Clinical genitourinary cancer最新文献

{"title":"Combination Chemotherapy With TS-1 and Cisplatin for Urinary Adenocarcinoma: A Retrospective Case Series","authors":"Akifumi Omiya ,&nbsp;Satoshi Nitta ,&nbsp;Shuya Kandori ,&nbsp;Reo Takahashi ,&nbsp;Ichiro Chihara ,&nbsp;Masanobu Shiga ,&nbsp;Kosuke Kojo ,&nbsp;Yoshiyuki Nagumo ,&nbsp;Atsushi Ikeda ,&nbsp;Takashi Kawahara ,&nbsp;Akio Hoshi ,&nbsp;Bryan J. Mathis ,&nbsp;Hiromitsu Negoro ,&nbsp;Hiroyuki Nishiyama","doi":"10.1016/j.clgc.2024.102149","DOIUrl":"10.1016/j.clgc.2024.102149","url":null,"abstract":"<div><p></p><ul><li><span>•</span><span><p>Urinary adenocarcinoma is a rare histological subtype in urinary tract cancers and standard chemotherapy regimens remain unestablished. We retrospectively analyzed the clinical information of patients with rare urinary adenocarcinoma who received TS-1 plus cisplatin chemotherapy at the University of Tsukuba Hospital. In this study, a total of 9 patients were included and 1 and 3 had complete or partial responses, resulting in an overall response rate of 44%. The median follow-up period was 21.2 months (range, 8.5-91.6). The median OS and PFS were 16.2 months (range, 3.6-90.2) and 4.8 months (range, 1.7-20.0), respectively. The major adverse events over Grade 3 were neutropenia in 2 patients (22%) and anemia in 1 patient (11%). This study suggests the efficacy and safety of TS-1 in combination with cisplatin with regard to rare urinary adenocarcinoma. Multicenter, large, and prospective studies are necessary to validate these findings.</p></span></li></ul></div>","PeriodicalId":10380,"journal":{"name":"Clinical genitourinary cancer","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141708337","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":"Comment on “Evaluating Biomarkers for Testosterone Replacement Efficacy in Testicular Cancer Survivors With Mild Leydig Cell Insufficiency”","authors":"Gokul Sudhakaran","doi":"10.1016/j.clgc.2024.102151","DOIUrl":"10.1016/j.clgc.2024.102151","url":null,"abstract":"","PeriodicalId":10380,"journal":{"name":"Clinical genitourinary cancer","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141732364","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":"Comment on “An Update on Focal Therapy for Prostate Cancer”","authors":"Gokul Sudhakaran","doi":"10.1016/j.clgc.2024.102150","DOIUrl":"10.1016/j.clgc.2024.102150","url":null,"abstract":"","PeriodicalId":10380,"journal":{"name":"Clinical genitourinary cancer","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141710374","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":"Organ-Specific Tumor Response to Enfortumab Vedotin for Metastatic Urothelial Carcinoma: A Multicenter Retrospective Study","authors":"Akinori Minato ,&nbsp;Nobuki Furubayashi ,&nbsp;Toshihisa Tomoda ,&nbsp;Hiroyuki Masaoka ,&nbsp;Yoohyun Song ,&nbsp;Yoshifumi Hori ,&nbsp;Keijiro Kiyoshima ,&nbsp;Takahito Negishi ,&nbsp;Kentaro Kuroiwa ,&nbsp;Narihito Seki ,&nbsp;Ikko Tomisaki ,&nbsp;Kenichi Harada ,&nbsp;Motonobu Nakamura ,&nbsp;Naohiro Fujimoto","doi":"10.1016/j.clgc.2024.102148","DOIUrl":"10.1016/j.clgc.2024.102148","url":null,"abstract":"<div><h3>Introduction</h3><p>To evaluate the organ-specific therapeutic effect of enfortumab vedotin (EV) after chemotherapy and immunotherapy failed for advanced urothelial carcinoma.</p></div><div><h3>Materials methods</h3><p>At 6 institutions between December 2021 and July 2023, we retrospectively analyzed patients with metastatic upper and lower urinary tract cancer who received EV monotherapy after platinum-based chemotherapy and immune checkpoint blockade therapy. Objective response rate (ORR) and organ-specific response rate (OSRR) were evaluated according to the Response Evaluation Criteria in Solid Tumors, version 1.1.