European urology最新文献

{"title":"Re: Characterizing Psychological Resources and Resilience in Patients with Bladder Cancer: Associations with Frailty and Quality of Life","authors":"Rodolfo Hurle, Bruno Bernardini, Roberto Contieri, Massimo Lazzeri","doi":"10.1016/j.eururo.2025.01.011","DOIUrl":"https://doi.org/10.1016/j.eururo.2025.01.011","url":null,"abstract":"No Abstract","PeriodicalId":12223,"journal":{"name":"European urology","volume":"28 1","pages":""},"PeriodicalIF":23.4,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143083766","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"PARP Inhibitors and Prostate Cancer: The Struggle To Separate the Grain from the Chaff","authors":"Elena Castro, David Lorente, David Olmos","doi":"10.1016/j.eururo.2025.01.012","DOIUrl":"https://doi.org/10.1016/j.eururo.2025.01.012","url":null,"abstract":"No Abstract","PeriodicalId":12223,"journal":{"name":"European urology","volume":"77 4 Pt 2 1","pages":""},"PeriodicalIF":23.4,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143084177","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Updated European Association of Urology Guidelines on the Use of Adjuvant Immune Checkpoint Inhibitors and Subsequent Therapy for Renal Cell Carcinoma","authors":"Jens Bedke, Yasmin Abu Ghanem, Laurence Albiges, Stephanie Bonn, Riccardo Campi, Umberto Capitanio, Saeed Dabestani, Milan Hora, Tobias Klatte, Teele Kuusk, Lars Lund, Lorenzo Marconi, Carlotta Palumbo, Geraldine Pignot, Thomas Powles, Maxine Tran, Alessandro Volpe, Axel Bex","doi":"10.1016/j.eururo.2025.01.014","DOIUrl":"https://doi.org/10.1016/j.eururo.2025.01.014","url":null,"abstract":"The KEYNOTE-564 trial showed that adjuvant immune checkpoint inhibitor (ICI) therapy with pembrolizumab, a PD-1 antibody, significantly improved disease-free survival (DFS) and overall (OS) survival in localised clear-cell renal cell carcinoma (RCC) with a high risk of relapse. The TiNivo and CONTACT-03 trials have reported results for subsequent therapy after progression on ICI therapy in the metastatic setting. The European Association of Urology (EAU) RCC guidelines panel reassessed the new trial results to update recommendations for adjuvant therapy and post-adjuvant therapy. Adjuvant pembrolizumab significantly improved OS (hazard ratio 0.62, 95% confidence interval 0.44–0.87; <em>p</em> = 0.005). Recent trials of subsequent ICI after recurrence on ICI in the metastatic setting do not support ICI monotherapy or combination therapy in patients with recurrence on or after adjuvant ICI therapy. There are no prospective trial results for treatment after adjuvant pembrolizumab failure. On the basis of the recent results, the EAU RCC guidelines panel has updated the recommendation for adjuvant therapy and now issues a strong recommendation for adjuvant pembrolizumab. ICI monotherapy or combination therapy is not recommended in patients with recurrence during or shortly after adjuvant pembrolizumab.<h3>Patient summary</h3>Treatment with an immunotherapy drug called pembrolizumab after surgery in patients with intermediate-risk or high-risk kidney cancer delays the time to recurrence of cancer and prolongs survival. Therefore, pembrolizumab after surgery is strongly recommended for these patients. However, a significant proportion of patients have life-changing or serious side effects and these must be discussed.","PeriodicalId":12223,"journal":{"name":"European urology","volume":"48 1","pages":""},"PeriodicalIF":23.4,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143083765","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intraductal Carcinoma and Cribriform Pattern in Prostate Cancer: Challenges and Emerging Perspectives","authors":"Rui M. Bernardino, Theodorus van der Kwast, Neil E. Fleshner","doi":"10.1016/j.eururo.2025.01.013","DOIUrl":"https://doi.org/10.1016/j.eururo.2025.01.013","url":null,"abstract":"&lt;h2&gt;Section snippets&lt;/h2&gt;&lt;section&gt;&lt;section&gt;&lt;h2&gt;Limitations of current strategies for IDC/Crib detection&lt;/h2&gt;Reliable detection of these aggressive subtypes remains difficult, as conventional biopsy has demonstrated limited sensitivity. Data from matched biopsy and RP studies indicate