European urology oncology最新文献

{"title":"Prevalence of Kidney Cancer in Attendees for Combined Lung and Kidney Cancer Screening by Computed Tomography Scanning.","authors":"Sabrina H Rossi, Jessica Kitt, Angela Godoy, Fiona Farquhar, Jon Cartledge, Michael Kimuli, Hannah Bailey, Simon Burbidge, Neil Hancock, Catriona Marshall, Suzanne Rogerson, Matthew E J Callister, Juliet A Usher-Smith, Grant D Stewart","doi":"10.1016/j.euo.2025.07.004","DOIUrl":"https://doi.org/10.1016/j.euo.2025.07.004","url":null,"abstract":"<p><p>Kidney cancer (KC) screening may be facilitated by targeting individuals at a higher risk and combining with other screening programmes. Previous estimates of the prevalence of screen-detected KC are outdated and do not enable an accurate assessment in a high-risk group. The Yorkshire Kidney Screening Trial (YKST) is a unique study of the feasibility of adding KC screening via an abdominal noncontrast computed tomography (CT) scan to the thoracic low-dose CT within a targeted lung cancer screening trial in ever smokers (Yorkshire Lung Screening Trial; YLST). Seventeen histologically confirmed KC cases were detected on thoracic CT in YLST (N = 6650; prevalence 0.26%; 95% confidence interval [CI] 0.15-0.41%), which has implications for future service planning to accommodate the investigation and treatment of screen-detected KC patients following the national adoption of lung cancer screening. Adding abdominal CT in YKST (n = 4019) identified an additional ten histologically confirmed KC patients (prevalence 0.25%; 95% CI 0.12-0.46%). In summary, using data from YKST, we report the first contemporary estimates of the prevalence of KC in high-risk individuals, key data required to plan future prospective screening studies.</p>","PeriodicalId":12256,"journal":{"name":"European urology oncology","volume":" ","pages":""},"PeriodicalIF":9.3,"publicationDate":"2025-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144947963","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":"Development of a Health-related Quality of Life Questionnaire for Patients with Metastatic or Localized Renal Cell Carcinoma.","authors":"Cristiane D Bergerot, David Cella, Paulo G Bergerot, Daniela V Castro, Benjamin D Mercier, Elizabeth Nally, Adil A Ali, Errol J Philip, Thomas Hutson, Axel Bex, Sarah P Psutka, Brian Rini, Elizabeth R Plimack, Viktor Grünwald, Viraj Master, Laurence Albiges, Toni K Choueiri, Sumanta K Pal, Thomas Powles","doi":"10.1016/j.euo.2025.07.012","DOIUrl":"10.1016/j.euo.2025.07.012","url":null,"abstract":"<p><strong>Background and objective: </strong>Despite significant advances in treatments for renal cell carcinoma (RCC) over the past decade, health-related quality of life (HRQOL) assessments have not been updated to reflect these developments. The aim of our study was to refine assessment of HRQOL for patients with localized or metastatic RCC.</p><p><strong>Methods: </strong>We conducted a four-phase international study (August 2022-October 2024). Phase 1 involved a patient survey identifying relevant HRQOL issues. In phase 2, an expert panel refined items, followed by patient advocate feedback in phase 3. Phase 4 harmonized items with the Functional Assessment of Chronic Illness Therapy library for consistency across RCC stages. Data analysis included descriptive statistics and qualitative analysis of the content.</p><p><strong>Key findings and limitations: </strong>Of 54 items from the Functional Assessment of Cancer Therapy-Kidney Symptom Index (FKSI-19), European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30, and EuroQol Group-Five Dimension questionnaires, the metastatic RCC cohort endorsed 15 items, while the localized RCC cohort endorsed six. Expert panel review and patient advocate feedback resulted in a revised 23-item FKSI questionnaire with targeted subsets of 11 items for localized RCC and 12 items for metastatic RCC. Application of a relevance threshold of 66% ensured clinical significance but limited the sensitivity. Future studies could explore complementary approaches to refine item selection and enhance score interpretability. Study limitations include a potentially limited patient sample and reliance on patient recall of patient-reported outcomes.