</p></div><div><h3>Results</h3><p>This study analyzed 58 patients with 210 tumor lesions, of which 24% were females and 48% had upper urinary tract cancer. The ORR and disease control rate were 53.5% and 74.1%. Moreover, we found 15 target lesions in the primary site, 7 in local recurrence, 93 in the lymph nodes, 46 in the lung, 29 in the liver, and 20 in the bone, with OSRRs of 40%, 71.4%, 61.1%, 70.6%, 90.9%, and 18.2%, respectively. Over time from baseline, the reduction rate (median) in tumor burden was 50% or more in the lymph node, lung, and liver metastases.</p></div><div><h3>Conclusion</h3><p>The organ-specific tumor response to EV in patients with metastatic urothelial carcinoma was almost favorable. The antitumor activity of EV monotherapy may be less in bone metastasis than in other organ sites. Conversely, EV showed remarkably high efficacy against liver metastasis.</p></div>","PeriodicalId":10380,"journal":{"name":"Clinical genitourinary cancer","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1558767324001198/pdfft?md5=e2ea65cac46cd19beb4f03e9e61337b2&pid=1-s2.0-S1558767324001198-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141700681","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":"A Comparison of ChatGPT and Human Questionnaire Evaluations of the Urological Cancer Videos Most Watched on YouTube","authors":"Aykut Demirci","doi":"10.1016/j.clgc.2024.102145","DOIUrl":"10.1016/j.clgc.2024.102145","url":null,"abstract":"<div><h3>Aim</h3><p>To examine the reliability of ChatGPT in evaluating the quality of medical content of the most watched videos related to urological cancers on YouTube.</p></div><div><h3>Material and methods</h3><p>In March 2024 a playlist was created of the first 20 videos watched on YouTube for each type of urological cancer. The video texts were evaluated by ChatGPT and by a urology specialist using the DISCERN-5 and Global Quality Scale (GQS) questionnaires. The results obtained were compared using the Kruskal-Wallis test.</p></div><div><h3>Results</h3><p>For the prostate, bladder, renal, and testicular cancer videos, the median (IQR) DISCERN-5 scores given by the human evaluator and ChatGPT were (Human: 4 [1], 3 [0], 3 [2], 3 [1], <em>P</em> = .11; ChatGPT: 3 [1.75], 3 [1], 3 [2], 3 [0], <em>P</em> = .4, respectively) and the GQS scores were (Human: 4 [1.75], 3 [0.75], 3.5 [2], 3.5 [1], <em>P</em> = .12; ChatGPT: 4 [1], 3 [0.75], 3 [1], 3.5 [1], <em>P</em> = .1, respectively), with no significant difference determined between the scores. The repeatability of the ChatGPT responses was determined to be similar at 25 % for prostate cancer, 30 % for bladder cancer, 30 % for renal cancer, and 35 % for testicular cancer (<em>P</em> = .92). No statistically significant difference was determined between the median (IQR) DISCERN-5 and GQS scores given by humans and ChatGPT for the content of videos about prostate, bladder, renal, and testicular cancer (<em>P</em> &gt; .05)<strong>.</strong></p></div><div><h3>Conclusion</h3><p>Although ChatGPT is successful in evaluating the medical quality of video texts, the results should be evaluated with caution as the repeatability of the results is low.</p></div>","PeriodicalId":10380,"journal":{"name":"Clinical genitourinary cancer","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141720856","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":"Concomitant Administration of VEGFR Tyrosine Kinase and Proton Pump Inhibitors May Impair Clinical Outcome of Patients With Metastatic Renal Cancer","authors":"Marzia Del Re ,&nbsp;Stefania Crucitta ,&nbsp;Nicole Brighi ,&nbsp;Stefania Kinspergher ,&nbsp;Chiara Mercinelli ,&nbsp;Mimma Rizzo ,&nbsp;Vincenza Conteduca ,&nbsp;Sara Elena Rebuzzi ,&nbsp;Teresa Beninato ,&nbsp;Giulia Venturi ,&nbsp;Laura Doni ,&nbsp;Elena Verzoni ,&nbsp;Silvia Puglisi ,&nbsp;Matteo Landriscina ,&nbsp;Camillo Porta ,&nbsp;Fiorella Manfredi ,&nbsp;Orazio Caffo ,&nbsp;Ugo De Giorgi ,&nbsp;Stefano Fogli ,&nbsp;Romano Danesi","doi":"10.1016/j.clgc.2024.102147","DOIUrl":"10.1016/j.clgc.2024.102147","url":null,"abstract":"<div><h3>Introduction</h3><p>The administration of proton pump inhibitors (PPIs) is a common practice to reduce gastro-esophageal adverse events associated with drug treatments but may impair absorption and exposure to oncology drugs. This study investigated the effect of concomitant administration of PPIs and pazopanib, sunitinib and cabozantinib on survival of patients with metastatic clear cell renal carcinoma (mRCC).