European urology最新文献

{"title":"Re: Marie-Pier St-Laurent, Bernard Bochner, James Catto, et al. Increasing Life Expectancy in Patients with Genitourinary Malignancies: Impact of Treatment Burden on Disease Management and Quality of Life. Eur Urol. In press. https://doi.org/10.1016/j.eururo.2024.11.026","authors":"Chang-kun Mao, , Jun-ting Li","doi":"10.1016/j.eururo.2025.01.024","DOIUrl":"https://doi.org/10.1016/j.eururo.2025.01.024","url":null,"abstract":"No Abstract","PeriodicalId":12223,"journal":{"name":"European urology","volume":"11 1","pages":""},"PeriodicalIF":23.4,"publicationDate":"2025-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143418455","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":"Combination Therapies in Locally Advanced and Metastatic Hormone-sensitive Prostate Cancer","authors":"Arun A. Azad ,&nbsp;Louise Kostos ,&nbsp;Neeraj Agarwal ,&nbsp;Gerhardt Attard ,&nbsp;Ian D. Davis ,&nbsp;Tanya Dorff ,&nbsp;Silke Gillessen ,&nbsp;Chris Parker ,&nbsp;Matthew R. Smith ,&nbsp;Christopher J. Sweeney ,&nbsp;Bertrand Tombal ,&nbsp;Karim Fizazi","doi":"10.1016/j.eururo.2025.01.010","DOIUrl":"10.1016/j.eururo.2025.01.010","url":null,"abstract":"<div><h3>Background and objective</h3><div>The treatment landscape for advanced prostate cancer has evolved significantly over the past decade. The introduction of docetaxel, androgen receptor pathway inhibitors (ARPIs), poly(ADP-ribose) polymerase inhibitors, and targeted radionuclides has redefined the treatment paradigm, with a focus now on early treatment intensification through combination therapies. This narrative collaborative review summarises the current evidence of combination therapies in locally advanced and metastatic hormone-sensitive prostate cancer (mHSPC).</div></div><div><h3>Methods</h3><div>We conducted a literature search up to November 2024. Search terms included “metastatic hormone-sensitive prostate cancer”, “metastatic castration-sensitive prostate cancer”, “locally advanced prostate cancer”, “combination”, “intensification”, and “de-escalation”. Articles were selected by the authors based on their scientific merit, clinical impact, and relevance to provide a summary of the evidence surrounding combination therapy in locally advanced prostate cancer and mHSPC.</div></div><div><h3>Key findings and limitations</h3><div>A doublet approach with an androgen deprivation therapy (ADT) backbone and an ARPI is now considered the standard treatment for mHSPC, with a triplet regimen incorporating docetaxel considered in select subgroups. Similar efforts to improve survival in the high-risk localised and locally advanced disease setting have led to several trials evaluating the benefit of combination therapy in addition to standard-of-care surgery or radiotherapy with ADT. Continued improvements in survival have turned the focus to optimising patient selection for treatment intensification and, in some cases, de-escalation, with the goal of reducing unnecessary overtreatment and minimising harm from long-term treatment toxicity. This is particularly important with the integration of prostate-specific membrane antigen positron emission tomography, which has led to the earlier detection of metastatic disease.</div></div><div><h3>Conclusions and clinical implications</h3><div>In select subgroups, early treatment intensification with combination therapy leads to improved survival, though it can be associated with long-term toxicity.</div></div>","PeriodicalId":12223,"journal":{"name":"European urology","volume":"87 4","pages":"Pages 455-467"},"PeriodicalIF":25.3,"publicationDate":"2025-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143401253","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-term Outcomes and Prognostic Impact of Residual Cancer Burden After Intensified Neoadjuvant Therapy in High-risk Prostate Cancer","authors":"Praful Ravi, Lucia Kwak, Andres M. Acosta, Saahil Rastogi, Wanling Xie, Aya Abdelnaser, David J. Einstein, Peter Chang, Andrew A. Wagner, Rana R. McKay, Adam S. Kibel, Mary-Ellen Taplin","doi":"10.1016/j.eururo.2025.01.015","DOIUrl":"https://doi.org/10.1016/j.eururo.2025.01.015","url":null,"abstract":"<h3>Background and objective</h3>Long-term outcomes and the prognostic impact of the extent of residual disease after neoadjuvant therapy (NAT) with androgen deprivation therapy (ADT) and an androgen receptor pathway inhibitor (ARPI) before radical prostatectomy (RP) for high-risk localized prostate cancer (HRLPC) are not known.