European urology oncology最新文献

{"title":"Adjuvant Docetaxel Versus Surveillance in Intermediate- or High-risk Prostate Cancer After Radical Curative Radiotherapy: Final Survival Results from the SPCG-13 Trial","authors":"Pirkko-Liisa Kellokumpu-Lehtinen ,&nbsp;Ann-Sofie Fransson ,&nbsp;Timo Marttila ,&nbsp;Ilari Lehtinen ,&nbsp;Teppo Huttunen ,&nbsp;Camilla Thellenberg-Karlsson ,&nbsp;SPCG-13 Investigators","doi":"10.1016/j.euo.2025.04.013","DOIUrl":"10.1016/j.euo.2025.04.013","url":null,"abstract":"<div><div>The SPCG-13 trial investigated whether six cycles of adjuvant docetaxel (aDoc) improves survival in patients with intermediate- or high-risk prostate cancer after radical curative radiotherapy and androgen deprivation therapy. There was no difference in biochemical recurrence–free survival (primary endpoint) at 5-yr between the surveillance (SV) and aDoc arms. Here we report 10-yr survival data (planned secondary endpoint). Updated overall survival (OS) and metastasis-free survival data were available for 233 patients. There were no demographic differences between the original randomized cohort and the 10-yr survival population. Thus, this 10-yr sample is deemed representative of the original patient population. Median OS was 14.5 yr in the SV and was not reached in the aDoc arm. No significant difference in Kaplan-Meier survival emerged between the arms over time (log-rank test <em>p</em> = 0.154). Estimates of the 10-yr OS rate favored aDoc (77.4% vs 66.8%). Cox regression analysis revealed a trend towards worse OS for patients with a high Gleason score (GS; hazard ratio [HR] 1.925, 95% confidence interval [CI] 1.213–3.053; <em>p</em> = 0.005). A Cox model adjusted for GS risk revealed an OS HR of 0.776 (95% CI 0.508–1.187; <em>p</em> = 0.242) for aDoc versus SV. In conclusion, aDoc was associated with a slight, but not statistically significant, improvement in 10-yr OS, especially in the high-GS group.</div></div><div><h3>Patient summary</h3><div>Our 10-year survival analysis for the SPCG-13 trial showed that six cycles of chemotherapy with docetaxel after radiotherapy and androgen deprivation therapy for intermediate- or high-risk localized prostate cancer did not significantly increase survival. Survival was worse for cancers with a high Gleason score, so docetaxel could be considered after a careful discussion of the benefits and harms of chemotherapy. Further trials are needed to investigate options for this group of patients.</div></div>","PeriodicalId":12256,"journal":{"name":"European urology oncology","volume":"8 4","pages":"Pages 999-1002"},"PeriodicalIF":9.3,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143985504","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":"Cabozantinib plus Pembrolizumab as First-line Therapy for Cisplatin-ineligible Advanced Urothelial Carcinoma: The PemCab Trial","authors":"Rohit K. Jain ,&nbsp;Umang Swami ,&nbsp;Mehmet A. Bilen ,&nbsp;Georges Gebrael ,&nbsp;Kenneth M. Boucher ,&nbsp;Emma Braun ,&nbsp;Jacqueline T. Brown ,&nbsp;Jad Chahoud ,&nbsp;Sumati Gupta ,&nbsp;Neeraj Agarwal ,&nbsp;Guru Sonpavde ,&nbsp;Benjamin L. Maughan","doi":"10.1016/j.euo.2025.04.005","DOIUrl":"10.1016/j.euo.2025.04.005","url":null,"abstract":"<div><h3>Background and objective</h3><div>Pembrolizumab monotherapy is approved for patients with platinum-ineligible metastatic urothelial carcinoma (mUC). Cabozantinib is a multireceptor tyrosine kinase inhibitor with activity against MET and VEGFR2 and is approved as monotherapy or in combination with a PD-1 inhibitor for other malignancies. The objective was to determine the safety and efficacy of pembrolizumab + cabozantinib as first-line treatment for patients with mUC.