</p></div><div><h3>Patients and Methods</h3><p>Total 451 patients receiving pazopanib, sunitinib and cabozantinib as first line treatment were enrolled in this retrospective study. Patients were defined as “no concomitant PPIs (PPI−)” if no PPIs were administered during TKIs, and as “concomitant PPIs (PPI+)” if the administration of PPIs was at least 75% of the time during which TKIs were given.</p></div><div><h3>Results</h3><p>Eighty patients administered pazopanib were PPI− and 86 PPI+; no difference in PFS was observed (10.7 vs. 11.9 months, <em>P</em> = .79). If patients were stratified as short (n = 89) and long (n = 77) responders, there was a significant difference in terms of PFS in PPI+ (n = 47) versus PPI− (n = 30) in long responders, being 24.7 versus 38 months (<em>P</em> = .04), respectively. In the sunitinib cohort, no significant difference of PFS in PPI+ (n = 102) versus PPI− (n = 131) was found, being 11.3 versus 18.1 months, respectively (<em>P</em>=0.15). In the cabozantinib cohort, there was a statistically significant difference in PFS of PPI+ versus PPI− (6 months vs. not reached, <em>P</em> = .04). No correlation with adverse events was found.</p></div><div><h3>Conclusions</h3><p>This study demonstrates an association between PPIs and impaired PFS in mRCC patients given pazopanib and cabozantinib and recommends caution on their concomitant use.</p></div>","PeriodicalId":10380,"journal":{"name":"Clinical genitourinary cancer","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141720855","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 Urethra-Preserving Surgery During Radical Cystectomy: An Optimal Urethral Management in the Robotic Era","authors":"Kenji Zennami ,&nbsp;Makoto Sumitomo ,&nbsp;Takuhisa Nukaya ,&nbsp;Masashi Takenaka ,&nbsp;Manabu Ichino ,&nbsp;Kiyoshi Takahara ,&nbsp;Hitomi Sasaki ,&nbsp;Mamoru Kusaka ,&nbsp;Ryoichi Shiroki","doi":"10.1016/j.clgc.2024.102146","DOIUrl":"10.1016/j.clgc.2024.102146","url":null,"abstract":"<div><h3>Objectives</h3><p>The optimal indication and survival benefits of prophylactic urethrectomy<span> (PU) during radical cystectomy remain unclear. Therefore, this study aims to evaluate the impact of urethra-preserving surgery (UPS) on oncological outcome including its recurrence patterns, and to establish an optimal urethral management strategy with a novel UPS technique in the robotic era.</span></p></div><div><h3>Patients and methods</h3><p>We retrospectively analyzed 281 male patients with bladder cancer who received radical cystectomy (RC) (115 with and 166 without PU) at our institutions between 2010 and 2023. Subsequently, perioperative and oncological outcomes were assessed between propensity score-matched cohorts.</p></div><div><h3>Results</h3><p><span>Urethral recurrence (UR) occurred in 5 patients (5/166, 3.0%), all of whom underwent open-RC. Three among those (1.8%) with concomitant metastasis were died of cancer. There were no statistically significant differences between the PU and UPS groups in urethral-recurrence free survival (urethral-RFS) (</span><em>P</em> = .14), local-RFS (<em>P</em> = .59) and overall survival (OS) (<em>P</em> = .84) in the entire cohort. However, the UPS group showed significantly worse urethral-RFS (<em>P</em> = .008), local-RFS (<em>P</em> = .005) and OS (<em>P</em> = .03) in patients with high-risk of UR. Analysis of recurrence patterns revealed that UPS in high-risk patients significantly increased local recurrence (25.8% vs. 5.0%, <em>P</em> = .02). Conversely, a novel robotic-UPS technique demonstrated significantly favorable perioperative outcomes, comparable local-RFS (<em>P</em> = .79) and OS (<em>P</em> = .16) without UR (0/134, 0%) when compared to robotic-PU. Robotic-UPS also exhibited significantly better local-RFS (<em>P</em> =.007) and OS (<em>P</em> &lt; .001) than open-UPS.