Clinical genitourinary cancer最新文献

{"title":"Robot-Assisted Cystectomy in Patients With Previous Pelvic Irradiation: A Comprehensive Systematic Review and Single-Arm Meta-Analysis","authors":"Richard Dobrucki de Lima ,&nbsp;Lucas Schenk de Almeida ,&nbsp;Eduardo Lopes Martins Filho ,&nbsp;José Maurício Mota ,&nbsp;Leopoldo Alves Ribeiro-Filho ,&nbsp;Caio Vinicius Suartz","doi":"10.1016/j.clgc.2024.102259","DOIUrl":"10.1016/j.clgc.2024.102259","url":null,"abstract":"<div><div>To evaluate the perioperative outcomes of robot-assisted cystectomy in previous pelvic irradiation patients. We performed a systematic review with a single-arm meta-analysis, searching the PubMed, Embase, Scopus, and Cochrane databases through July 2024. Included studies reported perioperative outcomes of robot-assisted radical cystectomy in patients with prior pelvic irradiation. Extracted data included operative time, blood loss, complication rates (using the Clavien-Dindo classification), readmission rates, and length of hospital stay. Study quality was assessed and a single-arm meta-analysis was conducted to synthesize the data. This systematic review included 150 patients from 4 retrospective studies. The median operative time ranged from 330 to 382 minutes (Overall Mean = 349.50 min; 95% CI, 331-380), and blood loss varied between 264 mL and 495 mL (Overall Mean = 351.50 mL; 95% CI, 264-495). Major complications, defined as Clavien-Dindo grade ≥ III, were reported in 20% to 32% of cases, while total early complications within 90 days ranged from 53% to 59% (Overall rate = 0.58; 95% CI, 0.42-0.75). The readmission rate within 90 days varied between 22% and 40% (Overall rate = 0.31; 95% CI, 0.16-0.47). RARC in patients with prior pelvic irradiation resulted in comparable perioperative outcomes to nonirradiated patients. This review highlights the potential safety and efficacy of RARC in this complex patient group. Future studies comparing surgical approaches with detailed reporting on radiation exposure are essential to validate these findings.</div></div>","PeriodicalId":10380,"journal":{"name":"Clinical genitourinary cancer","volume":"23 1","pages":"Article 102259"},"PeriodicalIF":2.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142788061","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 With Immune Checkpoint Inhibitors in Patients With FGFR2/3, MTAP or ERBB2 Genomic Alterations in Advanced Urothelial Carcinoma","authors":"Rafee Talukder ,&nbsp;Dimitra Rafailia Bakaloudi ,&nbsp;Dimitrios Makrakis ,&nbsp;Leonidas N. Diamantopoulos ,&nbsp;Thomas Enright ,&nbsp;Jacob B. Leary ,&nbsp;Ruben Raychaudhuri ,&nbsp;Nishita Tripathi ,&nbsp;Neeraj Agarwal ,&nbsp;Tanya Jindal ,&nbsp;Jason R. Brown ,&nbsp;Yousef Zakharia ,&nbsp;Macarena Rey-Cárdenas ,&nbsp;Daniel Castellano ,&nbsp;Charles B. Nguyen ,&nbsp;Ajjai Alva ,&nbsp;Roubini Zakopoulou ,&nbsp;Aristotelis Bamias ,&nbsp;Rafael Morales Barrera ,&nbsp;David Marmolejo ,&nbsp;Petros Grivas","doi":"10.1016/j.clgc.2024.102284","DOIUrl":"10.1016/j.clgc.2024.102284","url":null,"abstract":"<div><h3>Background</h3><div><em>FGFR2/3, MTAP</em> and <em>ERBB2</em> genomic alterations have treatment targets in advanced urothelial carcinoma (aUC). These alterations may affect tumor microenvironment and outcomes with immune checkpoint inhibitors (ICIs) in aUC.</div></div><div><h3>Patients and Methods</h3><div>We identified patients with available genomic data in our multi-institution cohort of patients with aUC treated with ICI. Outcomes (observed response rate [ORR], progression-free and overall survival [PFS, OS]) with ICI were compared between patients with and without <em>FGFR 2/3, MTAP, ERBB2</em> alterations. We compared ORR using logistic regression and PFS/OS using Cox proportional hazards.</div></div><div><h3>Results</h3><div>Out of 1,514 patients, 276 (18%), 174 (11%) and 208 (14%) patients had known <em>FGFR2/3, MTAP</em> and <em>ERBB2</em> alteration status, respectively. and were treated with ICI in 1L or 2 + L. In patients with (vs. without) <em>FGFR2/3</em> alteration, ORR with ICI was 21% vs. 32% (OR 0.54; [95%CI 0.32-0.91]), PFS was significantly shorter in patients with <em>FGFR2/3</em> alterations (HR = 1.36 [95%CI 1.03-1.80]; <em>P=</em>0<em>.