European urology focus最新文献

{"title":"Enhancing the Immunogenicity of Nivolumab plus Ipilimumab with Live Bacterial Supplementation in Metastatic Renal Cell Carcinoma.","authors":"Kevin K Zarrabi, Ulka Vaishampayan, Pedro C Barata","doi":"10.1016/j.euf.2025.01.003","DOIUrl":"https://doi.org/10.1016/j.euf.2025.01.003","url":null,"abstract":"<p><p>Dysbiosis may hinder effective tumor immunity and reduce the efficacy of therapies such as immune checkpoint blockade (ICB) in renal cell carcinoma (RCC). CBM588, a product containing live Clostridium butyricum, has shown promise in enhancing ICB effectiveness in metastatic RCC in terms of response rates and progression-free survival. Further research to confirm these findings should take factors such as diet and microbiome composition into account and include predictive biomarkers for patient selection.</p>","PeriodicalId":12160,"journal":{"name":"European urology focus","volume":" ","pages":""},"PeriodicalIF":4.8,"publicationDate":"2025-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143002885","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Human Urinary Microbiome and Its Potential Role in Urinary Tract Infections.","authors":"Ceejay N Saenz, Michael L Neugent, Nicole J De Nisco","doi":"10.1016/j.euf.2024.12.005","DOIUrl":"https://doi.org/10.1016/j.euf.2024.12.005","url":null,"abstract":"<p><p>After identifying a urinary microbiota, new insights have emerged into how urinary tract infections (UTIs) develop and recur in women. This review explores factors influencing the urinary microbiome, and its role in UTI susceptibility and recurrence. Age, menopausal status, estrogen, and prior UTIs can impact the urinary microbiome significantly, with estrogen promoting predominance of beneficial Lactobacillus species in women. Study of the urinary microbiome has identified anaerobic bacteria as emerging uropathogens, as well as microbiome species that are markers of recurrent UTI susceptibility. UTIs also impact microbiome functions, including disrupting microbiome scaffolding sites (ie, glycosaminoglycans) and enriching antibiotic resistance genes. A clear link is becoming established between the natural flora of the human urinary tract and UTI susceptibility, which is also impacted by aging and the menopausal transition. Deepening this understanding can lead to the development of a new generation of UTI therapeutic and preventative strategies aimed at modulating the urinary microbiome. PATIENT SUMMARY: A clear link is becoming established between the natural flora of the human urinary tract and urinary tract infection (UTI) susceptibility, which is also impacted by aging and the menopausal transition. Deepening this understanding can lead to the development of a new generation of UTI therapeutic and preventative strategies aimed at modulating the urinary microbiome.</p>","PeriodicalId":12160,"journal":{"name":"European urology focus","volume":" ","pages":""},"PeriodicalIF":4.8,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143002887","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Applications of Microbiome in Renal Cell Carcinoma.","authors":"Sara Elyas, Pedro Barata, Ulka Vaishampayan","doi":"10.1016/j.euf.2024.12.006","DOIUrl":"https://doi.org/10.1016/j.euf.2024.12.006","url":null,"abstract":"<p><p>Advancements in microbiome research reveal its impact on cancer treatment outcomes, particularly in renal cell carcinoma (RCC). While immune checkpoint inhibitors (ICIs) have improved survival in metastatic RCC, composition of the gut microbiome has the potential to influence their efficacy. Antibiotic-induced microbiome disruptions correlate with diminished outcomes, while strains such as Akkermansia muciniphila, Clostridium butyricum, and others enhance immune responses and progression-free survival. Some prebiotics such as inulin gel can alter the gut flora to overcome the resistant strains occurring in response to immune therapy. This mini-review explores microbiome-targeted interventions, such as pre/probiotics and fecal microbiota transplantation, for overcoming ICI resistance. Although promising, prospective randomized trials are needed to standardize clinical applications and optimize microbiome-targeted treatments. The standard use of gut-modulating therapy cannot be recommended at present outside of clinical trials. A double-blind placebo-controlled randomized trial of ICI ± gut modulating therapy is being planned in frontline therapy of advanced RCC (BIOFRONT trial by the Southwest Oncology Group).