treatment-related toxicities when making treatment decision.</div></div>","PeriodicalId":10380,"journal":{"name":"Clinical genitourinary cancer","volume":"23 4","pages":"Article 102380"},"PeriodicalIF":2.3,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144369652","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}