</em>03); OS was not significantly different (HR = 1.22 [95%CI 0.86-1.47]). In patients with (vs. without) <em>MTAP</em> alteration, ORR with ICI was 25% versus 40% (OR 0.52 [95%CI 0.20-1.38]); PFS and OS were nonsignificantly different. In patients with (vs. without) <em>ERBB2</em> alteration, ORR with ICI was similar (37% vs. 35%; OR 1.06; 95%CI 0.57-1.97); PFS and OS were significantly longer in patients with <em>ERBB2</em> alteration [HR 0.63 (95%CI 0.41-0.95); <em>P=</em>0<em>.</em>03; HR 0.66, [95% CI 0.44-0.97]), respectively.</div></div><div><h3>Conclusion</h3><div>Our results support further evaluation of <em>FGFR2/3, MTAP</em> and <em>ERBB2</em> alterations as putative biomarkers in patients with aUC treated with ICI.</div></div>","PeriodicalId":10380,"journal":{"name":"Clinical genitourinary cancer","volume":"23 1","pages":"Article 102284"},"PeriodicalIF":2.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142973827","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 Gemcitabine and Carboplatin Dosing in Patients With Cisplatin-Ineligible Metastatic Urothelial Carcinoma","authors":"Eleni Gamvroulas ,&nbsp;Erin Bailey ,&nbsp;Erik Harrington ,&nbsp;Emma Jones ,&nbsp;Rebecca Martin ,&nbsp;Benjamin L. Maughan","doi":"10.1016/j.clgc.2024.102279","DOIUrl":"10.1016/j.clgc.2024.102279","url":null,"abstract":"<div><h3>Background</h3><div>The National Comprehensive Cancer Network Bladder Cancer Guidelines recommend carboplatin and gemcitabine first-line treatment in patients with cisplatin-ineligible, metastatic urothelial cancer (mUC) -- a Category 1 recommendation. For these patients, the median overall survival is 9.3 months. While carboplatin is purported to offer a more tolerable side-effect profile, many patients still require dose-reductions, dose-delays, and hospitalizations. Given the inability for mUC patients to tolerate this palliative regimen, we aim to determine whether initiating therapy with a lower dose regimen is justified.</div></div><div><h3>Methods</h3><div>A single-institution retrospective analysis was conducted to review eligible patients treated with carboplatin plus gemcitabine from May 2014 through October 2022. Data collected via manual chart review included patient baseline characteristics, chemotherapy doses, reductions, delays, toxicities, and effectiveness.</div></div><div><h3>Results</h3><div>Forty-three patients met inclusion criteria. Nineteen patients (44%) required ≥ 1 dose reduction during therapy. Twenty-six patients (60%) started with a full-dose regimen, and 14 (54%) of those patients required a dose reduction during treatment. Seventeen patients (40%) started with a reduced-dose regimen, and 5 (29%) of those patients required a dose reduction during treatment. No patients received the anticipated 6 cycles at full dose, but 14% completed 6 cycles with dose reductions. One patient (2%) was able to tolerate &gt;80% relative dose intensity of both carboplatin and gemcitabine.</div></div><div><h3>Conclusions</h3><div>Cisplatin-ineligible mUC patients were unable to tolerate full-dose carboplatin and gemcitabine. As this is a palliative regimen, it would be pertinent to consider starting therapy at a reduced dose to minimize treatment interruptions, dose omissions and side effects.</div></div>","PeriodicalId":10380,"journal":{"name":"Clinical genitourinary cancer","volume":"23 1","pages":"Article 102279"},"PeriodicalIF":2.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142857013","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":"A Clinical Case Series of BCGosis as a Rare Complication of Intravesical BCG","authors":"Joseph Inauen ,&nbsp;James Geake ,&nbsp;Alice Sawka ,&nbsp;Sam Labroome ,&nbsp;Richard Hoffmann ,&nbsp;Simone Barry","doi":"10.1016/j.clgc.2024.102271","DOIUrl":"10.1016/j.clgc.2024.102271","url":null,"abstract":"<div><div><ul><li><span>•</span><span><div>Intravesical BCG treatment for NMIBC can be associated with severe systemic complications including disseminated BCG infection (BCGosis).</div></span></li><li><span>•</span><span><div>Clinicians should be aware of the vast array of clinical presentations and diagnostic challenges of BCGosis.