</p><p><strong>Conclusions and clinical implications: </strong>We successfully developed item subsets of the FKSI-23 questionnaire that address the multifaceted impact of localized and metastatic RCC on patients' HRQOL. These two clinical settings required distinct tools for optimal measurement of HRQOL. Validation of the resulting FKSI-23 tool is under way in forthcoming clinical trials.</p>","PeriodicalId":12256,"journal":{"name":"European urology oncology","volume":" ","pages":""},"PeriodicalIF":9.3,"publicationDate":"2025-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144882504","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":"Challenges in Follow-up After Kidney-sparing Surgery for Upper Tract Urothelial Carcinoma: Insights from a Delphi Consensus.","authors":"Orlane Figaroa, Hugo Schuil, Guido Kamphuis, Luna van den Brink, Nora Hendriks, Michaël Henderickx, Adriaan Bins, Jeroen van Moorselaar, Leye Ajayi, Mieke Bus, Vitor Cavadas, Cecilia Maria Cracco, David D Andrea, Ranan Dasgupta, Vincent De Coninck, Otas Durutovic, Ida Ebbensgaard, Stefania Ferretti, Andrea Gallioli, Etienne Xavier Keller, Francis Xavier Keeley, Palle Jörn Sloth Osther, Marcin Popiolek, Benjamin Pradere, Silvia Proietti, Iliya Saltirov, Bhaskar Somani, Thomas Tailly, Kay Thomas, Ben Turney, Øyvind Ulvik, Carl Van Haute, Bart van der Heij, Juan Luis Vasquez, Marianne Brehmer, Joyce Baard","doi":"10.1016/j.euo.2025.07.003","DOIUrl":"https://doi.org/10.1016/j.euo.2025.07.003","url":null,"abstract":"<p><strong>Background and objective: </strong>Kidney-sparing surgery (KSS) is the preferred treatment for patients with low-risk upper tract urothelial carcinoma (UTUC), offering a balance between oncologic efficacy and renal preservation. However, follow-up protocols are lacking due to insufficient evidence, resulting in clinical variability. In response, a Delphi consensus process has been initiated with the aim to refine and establish unified surveillance recommendations following KSS for low-risk UTUC.</p><p><strong>Methods: </strong>A multistage Delphi consensus project was conducted by an expert panel, which completed four rounds of questionnaires using both open-ended and Likert scale-based questions, with the goal of achieving consensus on four key topics.</p><p><strong>Key findings and limitations: </strong>In total, 28 invited experts participated in the Delphi panel, achieving consensus on the primary goals of UTUC follow-up, including tumour recurrence detection, renal function preservation, and maintaining quality of life. While consensus was reached on key diagnostic modalities (kidney function, computed tomography urography, cystoscopy, and ureteroscopy) and follow-up adjustments based on treatment indications, the precise schedules and long-term follow-up duration remained unresolved.</p><p><strong>Conclusions and clinical implications: </strong>This Delphi project underscores the challenges of standardising follow-up protocols after KSS for UTUC. A balanced approach is needed to ensure early recurrence detection while preserving renal function and quality of life. Robust data on prognostic factors are essential to better identify patients at risk of recurrence and to refine surveillance strategies. Collaborative research remains essential for developing evidence-based follow-up protocols for this rare disease.