that traditional biopsy methods (with or without magnetic resonance imaging [MRI] fusion) have sensitivity as low as 42% for Crib and 44% for IDC detection [4]. Sampling bias in biopsies may explain this, as they are more likely to detect extensive IDC/Crib. In addition, the difficulty in sampling the anterior zone via&lt;/section&gt;&lt;/section&gt;&lt;section&gt;&lt;section&gt;&lt;h2&gt;Clinical implications of failure to detect IDC/Crib&lt;/h2&gt;The landscape of PCa management has evolved, with an emphasis now on risk-adapted approaches that balance treatment intensity with quality-of-life considerations. Active surveillance (AS) is increasingly adopted for favorable intermediate-risk PCa, particularly grade group 2 [GS 7 (3 + 4)], as supported by emerging studies and recognition that not all intermediate-risk cases involve aggressive progression [7]. According to the European Association of Urology guidelines, AS is inappropriate for&lt;/section&gt;&lt;/section&gt;&lt;section&gt;&lt;section&gt;&lt;h2&gt;IDC/Crib in high-risk PCa&lt;/h2&gt;In a study by Yu et al [8], IDC or Crib morphology was observed in 95% of RP specimens with nodal metastases and was a strong independent predictor of prognosis. Incorporation of IDC/Crib in Cancer of the Prostate Risk Assessment and National Comprehensive Cancer Network models enhances their predictive accuracy for BCR after RP, particularly in high-risk and very high-risk groups. This emphasizes the critical need for pathologists to document these features, particularly in cases with biopsy&lt;/section&gt;&lt;/section&gt;&lt;section&gt;&lt;section&gt;&lt;h2&gt;Imaging for detection of metastasis in IDC/Crib&lt;/h2&gt;Prostate-specific membrane antigen (PSMA)-based positron emission tomography (PET)/computed tomography (CT) is increasingly being used in BCR and pretreatment settings. The higher sensitivity of this imaging modality reveals novel metastatic patterns, adding complexity to stage migration [9], [10]. IDC presence in RP specimens correlates with higher likelihood of metastasis on PSMA PET/CT. Among patients with metastasis detected on PSMA PET/CT, Crib is particularly associated with lymphatic&lt;/section&gt;&lt;/section&gt;&lt;section&gt;&lt;section&gt;&lt;h2&gt;Molecular alterations in IDC/Crib&lt;/h2&gt;Both Crib and IDC exhibit higher rates of genetic instability and copy number alterations, frequently involving mutations in key tumor suppressor genes and oncogenes such as &lt;em&gt;PTEN&lt;/em&gt; (commonly lost in IDC), &lt;em&gt;TP53&lt;/em&gt;, &lt;em&gt;BRCA2&lt;/em&gt;, &lt;em&gt;ATM&lt;/em&gt;, &lt;em&gt;RB1&lt;/em&gt;, and &lt;em&gt;SPOP&lt;/em&gt;. Oncogenic pathway deregulation events, including &lt;em&gt;MYC&lt;/em&gt; amplification and alterations in the PI3K-AKT-mTOR, JAK-STAT, KRAS, and MAPK pathways, drive tumor progression in these patterns [11]. These molecular changes underscore the aggressive nature of IDC/Crib and&lt;/","PeriodicalId":12223,"journal":{"name":"European urology","volume":"79 1 1","pages":""},"PeriodicalIF":23.4,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143071695","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Final Overall Survival and Molecular Data Associated with Clinical Outcomes in Patients Receiving Ipatasertib and Abiraterone in the Phase 3 IPATential150 Trial","authors":"Johann S. de Bono, Meng He, Zhen Shi, Malgorzata Nowicka, Sergio Bracarda, Cora N. Sternberg, Kim N. Chi, David Olmos, Shahneen Sandhu, Christophe Massard, Nobuaki Matsubara, Geng Chen, Nives Selak Bienz, Daniel Canter, Matthew Wongchenko, Christopher Sweeney","doi":"10.1016/j.eururo.2024.12.015","DOIUrl":"https://doi.org/10.1016/j.eururo.2024.12.015","url":null,"abstract":"<h3>Background and objective</h3>In the phase 3 IPATential150 trial, ipatasertib addition to abiraterone significantly reduced the risk of disease progression in men with metastatic castration-resistant prostate cancer (mCRPC) with PTEN loss on immunohistochemistry (IHC), but not in the intention-to-treat (ITT) population. Here we report the final overall survival (OS) analysis and present results for prespecified and exploratory biomarker analyses.