</div></span></li><li><span>•</span><span><div>Morbidity can be associated not only with disseminated BCG infection but also with its treatment which is long and not uncommonly poorly tolerated.</div></span></li></ul></div></div>","PeriodicalId":10380,"journal":{"name":"Clinical genitourinary cancer","volume":"23 1","pages":"Article 102271"},"PeriodicalIF":2.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142796670","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 Clinical Outcomes in Patients With Locally Advanced or Metastatic Urothelial Carcinoma by Eligibility for Maintenance Avelumab","authors":"Alicia K. Morgans ,&nbsp;Guru P. Sonpavde ,&nbsp;Vanessa Shih ,&nbsp;Phoebe Wright ,&nbsp;Zsolt Hepp ,&nbsp;Candice L. Willmon ,&nbsp;Nancy N. Chang ,&nbsp;Lisa Mucha ,&nbsp;Sai Sriteja Boppudi Naga ,&nbsp;Thomas Powles","doi":"10.1016/j.clgc.2024.102270","DOIUrl":"10.1016/j.clgc.2024.102270","url":null,"abstract":"<div><h3>Introduction</h3><div>1L PBC has historically been recommended for patients with la/mUC. Maintenance avelumab is recommended for patients without disease progression following 1L PBC. Real-world data on the proportion of patients eligible for maintenance avelumab are limited, and outcomes among patients ineligible for maintenance avelumab are uncertain. This study assessed the proportion of patients with la/mUC initiating 1L PBC who were maintenance-avelumab eligible and real-world outcomes following 1L PBC by maintenance-avelumab eligibility.</div></div><div><h3>Methods</h3><div>A retrospective, observational study was conducted using a longitudinal electronic health record–derived database comprising de-identified patient-level structured and unstructured data including adults with Ia/mUC who received ≥1 dose of 1L PBC (April 2020-January 2022). The proportion of patients eligible for maintenance avelumab (real-world stable disease, partial response, or complete response following 1L PBC) was estimated and median overall survival (mOS) assessed for maintenance avelumab–eligible and –ineligible patients.</div></div><div><h3>Results</h3><div>Of 336 patients with Ia/mUC treated with 1L PBC (55.4% received cisplatin-based treatment 44.6% carboplatin-based treatment); 181 (54%) were maintenance-avelumab eligible; and 138 (41%) maintenance-avelumab ineligible (17 [5%] were nonevaluable). Of 181 maintenance-avelumab–eligible patients, 67 (37.0%; 19.9% of all 1L PBC–treated patients) received maintenance avelumab. mOS (95% CI) among all 1L PBC–treated patients was 15.0 (12.2-19.6) months and among maintenance-avelumab–ineligible patients was 8.0 (6.7-10.3) months; whereas among maintenance-avelumab–eligible patients (including 37% who received maintenance avelumab), mOS was 27.6 (23.4-not reached) months.</div></div><div><h3>Conclusions</h3><div>In this study, approximately half of 1L PBC–treated patients were maintenance-avelumab eligible, and one-fifth received it. Real-world OS remains short for the overall 1L PBC–treated population. These results support the use of treatment-guideline preferred 1L treatment options that demonstrate survival benefit for all patients with la/mUC, and are available to patients irrespective of their eligibility for cisplatin, or response to PBC.</div></div>","PeriodicalId":10380,"journal":{"name":"Clinical genitourinary cancer","volume":"23 1","pages":"Article 102270"},"PeriodicalIF":2.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142815300","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":"Impact of BMI Category on Recurrence and Progression of Nonmuscle Invasive Bladder Cancer Prognosis","authors":"Jamie Thomas ,&nbsp;Aakangsha Jain ,&nbsp;Ram Hirpara ,&nbsp;Ruben Blachman-Braun ,&nbsp;Helen Y. Hougen ,&nbsp;Nachiketh Soodana-Prakash ,&nbsp;Maria C. Velasquez ,&nbsp;Tarek Ajami ,&nbsp;Bruno Nahar ,&nbsp;Mark L. Gonzalgo ,&nbsp;Bruce Kava ,&nbsp;Sanoj Punnen ,&nbsp;Dipen J. Parekh ,&nbsp;Chad R. Ritch","doi":"10.1016/j.clgc.2024.102286","DOIUrl":"10.1016/j.clgc.2024.102286","url":null,"abstract":"<div><h3>Objective</h3><div>To assess the association of being overweight or obese with Nonmuscle invasive bladder cancer (NMIBC) recurrence, stage progression, and grade progression.