European urology最新文献

{"title":"Long-term Outcomes and Patterns of Relapse Following High-dose Elective Salvage Radiotherapy and Hormone Therapy in Oligorecurrent Pelvic Nodes in Prostate Cancer: OLIGOPELVIS (GETUG-P07)","authors":"Loig Vaugier ,&nbsp;Cyrille Morvan ,&nbsp;David Pasquier ,&nbsp;Xavier Buthaud ,&nbsp;Nicolas Magné ,&nbsp;Veronique Beckendorf ,&nbsp;Paul Sargos ,&nbsp;Gilles Crehange ,&nbsp;Pascal Pommier ,&nbsp;Genevieve Loos ,&nbsp;Ali Hasbini ,&nbsp;Igor Latorzeff ,&nbsp;Marlon Silva ,&nbsp;Julie Paul ,&nbsp;Audrey Blanc-Lapierre ,&nbsp;Stéphane Supiot","doi":"10.1016/j.eururo.2024.02.013","DOIUrl":"10.1016/j.eururo.2024.02.013","url":null,"abstract":"<div><h3>Background and Objective</h3><div>Androgen deprivation therapy (ADT) is a mainstay in metastatic prostate cancer, while additional salvage radiotherapy may offer prolonged remission for patients with regional node relapses. We performed an open-label, phase II trial to assess the long-term outcomes and patterns of relapse of 6-months ADT and elective pelvic radiotherapy in men with oligorecurrent (&lt;6) pelvic nodes in prostate cancer (Oligopelvis GETUG-P07).</div></div><div><h3>Methods</h3><div>We analyzed the 5-yr outcomes. Progression was defined as two consecutive prostate-specific antigen levels above the level at inclusion and/or clinical progression as per RECIST 1.1 and/or death from any cause.</div></div><div><h3>Key Findings and Limitations</h3><div>Sixty-seven patients were recruited. The median follow-up was 6.1 yr (95%CI: 5.9-6.3). Grade 2+ 3-yr, 4-yr and 5-yr genito-urinary and gastro-intestinal toxicities affected 15%, 9%, 4% and 2%, 3%, 4% of non-progressive patients, respectively. 5-yr progression-free, biochemical relapse–free and ADT-free survivals were 39%, 31% and 64%, respectively. In total, 45 patients had progression and 38 had the following clinical progression: local (18%), N1 (29%), M1a (50%), M1b (32%) and M1c (11%).</div></div><div><h3>Conclusions and Clinical Implications</h3><div>Finally, combined elective pelvic radiotherapy and ADT appeared to prolong tumor control with limited toxicity. At 5 years, one third of patients had not relapsed biochemically. The major site of relapse was para-aortic lymph nodes.</div></div>","PeriodicalId":12223,"journal":{"name":"European urology","volume":"87 1","pages":"Pages 73-76"},"PeriodicalIF":25.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140137548","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.2024.11.021","DOIUrl":"10.1016/j.eururo.2024.11.021","url":null,"abstract":"","PeriodicalId":12223,"journal":{"name":"European urology","volume":"87 1","pages":"Pages e20-e21"},"PeriodicalIF":25.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142816210","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":"Sample Site Impacts RNA Biomarkers for Renal Cell Carcinoma","authors":"Lennert Eismann ,&nbsp;Amy X. Xie ,&nbsp;Cerise Tang ,&nbsp;Andrea Knezevic ,&nbsp;Irina Ostrovnaya ,&nbsp;Fengshen Kuo ,&nbsp;A. Ari Hakimi ,&nbsp;Ed Reznik ,&nbsp;Ritesh R. Kotecha","doi":"10.1016/j.eururo.2024.09.004","DOIUrl":"10.1016/j.eururo.2024.09.004","url":null,"abstract":"<div><div>Immunotherapy (ICIs) remains a mainstay for treatment of advanced clear-cell renal cell carcinoma (ccRCC). Biomarker analyses have demonstrated that gene expression profiles are associated with regimen-specific outcomes. These transcriptomic analyses used mixed sample cohorts (primary and metastatic tumor specimens) and it is unknown whether the clinical relevance of transcriptomic signatures is impacted by tissue site. We evaluated data for 1132 patients