</p></div><div><h3>Conclusions</h3><p>UR-related death was rare and PU did not show a survival benefit for the entire cohort. However, inappropriate UPS in patients at high-risk of UR may increase local recurrence which might be responsible for poor survival after UPS rather than disease progression derived from UR. The robotic-UPS has the potential to reduce unnecessary PU, urethral and local recurrence without compromising survival.</p></div>","PeriodicalId":10380,"journal":{"name":"Clinical genitourinary cancer","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141753590","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 Sequencing and Outcomes With Cabozantinib After First-line Immune Checkpoint Inhibitor-based Combination Therapy For Patients With Advanced Renal Cell Carcinoma: CARINA Study Results","authors":"Paul Nathan ,&nbsp;Balaji Venugopal ,&nbsp;Jamshed Ali ,&nbsp;Jennifer Allison ,&nbsp;Mariangela Ceruso ,&nbsp;Natalie Charnley ,&nbsp;Richard Griffiths ,&nbsp;Agnieszka Michael ,&nbsp;Kathryn Moore ,&nbsp;Valérie Perrot ,&nbsp;Áine Prendergast ,&nbsp;Anand Sharma ,&nbsp;Bernadett Szabados ,&nbsp;James Larkin","doi":"10.1016/j.clgc.2024.102141","DOIUrl":"10.1016/j.clgc.2024.102141","url":null,"abstract":"<div><h3>Introduction</h3><p>Real-world data are limited on treatment sequencing and outcomes after first-line (1L) immune checkpoint inhibitor (CPI)-based combination treatment of advanced renal cell carcinoma (aRCC).</p></div><div><h3>Patients and Methods</h3><p>In this real-world, UK-based, retrospective study (CARINA; NCT04957160), data were obtained from hospital and electronic prescribing records. Patients were aged ≥ 18 years at aRCC diagnosis and had received 1L CPI–CPI or tyrosine kinase inhibitor (TKI)–CPI combination therapy before second-line (2L) therapy including cabozantinib. We describe treatment outcomes including 1L and 2L durations of treatment (DoT) and overall survival (OS).</p></div><div><h3>Results</h3><p>Data from April 2015 to June 2022 were collected on 281 patients from nine UK centres. Median 1L DoT was 2.3 months for CPI–CPI therapy (n = 171) and 5.0 months for TKI–CPI therapy (n = 58). After 1L CPI–CPI or TKI–CPI therapy, median 2L DoT was 5.8 versus 4.2 months, respectively, for cabozantinib (n = 163), and 3.8 versus 2.4 months for other therapies (n = 118); median 2L OS was 15.2 and 15.3 months, respectively, for cabozantinib, and 14.6 and 24.2 months for other therapies.</p></div><div><h3>Conclusion</h3><p>DoT for 2L treatment was numerically better for cabozantinib than for other therapies, and after 1L CPI–CPI therapy than after 1L TKI–CPI therapy. Median OS was similar for 2L cabozantinib and other 2L therapies, and median OS for 2L cabozantinib was similar after both 1L therapy types. These results demonstrate the antitumour effect of 2L therapies, including cabozantinib, after 1L CPI-based combination treatment, regardless of whether 1L CPI–CPI or TKI–CPI therapy is used.</p></div>","PeriodicalId":10380,"journal":{"name":"Clinical genitourinary cancer","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1558767324001125/pdfft?md5=86f50afef582ae210913e0ef51dedf9c&pid=1-s2.0-S1558767324001125-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141720857","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":"Prognostic Nutritional Index (PNI) as Independent Predictor of Poor Survival in Prostate Cancer: A Systematic Review and Meta-Analysis","authors":"Edwin Tobing ,&nbsp;Christiano Tansol ,&nbsp;Clarissa Tania ,&nbsp;Aaron Tigor Sihombing","doi":"10.1016/j.clgc.2024.102142","DOIUrl":"10.1016/j.clgc.2024.102142","url":null,"abstract":"<div><h3>Background</h3><p>The concentration of albumin and lymphocyte in the body can serve as indicators of both nutritional status and inflammation. The predictive significance of the prognostic nutritional index (PNI) has been documented in multiple cancer types. Consequently, a meta-analysis was conducted in order to investigate the prognostic impact of PNI on survival outcomes among individuals diagnosed with prostate cancer.