</div></div><div><h3>Methods</h3><div>Patients with NMIBC were included and categorized into 3 groups based on their body mass index (BMI): normal weight, overweight, and obese. Recurrence was defined as any histologically proven bladder cancer on subsequent transurethral resection of bladder tumor (TURBT). Progression was defined as upgrading from low to high grade, upstaging to pT1 from pTa, or to muscle-invasion from pT1 disease.</div></div><div><h3>Results</h3><div>A total of 457 patients were analyzed, 135 (29.5%) had normal weight, 192 (42.6%) were overweight, and 130 (28.4%) were obese, with a median BMI of 27.1 (24.4-30.7) Kg/m2. The study found no significant difference in the time to recurrence, stage progression, and grade progression within the BMI categories (<em>P</em> &lt; .05). Additionally, no increased risk was observed in BMI categories (Obesity recurrence HR: 1.067, CI 95%: 0.783-1.453; Obesity stage progression HR: 1.315, 95% CI: 0.635-2.724; Obesity grade progression HR: 0.586, 95% CI: 0.195-1.760).</div></div><div><h3>Conclusions</h3><div>In our cohort, body weight category showed no association with NMIBC recurrence, stage progression, or grade progression. These findings highlight the need to identify other potential risk factors that could improve NMIBC risk stratification. Further studies are warranted to validate our results and explore additional predictors of NMIBC outcomes.</div></div>","PeriodicalId":10380,"journal":{"name":"Clinical genitourinary cancer","volume":"23 1","pages":"Article 102286"},"PeriodicalIF":2.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142901168","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 Effectiveness of Single-Agent Enfortumab Vedotin in Patients With Advanced Urothelial Carcinoma","authors":"Nicolas Sayegh ,&nbsp;Yeonjung Jo ,&nbsp;Georges Gebrael ,&nbsp;Nishita Tripathi ,&nbsp;Beverly Chigarira ,&nbsp;Ayana Srivastava ,&nbsp;Blake Nordblad ,&nbsp;Emre Dal ,&nbsp;Chadi Hage Chehade ,&nbsp;Jon Mahlow ,&nbsp;Benjamin L. Maughan ,&nbsp;Sumati Gupta ,&nbsp;Neeraj Agarwal ,&nbsp;Umang Swami","doi":"10.1016/j.clgc.2024.102287","DOIUrl":"10.1016/j.clgc.2024.102287","url":null,"abstract":"<div><h3>Background</h3><div>Enfortumab vedotin (EV) is a nectin-4-directed antibody and microtubule inhibitor conjugate indicated for patients with metastatic urothelial carcinoma (mUC) who have received prior platinum-based chemotherapy and PD-1/L1 inhibitors or are ineligible for cisplatin-containing regimens and have undergone at least 1 prior line of therapy. EV is also indicated in combination with pembrolizumab in the first-line setting. However, real-world effectiveness of EV based on treatment line and impact of prior therapy remains unclear.</div></div><div><h3>Methods</h3><div>This retrospective study utilized the nationwide Flatiron Health electronic health record (EHR)-derived de-identified database. Patients with advanced, recurrent, or mUC of upper or lower urinary tract who received single-agent EV in the second-line or beyond after December 18, 2019 (FDA accelerated approval date), were included. Patients without documentation of first-line therapy or without evidence of contact for 90 days from mUC diagnosis were excluded. Time to next therapy (TTNT) and overall survival (OS) were analyzed based on treatment line and prior platinum-based chemotherapy and PD-1/L1 inhibitors using Kaplan-Meier survival estimates and its 95% confidence interval.</div></div><div><h3>Results</h3><div>Between January 17, 2020, and September 30, 2022, 6566 patients with mUC received systemic treatment, with 431 receiving EV. EV monotherapy was administered across various lines (N = 371): second (157), third (132), fourth (62), and fifth (20). Approximately 22% of patients had prior platinum-based therapy, and 48% had prior PD-1/L1 inhibitors. Median TTNT and OS varied across treatment lines, with patients with prior platinum exposure generally showing longer TTNT and OS, notably in those receiving EV in the fourth-line setting.