<h3>Methods</h3>Patients were randomized to receive ipatasertib (400 mg once daily) or placebo. All patients received abiraterone (1000 mg once daily) and prednisone (5 mg twice daily). OS was assessed in patients with PTEN loss on IHC and the ITT population. Exploratory biomarker analyses included <em>PTEN</em> status via next-generation sequencing (NGS) and other key genomic alterations.<h3>Key findings and limitations</h3>At final analysis (median follow-up 33.9 mo), ipatasertib addition did not improve OS for patients with PTEN loss in IHC (<em>n</em> = 521; stratified hazard ratio [sHR] 0.94, 95% confidence interval [CI] 0.76–1.17; <em>p</em> = 0.57) or the ITT population (<em>n</em> = 1101; sHR 0.91, 95% CI 0.79–1.07; not formally tested). Exploratory NGS assessments identified subgroups with genomic <em>PTEN</em> loss (<em>n</em> = 208) or <em>PIK3CA</em>/<em>AKT1</em>/<em>PTEN</em> alterations (<em>n</em> = 250), with potentially better outcomes from ipatasertib (HR 0.76, 95% CI 0.54–1.07; and HR 0.70, 95% CI 0.51–0.96, respectively). Limitations include the exploratory nature of the analysis, incomplete availability of NGS data, and potential intrapatient heterogeneity.<h3>Conclusions and clinical implications</h3>Ipatasertib addition to abiraterone did not improve OS for men with mCRPC, regardless of PTEN status on IHC. Exploratory biomarker analyses identified additional genomic alterations of potential clinical relevance for AKT blockade in mCRPC that require further validation in prospective studies.","PeriodicalId":12223,"journal":{"name":"European urology","volume":"39 1","pages":""},"PeriodicalIF":23.4,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143056966","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Cost of Bladder Cancer: What Can Be Done?","authors":"Arnulf Stenzl","doi":"10.1016/j.eururo.2025.01.006","DOIUrl":"https://doi.org/10.1016/j.eururo.2025.01.006","url":null,"abstract":"No Abstract","PeriodicalId":12223,"journal":{"name":"European urology","volume":"106 1","pages":""},"PeriodicalIF":23.4,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143055150","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Shining a Light in the Darkness: Exploring Treatment Burden in Genitourinary Oncology","authors":"Alicia K. Morgans, Stacy Loeb","doi":"10.1016/j.eururo.2025.01.008","DOIUrl":"https://doi.org/10.1016/j.eururo.2025.01.008","url":null,"abstract":"No Abstract","PeriodicalId":12223,"journal":{"name":"European urology","volume":"7 1","pages":""},"PeriodicalIF":23.4,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143049671","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Re: Standard or Extended Lymphadenectomy for Muscle-invasive Bladder Cancer","authors":"Daniele Raggi, Deep Chakrabarti, Harshani Green, Robert A. Huddart","doi":"10.1016/j.eururo.2025.01.009","DOIUrl":"https://doi.org/10.1016/j.eururo.2025.01.009","url":null,"abstract":"No Abstract","PeriodicalId":12223,"journal":{"name":"European urology","volume":"87 1","pages":""},"PeriodicalIF":23.4,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143049672","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Re: Guillaume Ploussard, Patrick Coloby, Thierry Chevallier, et al. Whole-gland or Subtotal High-intensity Focused Ultrasound Versus Radical Prostatectomy: The Prospective, Noninferiority, Nonrandomized HIFI Trial. Eur Urol. In press. https://doi.org/10.1016/j.eururo.2024.11.006","authors":"Jason Koehler, Abhinav Sidana","doi":"10.1016/j.eururo.2024.12.021","DOIUrl":"https://doi.org/10.1016/j.eururo.2024.12.021","url":null,"abstract":"No Abstract","PeriodicalId":12223,"journal":{"name":"European urology","volume":"41 1","pages":""},"PeriodicalIF":23.4,"publicationDate":"2025-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143031089","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Congress Calendar","authors":"","doi":"10.1016/j.eururo.2024.12.011","DOIUrl":"https://doi.org/10.1016/j.eururo.2024.12.011","url":null,"abstract":"No Abstract","PeriodicalId":12223,"journal":{"name":"European urology","volume":"45 1","pages":""},"PeriodicalIF":23.4,"publicationDate":"2025-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143026301","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}