with metastatic ccRCC treated with ICI in prior studies (IMmotion151 and CheckMate-009, -010, and -025). We identified significant and reproducible differences in gene expression by tissue site. We tested the association between previously described molecular tissue clusters (MTCs) by tissue site (MTC1-primary and MTC1-metastasis) and progression-free survival (PFS) and objective response to systemic therapy. In IMmotion151, MTC2-metastasis was significantly associated with better PFS on sunitinib (hazard ratio [HR] 3.39, 95% confidence interval [CI] 1.32–8.69; <em>p</em> = 0.01) in comparison to MTC2-primary (HR 0.95, 95% CI 0.65–1.38; <em>p</em> = 0.80; <em>p</em>_interaction = 0.02). Evaluation of known RNA signatures in the CheckMate trials revealed that JAVELIN-metastasis was associated with better PFS on ICI (HR 0.77, 95% CI 0.62–0.97; <em>p</em> = 0.03) in comparison to JAVELIN-primary (HR 1.04, 95% CI 0.91–1.19; <em>p</em> = 0.56; <em>p</em>_interaction = 0.02). These results indicate that tissue site may be a relevant confounder in biomarker analyses.</div></div>","PeriodicalId":12223,"journal":{"name":"European urology","volume":"87 1","pages":"Pages 79-83"},"PeriodicalIF":25.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11646181/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142368015","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":"Dose-escalated Adaptive Radiotherapy for Bladder Cancer: Results of the Phase 2 RAIDER Randomised Controlled Trial","authors":"Robert Huddart ,&nbsp;Shaista Hafeez ,&nbsp;Clare Griffin ,&nbsp;Ananya Choudhury ,&nbsp;Farshad Foroudi ,&nbsp;Isabel Syndikus ,&nbsp;Benjamin Hindson ,&nbsp;Amanda Webster ,&nbsp;Helen McNair ,&nbsp;Alison Birtle ,&nbsp;Mohini Varughese ,&nbsp;Ann Henry ,&nbsp;Duncan B McLaren ,&nbsp;Omi Parikh ,&nbsp;Ashok Nikapota ,&nbsp;Colin Tang ,&nbsp;Emma Patel ,&nbsp;Elizabeth Miles ,&nbsp;Karole Warren-Oseni ,&nbsp;Tomas Kron ,&nbsp;Emma Hall","doi":"10.1016/j.eururo.2024.09.006","DOIUrl":"10.1016/j.eururo.2024.09.006","url":null,"abstract":"<div><h3>Background and objective</h3><div>Delivering radiotherapy to the bladder is challenging as it is a mobile, deformable structure. Dose-escalated adaptive image-guided radiotherapy could improve outcomes. RAIDER aimed to demonstrate the safety of such a schedule.</div></div><div><h3>Methods</h3><div>RAIDER is an international phase 2 noncomparative randomised controlled trial (ISRCTN26779187). Patients with unifocal T2-T4a urothelial bladder cancer were randomised (1:1:2) to standard whole bladder radiotherapy (WBRT), standard-dose adaptive radiotherapy (SART), or dose-escalated adaptive radiotherapy (DART). Two fractionation (f) schedules recruited independently. WBRT and SART dose was 55 Gy/20f or 64 Gy/32f, and DART dose was 60 Gy/20f or 70 Gy/32f. For SART and DART, a radiotherapy plan (small, medium, or large) was chosen daily. The primary endpoint was the proportion of patients with radiotherapy-related late Common Terminology Criteria for Adverse Events grade ≥3 toxicity; the trial was designed to rule out &gt;20% toxicity with DART.</div></div><div><h3>Key findings and limitations</h3><div>A total of 345 patients were randomised between October 2015 and April 2020: 41/46 WBRT, 41/46 SART, and 81/90 DART patients in the 20f/32f cohorts, respectively. The median age was 72/73 yr; 78%/85% had T2 tumours, 46%/52% had neoadjuvant chemotherapy, and 70%/71% had radiosensitising therapy. The median follow-up was 42.1/38.2 mo. Sixty-six of 77 (86%) 20f and 74 of 82 (90%) 32f participants planned for DART met the mandatory medium plan dose constraints. Radiotherapy-related grade ≥3 toxicity was reported in one of 58 patients (90% confidence interval [CI] 0.1, 7.9) with 20f DART and zero of 56 patients with 32f DART. Two-year overall survival was 77% (95% CI 69, 82) for WBRT + SART and 80% (95% CI 73, 85) for DART (hazard ratio = 0.84, 95% CI 0.59, 1.21, <em>p</em> = 0.4). Thirteen of 345 (3.8%) participants had salvage cystectomy.