</div></div><div><h3>Conclusions</h3><div>EV demonstrates efficacy in patients with mUC regardless of prior receipt of platinum-based chemotherapy and PD-1/L1 inhibitors or treatment line. While only hypothesis-generating, these findings provide valuable insights for patient counseling, prognostication, and therapeutic decision-making in clinical practice.</div></div>","PeriodicalId":10380,"journal":{"name":"Clinical genitourinary cancer","volume":"23 1","pages":"Article 102287"},"PeriodicalIF":2.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142901200","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 and Survival of Patients With Prostate Cancer in North-Rhine Westphalia, Germany","authors":"Madeleine J. Karpinski MSc ,&nbsp;Kevin Claassen PhD ,&nbsp;Lennart Möller MSc ,&nbsp;Johannes Hüsing PhD ,&nbsp;Hiltraud Kajüter MSc ,&nbsp;Wolfgang P. Fendler MD ,&nbsp;Boris Hadaschik MD ,&nbsp;Andreas Stang MD","doi":"10.1016/j.clgc.2024.102289","DOIUrl":"10.1016/j.clgc.2024.102289","url":null,"abstract":"<div><h3>Introduction</h3><div>There is no organized prostate cancer screening in Germany. The aim of this study was to investigate the development of incidence and survival in patients with primary malignant tumors of the prostate in relation to changing recommendations of prostate-specific antigen (PSA) screening in guidelines.</div></div><div><h3>Methods</h3><div>Age-standardized incidence rates and 5-year relative survival (RS) (period approach) were calculated using data from the cancer registry North Rhine-Westphalia with the subset of the administrative district Münster respectively for the years 1992-2019. Analyses were stratified according to TNM classification.</div></div><div><h3>Results</h3><div>Until 2008 overall prostate cancer incidence increased, followed by a decrease up to 2017 and another increase thereafter. The same trend was observed in nonmetastatic but not in metastatic prostate cancer. Overall 5-year RS showed an increase of 10 percentage points up to period 2005-2009, followed by a constant RS. 5-year RS of patients with distant metastases remained constant from period 2000-2004 to 2015-2019, while 5-year RS with nonmetastatic prostate cancer and lymph node metastases increased slightly.</div></div><div><h3>Discussion</h3><div>Overall and nonmetastatic incidence rates reflect changes of recommendation in PSA screening guidelines from the United States. Accordingly, the increase in 5-year RS might be influenced by lead time bias. Incidence and survival of metastatic prostate cancer barely suggest any association with changing PSA screening recommendations.</div></div><div><h3>Conclusion</h3><div>Structured early detection of metastases with additionally applied diagnostic methods might improve 5-year RS rates of metastatic prostate cancer patients.</div></div>","PeriodicalId":10380,"journal":{"name":"Clinical genitourinary cancer","volume":"23 1","pages":"Article 102289"},"PeriodicalIF":2.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142916155","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":"Real-world Evidence for Enfortumab Vedotin in Patients with Metastatic Urothelial Cancer: An Austrian Multicentre Study","authors":"Dora Niedersuess-Beke ,&nbsp;Karl Mayrhofer ,&nbsp;Johanna Krauter ,&nbsp;Susanne Schnabel ,&nbsp;Simon Peter Gampenrieder ,&nbsp;Jan Miechowiecki ,&nbsp;David Kiesl ,&nbsp;Ferdinand Luger ,&nbsp;Jakob Pfuner ,&nbsp;Clemens Wiesinger ,&nbsp;Sonia Vallet ,&nbsp;Haleh Andalibi ,&nbsp;Dominik Vais ,&nbsp;Andreas Banner ,&nbsp;Franz Stoiber ,&nbsp;Jasmin Spielgelberg ,&nbsp;Dominik Barth ,&nbsp;Thomas Bauernhofer ,&nbsp;Stefan Aufderklamm ,&nbsp;Sabine Weibrecht ,&nbsp;Renate Pichler","doi":"10.1016/j.clgc.2024.102278","DOIUrl":"10.1016/j.clgc.2024.102278","url":null,"abstract":"<div><h3>Aim</h3><div>Enfortumab vedotin (EV) represents a novel treatment for patients with locally advanced or metastatic urothelial carcinoma (la/mUC) refractory to platinum-based chemotherapy and PD(L)-1 containing therapies. Real-world data are crucial for informing health policy decisions and validating clinical trial findings.