</p>","PeriodicalId":12160,"journal":{"name":"European urology focus","volume":" ","pages":""},"PeriodicalIF":4.8,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143002847","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Best Practice Guidelines for Collecting Microbiome Samples in Research Studies.","authors":"Ilaha Isali, Thomas R Wong, Shari Tian","doi":"10.1016/j.euf.2024.12.007","DOIUrl":"https://doi.org/10.1016/j.euf.2024.12.007","url":null,"abstract":"<p><p>Microbiome research has the potential to provide valuable information regarding the complex relationship between microbial communities and the human body. To help facilitate the translation of this potentially revolutionary research to clinical medicine, common guidelines and best practices are necessary. These guidelines should be based on the key findings of recent research in the field and address the primary areas of discrepancy in the previously published literature. Based on this review's findings, future microbiome research should adopt a consistent and clear approach to nomenclature, using standardized terminology to mitigate confusion. Additionally, only sample collection methods proven to reduce the risk of contamination should be utilized. While sample storage often creates difficulty in microbiome research, there are proven techniques that can improve results. With the wide array of research methodologies in the literature, standardization of metadata collection, kits, and analysis software could also be beneficial. Finally, documentation and records are critical in ensuring reproducibility, as is the case with all basic research. This brief review provides a foundation for evidence-based guidelines in microbiome research. PATIENT SUMMARY: This report outlines general guidelines and best practices for conducting microbiome research, which could significantly advance the field of medicine.</p>","PeriodicalId":12160,"journal":{"name":"European urology focus","volume":" ","pages":""},"PeriodicalIF":4.8,"publicationDate":"2025-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142983218","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reply to: Rong Dai and Changkai Deng's Letter to the Editor re: Anirban Dey, Georgios Georgiadis, Justin Umezurike, et al. Mirabegron Versus Placebo and Other Therapeutic Modalities in the Treatment of Patients with Overactive Bladder Syndrome-A Systematic Review. Eur Urol Focus. In press. https://doi.org/10.1016/j.euf.2024.09.012.","authors":"Anirban Dey, Georgios Georgiadis, Justin Umezurike, Yuhong Yuan, Fawzy Farag, James N'Dow, Muhammad Imran Omar, Charalampos Mamoulakis","doi":"10.1016/j.euf.2024.12.004","DOIUrl":"https://doi.org/10.1016/j.euf.2024.12.004","url":null,"abstract":"","PeriodicalId":12160,"journal":{"name":"European urology focus","volume":" ","pages":""},"PeriodicalIF":4.8,"publicationDate":"2025-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142946989","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reimagining Male Lower Urinary Tract Symptoms Due to Benign Prostatic Hyperplasia Treatment: A New Approach to First-line Interventional Therapy.","authors":"Dean Elterman, Steven A Kaplan","doi":"10.1016/j.euf.2024.12.008","DOIUrl":"https://doi.org/10.1016/j.euf.2024.12.008","url":null,"abstract":"<p><p>Benign prostatic hyperplasia is a prevalent condition leading to male lower urinary tract symptoms (mLUTS), particularly in aging populations. Current management strategies-spanning watchful waiting, pharmaceutical therapy, and surgical interventions such as transurethral resection of the prostate-face significant limitations, including side effects, low adherence, and patient hesitancy toward invasive treatments. First-line interventional therapy (FIT) emerges as a novel paradigm bridging the gap between medications and surgery. FIT aims to provide effective, minimally invasive symptom relief with rapid recovery, minimal side effects, and preserved treatment adaptability. Recent advancements in minimally invasive surgical therapies (MISTs) highlight potential; yet existing MIST procedures often fall short of meeting the FIT criteria. An ideal FIT would integrate outpatient feasibility, durability, and patient-centered outcomes, addressing both urologist and patient expectations. By reimagining treatment pathways, FIT has the potential to revolutionize mLUTS management, shifting the standard of care toward early, effective, and patient-friendly interventions, ultimately improving quality of life and long-term bladder health. PATIENT SUMMARY: In this report, we explored new treatment options for men with urinary symptoms caused by an enlarged prostate. We found that many men avoid surgery due to its risks and side effects, while medications often have limited success and unwanted effects. We suggest a new type of treatment, called first-line interventional therapy, which could provide faster symptom relief with fewer risks and quicker recovery, offering a better option for many patients.