</p>","PeriodicalId":12256,"journal":{"name":"European urology oncology","volume":" ","pages":""},"PeriodicalIF":9.3,"publicationDate":"2025-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144859071","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 Hatice Bolek's Letter to the Editor re: Hilin Yildirim, Katja K.H. Aben, Maarten J. Bijlsma, et al. A Nationwide Real-world Evaluation of Upfront Cytoreductive Nephrectomy in Patients with Synchronous Metastatic Renal Cell Carcinoma in the Immunotherapy Era. Eur Urol Oncol 2025;8:623-31.","authors":"Hilin Yildirim, Adriaan D Bins, Axel Bex, Patricia J Zondervan","doi":"10.1016/j.euo.2025.07.013","DOIUrl":"https://doi.org/10.1016/j.euo.2025.07.013","url":null,"abstract":"","PeriodicalId":12256,"journal":{"name":"European urology oncology","volume":" ","pages":""},"PeriodicalIF":9.3,"publicationDate":"2025-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144855037","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: Hilin Yildirim, Katja K.H. Aben, Maarten J. Bijlsma, et al. A Nationwide Real-world Evaluation of Upfront Cytoreductive Nephrectomy in Patients with Synchronous Metastatic Renal Cell Carcinoma in the Immunotherapy Era. Eur Urol Oncol 2025;8:623-31.","authors":"Hatice Bolek","doi":"10.1016/j.euo.2025.06.014","DOIUrl":"https://doi.org/10.1016/j.euo.2025.06.014","url":null,"abstract":"","PeriodicalId":12256,"journal":{"name":"European urology oncology","volume":" ","pages":""},"PeriodicalIF":9.3,"publicationDate":"2025-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144816136","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":"Results of the Prospective Randomized UroFollow Trial Comparing Marker-guided Versus Cystoscopy-based Surveillance in Patients with Low/Intermediate-risk Bladder Cancer","authors":"Bernd J. Schmitz-Dräger ,&nbsp;Ekkehardt Bismarck ,&nbsp;Florian Roghmann ,&nbsp;Nicolas von Landenberg ,&nbsp;Joachim Noldus ,&nbsp;Daniela Jahn ,&nbsp;Karoline Kernig ,&nbsp;Oliver W. Hakenberg ,&nbsp;Peter J. Goebell ,&nbsp;Jörg Hennenlotter ,&nbsp;Eva Erne ,&nbsp;Arnulf Stenzl ,&nbsp;Maciej Rowinski ,&nbsp;Guido Schiffhorst ,&nbsp;Thomas Baranek ,&nbsp;Natalya Benderska-Söder","doi":"10.1016/j.euo.2025.04.020","DOIUrl":"10.1016/j.euo.2025.04.020","url":null,"abstract":"<div><h3>Background and objective</h3><div>A growing body of evidence suggests that the intensity of current follow-up in non–muscle-invasive bladder cancer (NMIBC) patients greatly exceeds clinical necessities. The Uro<em>Follow</em> trial investigated the diagnostic accuracy of marker-based follow-up in patients with low/intermediate-risk NMIBC against the standard of care (SOC) for noninferiority (margin: &lt;20%).</div></div><div><h3>Methods</h3><div>Patients with Ta low- and high-grade (G1–2) NMIBC were randomized to the SOC or 6-monthly marker-based follow-up (algorithm comprising urine markers and ultrasound; marker-based surveillance regimen [MA]). After a negative 3-mo cystoscopy (white light cystoscopy [WLC]), only patients with a positive algorithm underwent WLC in the MA. End-of-study WLC was recommended at 3 yr to recurrence-free patients. Simultaneously, several innovative urine markers were examined.</div></div><div><h3>Key findings and limitations</h3><div>In total, 214 patients were randomized to the SOC (<em>n</em> = 109) and MA (<em>n</em> = 105). The median follow-up was 2.4 yr; 30 and 29 cases of tumor recurrence were diagnosed in the SOC and MA arms, respectively. Sensitivity was 96.5% versus 81.5% (<em>p</em> = 0.1), with one and five Ta low-grade tumors being overlooked in the SOC and MA patients, respectively. No tumor progressing in stage or grade was missed. A total of 589 WLC procedures were performed in the SOC and 148 in the MA arm (<em>p</em> &lt; 0.001). Among five other markers (ADX-Bladder, CellDetect, Bladder EpiCheck, UBC rapid, and Xpert bladder cancer monitor [BC-M]), Bladder EpiCheck and the Xpert BC-M showed similar performance to the algorithm.</div></div><div><h3>Conclusions and clinical implications</h3><div>Uro<em>Follow</em> is the first urine marker–based randomized trial in low/intermediate-risk NMIBC patients. We conclude that 6-monthly marker-based follow-up after negative 3-mo WLC is safe in this cohort. Results of contemporary urine markers suggest that their potential for use in marker-based surveillance, however, requires prospective confirmation.