<h3>Methods</h3>We analyzed data for patients treated in five trials evaluating 6 mo of ARPI NAT for HRLPC at our institution between 2006 and 2018. Residual cancer burden (RCB) was quantitated as the calculated tumor volume adjusted for cellularity in the primary tumor. The primary outcome was metastasis-free survival (MFS) according to conventional imaging. We explored RCB categories using the Contal-O’Quigley method to distinguish high- and low-risk groups for MFS.<h3>Key findings and limitations</h3>Among 218 eligible patients, median prostate-specific antigen at diagnosis was 8 ng/ml, 42 (20%) had cT3–4 disease, and 154 (71%) had a biopsy Gleason score of 8–10. At RP, 24 (11%) had a pathologic complete response and median RCB was 0.05 cm³ (interquartile range 0.00–0.32). By median follow-up of 5 yr, 45 patients had developed metastases and 11 died; the 5-yr MFS rate was 83% (95% confidence interval [CI] 77–88%). On multivariable analysis, higher RCB was associated with poorer MFS (hazard ratio 1.21, 95% CI 1.01–1.47). The 5-yr MFS rates were 100%, 90% (95% CI 72–97%), 82% (95% CI 73–88%), and 63% (95% CI 40–79%) for patients with RCB-0 (a pathologic complete response or no residual disease), RCB-1 (&lt;0.003 cm³), RCB-2 (0.003–0.672 cm³), and RCB-3 (≥0.672 cm³), respectively. The key limitation is lack of a validation cohort.<h3>Conclusions and clinical implications</h3>The 5-yr MFS rate for patients treated with ARPI NAT before RP for HRLPC was 83%. The depth of pathologic response, evaluated as the RCB, was highly prognostic for MFS. RCB could be used to guide NAT and post-NAT adjuvant trials in HRLPC.","PeriodicalId":12223,"journal":{"name":"European urology","volume":"11 1","pages":""},"PeriodicalIF":23.4,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143258067","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: Tracking Nongenetic Evolution from Primary to Metastatic ccRCC: TRACERx Renal","authors":"Hanzhong Zhang, Ying Liu, Peng Luo, Linhui Wang, Aimin Jiang","doi":"10.1016/j.eururo.2025.01.019","DOIUrl":"https://doi.org/10.1016/j.eururo.2025.01.019","url":null,"abstract":"No Abstract","PeriodicalId":12223,"journal":{"name":"European urology","volume":"55 1","pages":""},"PeriodicalIF":23.4,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143192030","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: Immunogenomic Determinants of Exceptional Response to Immune Checkpoint Inhibition in Renal Cell Carcinoma","authors":"Hanzhong Zhang, Ying Liu, Anqi Lin, Linhui Wang, Aimin Jiang","doi":"10.1016/j.eururo.2025.01.021","DOIUrl":"https://doi.org/10.1016/j.eururo.2025.01.021","url":null,"abstract":"No Abstract","PeriodicalId":12223,"journal":{"name":"European urology","volume":"9 1","pages":""},"PeriodicalIF":23.4,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143192029","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":"Reply to Jason Koehler and Abhinav Sidana’s Letter to the Editor 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. 2025;87:526–533","authors":"Pascal Rischmann ,&nbsp;Bob-Valéry Occéan ,&nbsp;Guillaume Ploussard","doi":"10.1016/j.eururo.2025.01.022","DOIUrl":"10.1016/j.eururo.2025.01.022","url":null,"abstract":"","PeriodicalId":12223,"journal":{"name":"European urology","volume":"87 5","pages":"Pages e90-e91"},"PeriodicalIF":25.3,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143192028","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: 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 ,&nbsp;Yasmin Abu Ghanem ,&nbsp;Laurence Albiges ,&nbsp;Stephanie Bonn ,&nbsp;Riccardo Campi ,&nbsp;Umberto Capitanio ,&nbsp;Saeed Dabestani ,&nbsp;Milan Hora ,&nbsp;Tobias Klatte ,&nbsp;Teele Kuusk ,&nbsp;Lars Lund ,&nbsp;Lorenzo Marconi ,&nbsp;Carlotta Palumbo ,&nbsp;Geraldine Pignot ,&nbsp;Thomas Powles ,&nbsp;Maxine Tran ,&nbsp;Alessandro Volpe ,&nbsp;Axel Bex","doi":"10.1016/j.eururo.2025.01.014","DOIUrl":"10.1016/j.eururo.2025.01.014","url":null,"abstract":"<div><div>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.</div></div><div><h3>Patient summary</h3><div>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.</div></div>","PeriodicalId":12223,"journal":{"name":"European urology","volume":"87 4","pages":"Pages 491-496"},"PeriodicalIF":25.3,"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":"Honing Stratification and Treatment for High-risk Prostate Cancer","authors":"Sophia C. Kamran,&nbsp;Jason A. Efstathiou","doi":"10.1016/j.eururo.2024.07.007","DOIUrl":"10.1016/j.eururo.2024.07.007","url":null,"abstract":"","PeriodicalId":12223,"journal":{"name":"European urology","volume":"87 2","pages":"Pages 225-227"},"PeriodicalIF":25.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141904009","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}