</div></div><div><h3>Methods</h3><div>In this open-label, single-arm, multicenter, phase 2 study, patients received pembrolizumab 200 mg every 3 wk + cabozantinib 40 mg daily. Key inclusion criteria were locally advanced UC or mUC, Eastern Cooperative Oncology Group performance status 0–2, ineligible for or refused cisplatin, and no prior PD-1/L1 inhibitor. The primary endpoint was the objective response rate (ORR). Secondary endpoints included progression-free survival (PFS) and overall survival (OS). According to the statistical plan, in a cohort of 35 evaluable participants, the lower bound of the 95% confidence interval (CI) would extend no more than 26% from the ORR observed, and in a scenario with ≥17 objective responses, the CI would exclude 32%.</div></div><div><h3>Key findings and limitations</h3><div>Responses were observed in 16 of 35 evaluable patients, with an ORR of 46% (95% CI 31–62%). Median PFS and OS were 8 mo (95% CI 5-13) and 17 mo (95% CI 13–not reached), respectively. The most common treatment-emergent adverse events (any grade) were diarrhea (58%), fatigue (56%), pruritus (39%), nausea (36%), palmar-plantar erythrodysesthesia (36%), and a decrease in appetite (33%).</div></div><div><h3>Conclusions and clinical implications</h3><div>This phase 2 trial of pembrolizumab + cabozantinib demonstrated a manageable toxicity profile and promising efficacy as a first-line therapy combination for cisplatin-ineligible patients with mUC.</div></div>","PeriodicalId":12256,"journal":{"name":"European urology oncology","volume":"8 4","pages":"Pages 952-960"},"PeriodicalIF":9.3,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143980411","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":"Prevalence of Potential Candidates for Targeted Therapies According to Treatment-related Transcriptomic Signatures Among 140 548 Patients with Nonmetastatic Prostate Cancer","authors":"Nicole Handa ,&nbsp;Eric V. Li ,&nbsp;Jamie Michael ,&nbsp;James A. Proudfoot ,&nbsp;Adam B. Weiner ,&nbsp;Ridwan Alam ,&nbsp;Mohammed Alshalalfa ,&nbsp;Yangyang Hao ,&nbsp;Alex Hakansson ,&nbsp;Xin Zhao ,&nbsp;Yang Liu ,&nbsp;Elai Davicioni ,&nbsp;Phillip G. Febbo ,&nbsp;Hiten D. Patel ,&nbsp;David J. VanderWeele ,&nbsp;Edward M. Schaeffer ,&nbsp;Ashley E. Ross","doi":"10.1016/j.euo.2025.04.022","DOIUrl":"10.1016/j.euo.2025.04.022","url":null,"abstract":"<div><h3>Background and objective</h3><div>Systemic therapies that have shown a benefit in advanced prostate cancer<span> are being evaluated in earlier disease stages. We sought to determine the prevalence of transcriptomic changes in signatures related to treatment susceptibilities in patients with nonmetastatic prostate cancer.</span></div></div><div><h3>Methods</h3><div>Patients with nonmetastatic prostate cancer with Decipher genomic classifier and whole-transcriptome profiling data for biopsy specimens from October 2016 to February 2024 were included (<em>n</em><span> = 140 548). Predefined treatment-related signatures of androgen receptor activity (AR-A), </span><em>PTEN</em> loss, homologous recombination deficiency (HRD), <em>RB</em> loss, immune activity, and prostate-specific membrane antigen (PSMA; <em>FOLH1</em>) expression, along with Decipher scores and prostate cancer subtypes, were assessed.</div></div><div><h3>Key findings and limitations</h3><div>The prevalence of low AR-A scores and the basal subtype, which are associated with lower responsiveness to androgen deprivation therapy (ADT), increased with American Joint Committee on Cancer (AJCC) stage and Decipher genomic risk. The prevalence of cancers with a potential response to PI3K inhibitors, according to <em>PTEN</em> loss, and a response to PARP inhibitors, according to HRD status, also increased with AJCC stage and Decipher genomic risk score (all <em>p</em> &lt; 0.001). The prevalence of high PSMA expression was greater in AJCC grade IIC–IIIC disease, so these patients would be potential candidates for PSMA radioligand therapies. More than 60% of patients with AJCC grade IIC–IIIC disease and very high Decipher scores (&gt;0.85) are potential candidates for targeted therapies.