</div></div><div><h3>Conclusions and clinical implications</h3><div>Grade ≥3 late toxicity was low. DART was safe and feasible to deliver, meeting preset toxicity thresholds. Disease-related outcomes are promising for dose-escalated treatments, with a low salvage cystectomy rate and overall survival similar to that seen in cystectomy cohorts.</div></div>","PeriodicalId":12223,"journal":{"name":"European urology","volume":"87 1","pages":"Pages 60-70"},"PeriodicalIF":25.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142384055","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":"Testosterone Recovery Following Androgen Suppression and Prostate Radiotherapy (TRANSPORT): A Pooled Analysis of Five Randomized Trials from the Meta-Analysis of Randomized Trials in Cancer of the Prostate (MARCAP) Consortium","authors":"Wee Loon Ong ,&nbsp;Tahmineh Romero ,&nbsp;Soumyajit Roy ,&nbsp;John Nikitas ,&nbsp;David Joseph ,&nbsp;Almudena Zapatero ,&nbsp;Shawn Malone ,&nbsp;Scott C. Morgan ,&nbsp;Michael L. Steinberg ,&nbsp;Luca F. Valle ,&nbsp;Nicholas G. Zaorsky ,&nbsp;Ting Martin Ma ,&nbsp;Matthew B. Rettig ,&nbsp;Nicholas Nickols ,&nbsp;Tommy Jiang ,&nbsp;Robert E. Reiter ,&nbsp;Sriram V. Eleswarapu ,&nbsp;Xavier Maldonado ,&nbsp;Yilun Sun ,&nbsp;Paul L. Nguyen ,&nbsp;Amar U. Kishan","doi":"10.1016/j.eururo.2024.09.009","DOIUrl":"10.1016/j.eururo.2024.09.009","url":null,"abstract":"<div><h3>Background and objective</h3><div>Time to testosterone recovery (TR) following androgen deprivation therapy (ADT) with gonadotropin-releasing hormone agonists varies widely. We evaluate TR kinetics and the oncological impact of an effective castration period in patients receiving definitive radiotherapy and ADT for prostate cancer.</div></div><div><h3>Methods</h3><div>We obtained individual patient data from randomized controlled trials of radiotherapy with ADT and prospectively collected serial testosterone data from the MARCAP Consortium. We estimated the times to noncastrate TR (&gt;1.7 nmol/l) and nonhypogonadal TR (&gt;8.0 nmol/l) were estimated for each prescribed ADT duration, and developed corresponding nomograms. The association between effective castration period and metastasis-free survival (MFS) for any given ADT duration was evaluated via multivariable Cox regression. We conducted cubic spline analyses to assess nonlinear associations.</div></div><div><h3>Key findings and limitations</h3><div>We included 1444 men from five trials in the analysis, of whom 115 received 4 mo, 880 received 6 mo, 353 received 18 mo, 36 received 28 mo, and 60 received 36 mo of ADT. Times to noncastrate TR and to nonhypogonadal TR varied considerably by ADT duration. Higher baseline testosterone and lower age were associated with a higher likelihood of TR (<em>p</em> &lt; 0.001 for both). Effective castration period was not linearly associated with MFS for any ADT duration on Cox regression. Cubic spline analysis revealed that the optimal effective castration period for an MFS benefit was 10.6 mo for men who received 6 mo of ADT and 18 mo for men who received 18 mo of ADT.