</p>","PeriodicalId":12160,"journal":{"name":"European urology focus","volume":" ","pages":""},"PeriodicalIF":4.8,"publicationDate":"2025-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142946987","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reply to Laila Schneidewind, Fabian P. Stangl, Jennifer Kranz, and Gernot Bonkat's Letter to Editor re: Fredrik Liedberg, Evanguelos Xylinas, Paolo Gontero. Quinolone Prophylaxis in Conjunction with Bacillus Calmette-Guérin Instillations for Bladder Cancer: Time To Reconsider the Evidence and Open the Quinolone Box? Eur Urol Focus 2024;10:564-6.","authors":"Fredrik Liedberg, Evanguelos Xylinas, Paolo Gontero","doi":"10.1016/j.euf.2024.12.001","DOIUrl":"https://doi.org/10.1016/j.euf.2024.12.001","url":null,"abstract":"","PeriodicalId":12160,"journal":{"name":"European urology focus","volume":" ","pages":""},"PeriodicalIF":4.8,"publicationDate":"2024-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142853378","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Re: Anirban Dey, Georgios Georgiadis, Justin Umezurike, et al. Mirabegron Versus Placebo and Other Therapeutic Modalities in the Treatment of Patients with Overactive Bladder Syndrome-A Systematic Review. Eur Urol Focus. In press. https://doi:10.1016/j.euf.2024.09.012.","authors":"Rong Dai, Changkai Deng","doi":"10.1016/j.euf.2024.11.013","DOIUrl":"https://doi.org/10.1016/j.euf.2024.11.013","url":null,"abstract":"","PeriodicalId":12160,"journal":{"name":"European urology focus","volume":" ","pages":""},"PeriodicalIF":4.8,"publicationDate":"2024-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142846285","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Re: Fredrik Liedberg, Evanguelos Xylinas, Paolo Gontero. Quinolone Prophylaxis in Conjunction with Bacillus Calmette-Guérin Instillations for Bladder Cancer: Time To Reconsider the Evidence and Open the Quinolone Box? Eur Urol Focus. In press. https://doi.org/10.1016/j.euf.2023.11.007.","authors":"Laila Schneidewind, Fabian P Stangl, Jennifer Kranz, Gernot Bonkat","doi":"10.1016/j.euf.2024.10.012","DOIUrl":"https://doi.org/10.1016/j.euf.2024.10.012","url":null,"abstract":"","PeriodicalId":12160,"journal":{"name":"European urology focus","volume":" ","pages":""},"PeriodicalIF":4.8,"publicationDate":"2024-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142824045","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cytoreductive Nephrectomy in Metastatic Renal Cell Carcinoma Treated with Immune Checkpoint Inhibitors: A Systematic Review and Meta-analysis of Individual Patient Data.","authors":"Dimitrios Makrakis, Pavlos Msaouel, Jose A Karam, Stepan Μ Esagian","doi":"10.1016/j.euf.2024.11.007","DOIUrl":"https://doi.org/10.1016/j.euf.2024.11.007","url":null,"abstract":"<p><strong>Background and objective: </strong>The role of cytoreductive nephrectomy (CN) in metastatic renal cell carcinoma (mRCC) in the era of immune checkpoint inhibitors (ICIs) is controversial. We aimed to investigate the survival benefit of CN in patients with mRCC treated with ICIs.</p><p><strong>Methods: </strong>We searched the EMBASE, MEDLINE, and Web of Science databases up to August 26, 2023 to identify studies comparing overall survival (OS) for patients with mRCC treated with ICIs with or without CN. We reconstructed individual patient data using published Kaplan-Meier curves and performed one- and two-stage meta-analyses using 6-mo and 12-mo landmarks to control for immortal time bias. We also performed subgroup analyses for patients treated with first-line ICI or upfront CN.</p><p><strong>Key findings and limitations: </strong>We identified eight eligible studies involving a total of 2319 patients. There were statistically significant differences in baseline characteristics (age, clear cell histology, International mRCC Database Consortium scores) between the ICI + CN and ICI-alone groups. Combined CN + ICI therapy was associated with superior OS in the primary analysis (hazard ratio [HR] 0.45, 95% confidence interval [CI] 0.37-0.54) and secondary analyses, and in subgroup analyses for patients receiving first-line ICI therapy (HR 0.39, 95% CI 0.30-0.48) and upfront CN (HR 0.52, 95% CI 0.40-0.69).</p><p><strong>Conclusions and clinical implications: </strong>CN combined with ICI therapy in mRCC may be associated with superior OS. Further studies are needed to confirm this finding and identify the patients most likely to benefit from CN in this setting.</p><p><strong>Patient summary: </strong>We compared outcomes after immune checkpoint inhibitor (ICI) therapy, which boosts the immune system to fight cancer, with or without nephrectomy (surgical removal of the kidney) in patients with metastatic kidney cancer. We found that the combination of nephrectomy and ICI therapy was associated with better survival than just ICI therapy.</p>","PeriodicalId":12160,"journal":{"name":"European urology focus","volume":" ","pages":""},"PeriodicalIF":4.8,"publicationDate":"2024-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142817634","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}