</div></div><div><h3>Methods</h3><div>We conducted a multicentre, retrospective real-world analysis comprising 128 patients with la/mUC from 16 Austrian centres treated with EV from April 2022 to April 2024, presenting the second largest real-world cohort to date. Data were analysed for efficacy and safety parameters.</div></div><div><h3>Results</h3><div>The median age was 69 years, the objective response rate 31% and the disease control rate 47%, with 9% of patients exhibiting a complete remission, 23% a partial remission and 16% a stable disease. After a median follow-up of 6.2 months, the median progression-free survival (mPFS) and the median overall survival (mOS) reached 4.8 and 10.75 months, respectively. Patients with good ECOG PS 0-1, metachronous metastatic disease and absence of liver metastases had significantly better OS. No difference in efficacy was observed in patients who received a reduced dose EV after experiencing adverse events. The safety profile was acceptable, showing grade ≥3 TRAEs in 25.8% of patients.</div></div><div><h3>Conclusion</h3><div>In our real-world population, the administration of EV was feasible and effective, with no new safety signals. Lower efficacy data compared to previous trials might be explained by the use in later therapy lines and in patients with poorer ECOG PS. Our data corroborate the efficacy and safety of EV monotherapy in later lines.</div></div>","PeriodicalId":10380,"journal":{"name":"Clinical genitourinary cancer","volume":"23 1","pages":"Article 102278"},"PeriodicalIF":2.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142822655","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 Clinicopathologic Study of 1598 Ultrasound-Guided Needle Prostate Biopsies and Trends in Prostate Cancer Over a 14-Year Period","authors":"Bahar Ebtehaj ,&nbsp;Mehdi Adhami ,&nbsp;Amir Javadi ,&nbsp;Fatemeh Hajmanoochehri","doi":"10.1016/j.clgc.2024.102272","DOIUrl":"10.1016/j.clgc.2024.102272","url":null,"abstract":"<div><h3>Background</h3><div>Prostate cancer manifests in various forms, ranging from occult and localized to metastatic disease. Analyzing prostate biopsies offers insights into histopathological characteristics, enhancing disease understanding and management.</div></div><div><h3>Methods</h3><div>This 14-year study reviewed ultrasound-guided needle prostate biopsies, collecting data via questionnaires and medical records, focusing on Gleason group, tumor involvement percentage, and predicted cancer stage. A comparative analysis across 2 distinct 7-year intervals was conducted. Statistical analyses included the Kolmogorov–Smirnov test, chi-square test, Fisher's exact test, and Analysis of Covariance, all performed using SPSS software.</div></div><div><h3>Results</h3><div>Among 1,598 biopsies, 624 cases of adenocarcinoma were identified. Malignancy incidence significantly correlated positively with age, prostate-specific antigen (PSA), and PSA density (PSAD), and inversely with prostate volume and the free-to-total PSA ratio (%fPSA). Notably, 30.8% of malignancies were classified as Gleason groups 4 or 5, displaying significantly higher PSA levels. Patients with prior transurethral resection of the prostate exhibited increased malignancy rates and higher Gleason groups. Diagnostic accuracy, measured by Area Under the Curve, was 0.719 for PSA, 0.730 for %fPSA, and 0.817 for PSAD. The later phase of the study showed higher cancer detection, lower PSA levels, and a greater incidence of higher Gleason groups despite a lower predicted stage.</div></div><div><h3>Conclusion</h3><div>The prevalence of higher Gleason groups was similar to other studies. PSAD demonstrated greater diagnostic reliability than PSA alone. Additionally, higher malignancy rates and Gleason groups were observed in patients with prior transurethral resection of the prostate. The increase in cancer detection rates during the second period likely indicates improved biopsy candidate selection.</div></div>","PeriodicalId":10380,"journal":{"name":"Clinical genitourinary cancer","volume":"23 1","pages":"Article 102272"},"PeriodicalIF":2.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142815279","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}