</p></div><div><h3>Methods</h3><p>A systematic search was conducted across 4 electronic databases to identify pertinent studies that evaluated the predictive significance of pretreatment PNI in patients with prostate cancer. The outcomes of interest in this study were overall survival (OS) and progression-free survival (PFS). The researchers utilized random-effect models to summarize the time-to-event outcomes, presenting the results as adjusted hazard ratios (aHR) along with their corresponding 95% confidence intervals (CI).</p></div><div><h3>Results</h3><p>A total of 2229 prostate cancer patients in 13 studies were included. Pooled analysis from these studies showed that low PNI value was associated with shorter OS [aHR 1.99 (95% CI, 1.45-2.72), <em>P</em> &lt; .0001], and PFS [aHR 1.97 (95% CI, 1.55-2.51), <em>P</em> &lt; .00001]. Sub-group analysis revealed that the ability of PNI to predict poor outcomes was better observed in patients with metastatic castration-resistant prostate cancer (mCRPC) and those who received androgen receptor pathway inhibitors (ARPIs).</p></div><div><h3>Conclusions</h3><p>This study suggests the role of PNI in predicting the survival and progression of prostate cancer. PNI values can be used in the risk stratification of patients with prostate cancer.</p></div>","PeriodicalId":10380,"journal":{"name":"Clinical genitourinary cancer","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141720858","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 Angiotensin Converting Enzyme Inhibitors on Pathologic Complete Response With Neoadjuvant Chemotherapy for Muscle Invasive Bladder Cancer","authors":"","doi":"10.1016/j.clgc.2024.102143","DOIUrl":"10.1016/j.clgc.2024.102143","url":null,"abstract":"<div><h3>Introduction</h3><p>The renin-angiotensin system (RAS) has been demonstrated to modulate cell proliferation, desmoplasia, angiogenesis and immunosuppression. We examined the association of RAS inhibitors (RASi)—namely angiotensin converting enzyme inhibitors (ACEi) and angiotensin receptor blockers (ARB)—with neoadjuvant chemotherapy (NAC) for muscle-invasive bladder cancer (MIBC) preceding radical cystectomy (RC).</p></div><div><h3>Patients and Methods</h3><p>We retrospectively investigated concurrent RASi use with NAC prior to RC in 302 patients with MIBC from 3 academic institutions. Outcomes included pathologic complete response (pCR) and overall survival (OS). Pathologic features, performance status (PS), clinical stage, type/number of cycles of NAC, and toxicities were collected.</p></div><div><h3>Results</h3><p>Overall pCR rate was 26.2% and 5-year OS was 62%. Concurrent ACEi intake with NAC approached significance for association with pCR (odds ratio [OR] = 1.71; 95% CI, 0.94-3.11; <em>P</em> = .077). Patients with cT3/4N0-N1 disease receiving ACEi had higher pCR rates (30.8% vs. 17.7%, <em>P</em> = .056) than those not on ACEi. Female sex had a statistically significant favorable interaction for pCR with ACEi intake (<em>P</em> = .044). ACEi intake was not associated with OS, while pCR, PS and lower clinical stage were significantly associated with improved OS.</p></div><div><h3>Conclusion</h3><p>ACEi intake is potentially associated with increased pCR in patients with MIBC receiving NAC prior to RC, and this association is more pronounced in patients with higher clinical stage of disease at the initiation of therapy and female sex. Our data suggest the potential relevance of the RAS as a therapeutic target in aggressive MIBC.</p></div>","PeriodicalId":10380,"journal":{"name":"Clinical genitourinary cancer","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141570100","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}