</div></div>","PeriodicalId":12256,"journal":{"name":"European urology oncology","volume":"8 4","pages":"Pages 1041-1049"},"PeriodicalIF":9.3,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144005284","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":"Avelumab First-line Maintenance for Advanced Urothelial Carcinoma: Long-term Analyses of Patient-reported Outcomes and Quality-adjusted Time Without Symptoms or Toxicity from the JAVELIN Bladder 100 Trial","authors":"Petros Grivas ,&nbsp;Jeanny B. Aragon-Ching ,&nbsp;Joaquim Bellmunt ,&nbsp;Yohann Loriot ,&nbsp;Miguel A. Climent Duran ,&nbsp;Srikala S. Sridhar ,&nbsp;Po-Jung Su ,&nbsp;Se Hoon Park ,&nbsp;Evgeny Kopyltsov ,&nbsp;Yoshiaki Yamamoto ,&nbsp;Natalia Jacob ,&nbsp;Jason Hoffman ,&nbsp;Karin Tyroller ,&nbsp;Juliane Manitz ,&nbsp;Mairead Kearney ,&nbsp;Michael Schlichting ,&nbsp;Thomas Powles","doi":"10.1016/j.euo.2025.04.004","DOIUrl":"10.1016/j.euo.2025.04.004","url":null,"abstract":"<div><h3>Background and objective</h3><div>In JAVELIN Bladder 100, avelumab first-line maintenance plus best supportive care (BSC) significantly prolonged overall survival versus BSC alone, with no detrimental impact on quality of life (QOL), in patients with advanced urothelial carcinoma without progression following first-line platinum-based chemotherapy. We report long-term analyses of patient-reported outcomes (PROs) in patients treated with avelumab (any duration or ≥12 mo) and a post hoc analysis comparing quality-adjusted time without symptoms or toxicity (Q-TWiST) between arms.</div></div><div><h3>Methods</h3><div>PROs were assessed using National Comprehensive Cancer Network/Functional Assessment of Cancer Therapy Bladder Symptom Index-18 (FBlSI-18) and EuroQol 5-level EQ-5D (EQ-5D-5L). Q-TWiST was calculated as the utility-weighted sum of mean time in three health states: time with all-cause grade 3/4 toxicity prior to progression, time without grade 3/4 toxicity or symptoms of progression, and time after progression.</div></div><div><h3>Key findings and limitations</h3><div>In the overall avelumab plus BSC arm (<em>n</em> = 350) and the subgroup treated for ≥12 mo (<em>n</em> = 118), completion rates for PRO assessments during treatment were &gt;80%. FBlSI-18 total and EQ-5D-5L index scores remained stable throughout 24 mo of treatment, with no clinically important changes from baseline. The mean Q-TWiST was 18.46 mo with avelumab plus BSC versus 15.13 mo with BSC alone (22% relative improvement). Limitations include open-label trial design and small patient numbers at later cycles.</div></div><div><h3>Conclusions and clinical implications</h3><div>Patients receiving avelumab had preserved health-related QOL and control of cancer-related symptoms with manageable toxicity, further supporting avelumab first-line maintenance as the recommended treatment for advanced urothelial carcinoma not progressed after platinum-based chemotherapy.</div></div>","PeriodicalId":12256,"journal":{"name":"European urology oncology","volume":"8 4","pages":"Pages 941-951"},"PeriodicalIF":9.3,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144005479","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":"Every Other Day or Once a Week: Long-term Oncological Outcomes in the Phase 2 PATRIOT Trial of Prostate Stereotactic Ablative Body Radiotherapy","authors":"Wee Loon Ong ,&nbsp;Harvey Quon ,&nbsp;Aldrich Ong ,&nbsp;Patrick Cheung ,&nbsp;William Chu ,&nbsp;Hans Chung ,&nbsp;Danny Vesprini ,&nbsp;Amit Chowdhury ,&nbsp;Dilip Panjwani ,&nbsp;Yasir Alayed ,&nbsp;Geordi Pang ,&nbsp;Renee Korol ,&nbsp;Melanie Davidson ,&nbsp;Ananth Ravi ,&nbsp;Boyd McCurdy ,&nbsp;Liying Zhang ,&nbsp;Meghan Kulasingham-Poon ,&nbsp;Alexandre Mamedov ,&nbsp;Andrea Deabreu ,&nbsp;Andrew Loblaw","doi":"10.1016/j.euo.2025.03.011","DOIUrl":"10.1016/j.euo.2025.03.011","url":null,"abstract":"<div><h3>Background and objective</h3><div>The PATRIOT multicentre phase 2 trial showed that prolongation of overall treatment time (OTT) for prostate stereotactic ablative body radiotherapy (SABR) was associated with better acute bowel and urinary quality of life. However, the impact on long-term cancer outcomes is unclear.