</div></div><div><h3>Conclusions and clinical implications</h3><div>Treatment-related signature scores vary by AJCC stage and Decipher score and may be useful in guiding trials and selecting targeted therapies for nonmetastatic prostate cancer. Higher-stage prostate cancers appear to be more basal and androgen-independent, and thus may be more susceptible to intensified ADT + androgen receptor pathway inhibitors or therapies targeting PARP or PSMA.</div></div>","PeriodicalId":12256,"journal":{"name":"European urology oncology","volume":"8 4","pages":"Pages 1050-1058"},"PeriodicalIF":9.3,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143960689","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 Natural History of Confirmed Grade Group 1 Prostate Cancer Managed with Active Surveillance in the Modern Era","authors":"Kevin Shee,&nbsp;Jonathan J. Song,&nbsp;Janet E. Cowan,&nbsp;Lufan Wang,&nbsp;James Nie,&nbsp;Meera Chappidi,&nbsp;Samuel L. Washington III,&nbsp;Hao G. Nguyen,&nbsp;Matthew R. Cooperberg,&nbsp;Katsuto Shinohara,&nbsp;Peter R. Carroll","doi":"10.1016/j.euo.2025.06.005","DOIUrl":"10.1016/j.euo.2025.06.005","url":null,"abstract":"<div><h3>Background and objective</h3><div>Grade group 1 (GG1, Gleason 3 + 3) prostate cancer (PCa) is considered low risk but can upgrade, and is managed with active surveillance (AS). Amidst recent controversy of whether GG1 PCa should be called cancer, we determined the nature of progression of GG1 disease in a modern AS cohort with multiparametric magnetic resonance imaging (mpMRI) and genomic testing.</div></div><div><h3>Methods</h3><div>The Urologic Outcomes Database at the University of California San Francisco was queried for men with confirmed GG1 PCa. The primary outcome was biopsy upgrade (≥GG2, Gleason ≥3 + 4). The secondary outcomes included major upgrade (≥GG3, Gleason ≥4 + 3), metastasis, mortality, PCa-specific mortality, and active treatment after upgrade. Life table estimates, Kaplan-Meier analyses, and multivariable Cox proportional hazards regression models were performed.</div></div><div><h3>Key findings and limitations</h3><div>A total of 1429 men met the inclusion criteria. The 10-yr rates of upgrade and major upgrade were 62% and 19%, respectively. The 10-yr rates of metastasis, mortality, and PCa-specific mortality were 1.9%, 3.4%, and 0.1%, respectively. The 5-yr rate of active treatment after upgrade was 73%. On multivariable regression analyses, increasing age, percentage of positive cores, and prostate-specific antigen density, but not positive mpMRI, change in mpMRI, or high-risk genomics, were significantly associated with the risk of upgrade. Upgrade to ≥GG3 was the only factor associated with advancement to active treatment.</div></div><div><h3>Conclusions and clinical implications</h3><div>Men with confirmed GG1 PCa on AS have high rates of upgrade, and low rates of metastasis and mortality at 10 yr, confirming the appropriateness of AS. A high-risk genomic score, and initial positive mpMRI or change in mpMRI were not associated with upgrade outcomes, requiring further optimization.</div></div>","PeriodicalId":12256,"journal":{"name":"European urology oncology","volume":"8 4","pages":"Pages 1094-1100"},"PeriodicalIF":9.3,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144575150","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":"Direct Treatment of All Visible Tumour in Synchronous Oligometastatic Prostate Cancer: Total Eradication of Tumour or the Full Monty Treatment","authors":"Alexander Giesen ,&nbsp;Niels De Preter ,&nbsp;Tamás Fazekas ,&nbsp;Gert De Meerleer ,&nbsp;Giorgio Gandaglia ,&nbsp;Giancarlo Marra ,&nbsp;Shahrokh F. Shariat ,&nbsp;Steven Joniau ,&nbsp;Pawel Rajwa ,&nbsp;European Association of Urology Young Academic Urologists Prostate Cancer Working Group","doi":"10.1016/j.euo.2025.04.011","DOIUrl":"10.1016/j.euo.2025.04.011","url":null,"abstract":"<div><div>Recent advances in the management of synchronous oligometastatic prostate cancer (PC) highlight the potential of combining local and systemic therapies. However, there is growing interest in metastasis-directed therapy (MDT) in this setting. When all modalities are combined, this is referred as “total