</div></div><div><h3>Conclusions and clinical implications</h3><div>Time to TR varies according to the ADT duration, baseline testosterone, and age. The relationship between effective castration period and MFS may be nonlinear, with a longer effective castration period being helpful for men receiving 6 mo of ADT.</div></div>","PeriodicalId":12223,"journal":{"name":"European urology","volume":"87 1","pages":"Pages 49-57"},"PeriodicalIF":25.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142304608","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":"Sensitive Detection of Urothelial Cancer via High-volume Urine DNA Analysis","authors":"Jussi Nikkola ,&nbsp;Lauri Ryyppö ,&nbsp;Juuso Vuorinen ,&nbsp;Heini Kallio ,&nbsp;Hanna Selin ,&nbsp;Pyry Jämsä ,&nbsp;Jonne Åkerla ,&nbsp;Tuomo Virtanen ,&nbsp;Tarmo Pekkarinen ,&nbsp;Antti Kaipia ,&nbsp;Johanna Pulkkinen ,&nbsp;Gillian Vandekerkhove ,&nbsp;David C. Müller ,&nbsp;Alexander W. Wyatt ,&nbsp;Peter C. Black ,&nbsp;Matti Nykter ,&nbsp;Thea Veitonmäki ,&nbsp;Matti Annala","doi":"10.1016/j.eururo.2024.10.014","DOIUrl":"10.1016/j.eururo.2024.10.014","url":null,"abstract":"","PeriodicalId":12223,"journal":{"name":"European urology","volume":"87 1","pages":"Pages 86-88"},"PeriodicalIF":25.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142487074","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":"OLIGOPELVIS and the “All You Can Eat” Strategy for Oligorecurrent Nodal Prostate Cancer: Are We Already Full?","authors":"Piet Ost ,&nbsp;Shankar Siva ,&nbsp;Thomas Zilli","doi":"10.1016/j.eururo.2024.03.039","DOIUrl":"10.1016/j.eururo.2024.03.039","url":null,"abstract":"","PeriodicalId":12223,"journal":{"name":"European urology","volume":"87 1","pages":"Pages 77-78"},"PeriodicalIF":25.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140873861","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: Pieter Vynckier, Lieven Annemans, Sarah Raes, et al. Systematic Review on the Cost Effectiveness of Prostate Cancer Screening in Europe. Eur Urol. 2024;86:400–408","authors":"Andrés Gutiérrez ,&nbsp;Julio Cesar Boada ,&nbsp;Sebastián Peña","doi":"10.1016/j.eururo.2024.08.027","DOIUrl":"10.1016/j.eururo.2024.08.027","url":null,"abstract":"","PeriodicalId":12223,"journal":{"name":"European urology","volume":"87 1","pages":"Pages e12-e13"},"PeriodicalIF":25.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142116444","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":"Tissue-based Biomarkers Steering Clinical Decisions in Patients with Urothelial Cancer","authors":"Luca Afferi ,&nbsp;Alessia Cimadamore ,&nbsp;Andrea Gallioli ,&nbsp;Benjamin Pradere ,&nbsp;Laura S. Mertens ,&nbsp;Gautier Marcq ,&nbsp;Georgia Anguera ,&nbsp;Andrea Necchi ,&nbsp;Alberto Briganti ,&nbsp;Francesco Montorsi ,&nbsp;Morgan Rouprêt ,&nbsp;Paolo Gontero ,&nbsp;Alberto Breda ,&nbsp;Marco Moschini ,&nbsp;European Association of Urology Young Academic Urologists Urothelial Carcinoma Working Group","doi":"10.1016/j.eururo.2024.08.033","DOIUrl":"10.1016/j.eururo.2024.08.033","url":null,"abstract":"","PeriodicalId":12223,"journal":{"name":"European urology","volume":"87 1","pages":"Pages 1-4"},"PeriodicalIF":25.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142304609","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":"From a Storm to Sunshine: The Future of Bladder-sparing Therapy is Bright","authors":"Paul Sargos ,&nbsp;Evanguelos Xylinas ,&nbsp;Jonathan Khalifa","doi":"10.1016/j.eururo.2024.09.031","DOIUrl":"10.1016/j.eururo.2024.09.031","url":null,"abstract":"","PeriodicalId":12223,"journal":{"name":"European urology","volume":"87 1","pages":"Pages 71-72"},"PeriodicalIF":25.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142384484","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}