</div></div><div><h3>Methods</h3><div>Men with favourable-risk localised prostate cancer in the PATRIOT trial were randomised to five-fraction prostate SABR every other day (EOD; <em>n</em> = 77) or once weekly (QW; <em>n</em> = 75).The cancer outcomes evaluated in this post hoc analyses were biochemical failure (BF), metastasis-free survival (MFS), prostate cancer–specific survival (PCSS), and overall survival (OS).</div></div><div><h3>Key findings and limitations</h3><div>Median follow-up was 91 mo. The 8-yr cumulative incidence rates for BF were 5.5% in the EOD arm versus 9.6% the QW arm (<em>p</em> = 0.2). The 8-yr probability rates were 100% versus 95.9% for MFS (<em>p</em> = 0.08), 100% versus 97.2% for PCSS (<em>p</em> = 0.2), and 96.0% versus 85.4% for OS (<em>p</em> = 0.3) for the EOD versus QW arms, respectively. The study is limited by the small sample size (powered to detect significant differences in acute bowel quality of life).</div></div><div><h3>Conclusions</h3><div>This study suggests no significant differences in long-term cancer outcomes between EOD and QW schedules for five-fraction prostate SABR.</div><div>This trial is registered on ClinicalTrials.gov as NCT01423474.</div></div>","PeriodicalId":12256,"journal":{"name":"European urology oncology","volume":"8 4","pages":"Pages 909-913"},"PeriodicalIF":9.3,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144005649","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":"Randomized Phase 2 Trial of Presurgical Androgen Deprivation Therapy With or Without Axitinib in Prostate Cancer Presenting With Lymph Node Metastasis","authors":"Amado J. Zurita ,&nbsp;Rebecca S. Tidwell ,&nbsp;Brian F. Chapin ,&nbsp;Deborah R. Harris ,&nbsp;Miao Zhang ,&nbsp;Louis L. Pisters ,&nbsp;Ana Aparicio ,&nbsp;John C. Araujo ,&nbsp;Sara Arce-Gallego ,&nbsp;Keyi Zhu ,&nbsp;Maria L. Lozano ,&nbsp;Lance Pagliaro ,&nbsp;Joaquin Mateo ,&nbsp;Christopher Logothetis ,&nbsp;Patricia Troncoso ,&nbsp;John W. Davis","doi":"10.1016/j.euo.2025.04.015","DOIUrl":"10.1016/j.euo.2025.04.015","url":null,"abstract":"<div><h3>Background and objective</h3><div><span><span>Strategies that combine systemic and locoregional therapies are increasingly used in prostate cancer (PC) with </span>lymph node metastasis (LNM) at presentation. We investigated whether the presurgical combination of androgen deprivation therapy (ADT) and the antiangiogenic agent </span>axitinib would be more effective than ADT alone in achieving time off systemic therapy after surgery in these patients.</div></div><div><h3>Methods</h3><div>Patients with newly diagnosed PC with either clinically detected LNM (cTxN1M0 or cTxNxM1a) or at very high risk for subclinical LNM were treated with ADT for 2 mo and then randomized 2:1 to addition of axitinib to ADT versus continuing ADT alone for an additional 4 mo before surgery and discontinuation of systemic therapy. The primary endpoint was the rate of freedom from treatment failure in the intention-to-treat population at 1 yr postoperatively (“success”). Failure was defined as prostate-specific antigen &gt;1.0 ng/ml, objective progression, or initiation of additional treatment.</div></div><div><h3>Key findings and limitations</h3><div>Of the 73 patients accrued, 49 received axitinib + ADT and 24 received ADT alone. Of the 49 patients who had surgery on protocol, success was achieved in 26, of whom 22 received axitinib + ADT and four received ADT alone. In the node-positive group of 55 patients, the success rate was 36.8% (95% credible interval [CrI] 22.5–52.5%) for axitinib + ADT and 19.0% (95% CrI 5.7–37.9%) for ADT alone; the probability of a higher success rate with axitinib + ADT was 0.935. The median time to progression was 9.8 mo (95% confidence interval [CI] 7.6–17.4) with axitinib + ADT versus 5.7 mo (95% CI 4.0–11.3) with ADT alone (<em>p</em> = 0.03). Pathologic responses, time to metastatic progression, and overall survival were similar between the arms. There were no grade 4–5 toxicities or unexpected perioperative complications.</div></div><div><h3>Conclusions and clinical implications</h3><div>In patients with newly diagnosed PC with LNM, a presurgical strategy that combines axitinib + ADT was feasible and was more likely than ADT alone to achieve significant time off treatment. However, the overall efficacy was limited, suggesting that patient selection and more effective combinations are needed.</div></div>","PeriodicalId":12256,"journal":{"name":"European urology oncology","volume":"8 4","pages":"Pages 1010-1019"},"PeriodicalIF":9.3,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144616853","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":"Association Between the Decipher Genomic Classifier and Prostate Cancer Outcome in the Real-world Setting","authors":"Michael S. Leapman ,&nbsp;Julian Ho ,&nbsp;Yang Liu ,&nbsp;Christopher Filson ,&nbsp;Xin Zhao ,&nbsp;Alexander Hakansson ,&nbsp;James A. Proudfoot ,&nbsp;Elai Davicioni ,&nbsp;Darryl T. Martin ,&nbsp;Yi An ,&nbsp;Tyler M. Seibert ,&nbsp;Daniel W. Lin ,&nbsp;Daniel E. Spratt ,&nbsp;Matthew R. Cooperberg ,&nbsp;Preston C. Sprenkle ,&nbsp;Ashley E. Ross","doi":"10.1016/j.euo.2024.07.010","DOIUrl":"10.1016/j.euo.2024.07.010","url":null,"abstract":"<div><h3>Background and objective</h3><div>Although the prognostic significance of the Decipher prostate cancer genomic classifier (GC) has been established largely from analyses of archival tissue, less is known about the associations between the results of Decipher testing and oncologic outcomes among patients receiving contemporaneous testing and treatment in the real-world practice setting. Our objective was to assess the associations between the Decipher GC and risks of metastasis and biochemical recurrence (BCR) following prostate biopsy and radical prostatectomy (RP) among patients tested and treated in the real-world setting.</div></div><div><h3>Methods</h3><div>A retrospective cohort study was conducted using a novel longitudinal linkage of transcriptomic data from the Decipher GC and real-world clinical data (RWD) aggregated from insurance claims, pharmacy records, and electronic health record data across payors and sites of care. Kaplan-Meier and Cox proportional hazards regressions were used to examine the associations between the GC and study outcomes, adjusting for clinical and pathologic factors.</div></div><div><h3>Key findings and limitations</h3><div>Metastasis from prostate cancer and BCR after radical prostatectomy, Decipher GC continuous score, and risk categories were evaluated. We identified 58 935 participants who underwent Decipher testing, including 33 379 on a biopsy specimen and 25 556 on an RP specimen. The median age was 67 yr (interquartile range [IQR] 62–72) at biopsy testing and 65 yr (IQR 59–69) at RP. The median GC score was 0.43 (IQR 0.27–0.66) among biopsy-tested patients and 0.54 (0.32–0.79) among RP-tested patients. The GC was independently associated with the risk of metastasis among biopsy-tested (hazard ratio [HR] per 0.1 unit increase in GC 1.21 [95% confidence interval {CI} 1.16–1.27], <em>p</em> &lt; 0.001) and RP-tested (HR 1.20 [95% CI 1.17–1.24], <em>p</em> &lt; 0.001) patients after adjusting for baseline clinical and pathologic risk factors. In addition, the GC was associated with the risk of BCR among RP-tested patients (HR 1.12 [95% CI 1.10–1.14], <em>p</em> &lt; 0.001) in models adjusted for age and Cancer of the Prostate Risk Assessment postsurgical score.</div></div><div><h3>Conclusions and clinical implications</h3><div>This real-world study of a novel transcriptomic linkage conducted at a national scale supports the external prognostic validity of the Decipher GC among patients managed in contemporary practice.</div></div><div><h3>Patient summary</h3><div>This study looked at the use of the Decipher genomic classifier, a test used to help understand the aggressiveness of a patient’s prostate cancer. Looking at the results of 58 935 participants who underwent testing, we found that the Decipher test helped estimate the risk of cancer recurrence and metastasis.</div></div>","PeriodicalId":12256,"journal":{"name":"European urology oncology","volume":"8 4","pages":"Pages 1101-1110"},"PeriodicalIF":9.3,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141888931","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}