eradication of tumour” (TET) or “full monty treatment” (FMT). Retrospective studies have revealed promising outcomes with approaches such as cytoreductive radical prostatectomy or radiotherapy alongside MDT and combination systemic therapy. Multiple studies have demonstrated a significant proportion of cases with undetectable prostate-specific antigen and noncastrate testosterone, while one comparative trial (± MDT) revealed some evidence of an overall survival benefit. Results from the prospective trials indicate the feasibility and effectiveness of this intensive treatment strategy, with biochemical remission and disease-free states achieved in a significant proportion of cases. Overall, limitations persist, including a reliance on conventional imaging in all studies and the absence of long-term prospective data. Ongoing trials will provide definitive insights into the treatment efficacy and safety of TET/FMT.</div></div><div><h3>Patient summary</h3><div>For patients with a new diagnosis of prostate cancer with only few metastases, cancer control results after treatment with local therapy, hormonal agents, and treatment targeted to all metastatic sites are promising. Further clinical trials of this approach with the inclusion of new scan techniques are eagerly awaited.</div></div>","PeriodicalId":12256,"journal":{"name":"European urology oncology","volume":"8 4","pages":"Pages 1203-1207"},"PeriodicalIF":9.3,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143959877","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":"Towards Defining Follow-up Strategies for Patients with Primary Intermediate-risk Non–muscle-invasive Bladder Cancer","authors":"Roberto Contieri ,&nbsp;Alberto Martini ,&nbsp;Irene J. Beijert ,&nbsp;Laura S. Mertens ,&nbsp;Anouk E. Hentschel ,&nbsp;Johannes Bründl ,&nbsp;Eva M. Compérat ,&nbsp;Karin Plass ,&nbsp;Oscar Rodríguez ,&nbsp;Jose D. Subiela Henríquez ,&nbsp;Virginia Hernández ,&nbsp;Enrique de la Peña ,&nbsp;Isabel Alemany ,&nbsp;Diana Turturica ,&nbsp;Francesca Pisano ,&nbsp;Francesco Soria ,&nbsp;Otakar Čapoun ,&nbsp;Lenka Bauerová ,&nbsp;Michael Pešl ,&nbsp;H. Maxim Bruins ,&nbsp;Bas W.G. van Rhijn","doi":"10.1016/j.euo.2025.04.010","DOIUrl":"10.1016/j.euo.2025.04.010","url":null,"abstract":"<div><h3>Background and objective</h3><div>The current European Association of Urology (EAU) guidelines on non–muscle-invasive bladder cancer (NMIBC) categorize patients into four risk groups. In 2024, a specific follow-up schedule was introduced for intermediate-risk (IR) disease. However, recommendations are based on expert opinion and restricted to patients with IR-NMIBC who have primary low-grade or high-grade/grade 2 disease. Our aim was to identify a subgroup of patients with IR-NMIBC who may require more stringent follow-up.</div></div><div><h3>Methods</h3><div>We conducted a retrospective analysis of 2086 patients with IR-NMIBC classified according to the World Health Organization 1973 grading scheme. Multivariable Cox-regression models were fitted to identify predictors of recurrence, which were then used to dichotomize groups with low risk of recurrence (IR-Low) versus high risk of recurrence (IR-High). Kaplan-Meier curves were plotted to estimate recurrence-free survival (RFS) and progression-free survival (PFS). Smoothed hazard estimates of first recurrence were plotted by risk group.</div></div><div><h3>Key findings and limitations</h3><div>Multifocality and tumor size ≥3 cm were significantly associated with higher risk of first recurrence and were used to define the IR-High and IR-Low (unifocal, size &lt;3 cm; <em>n</em> = 1087) groups. The 3-yr RFS rate was significantly worse for the IR-High group (51%, 95% confidence interval [CI] 48–54%) than for IR-Low (68%, 95% CI 65–71%). The risk of progression was low (5-yr PFS rate 96%) with no significant difference between the IR-High and IR-Low groups.</div></div><div><h3>Conclusions and clinical implications</h3><div>During IR-NMIBC follow-up for recurrence, tumor size and focality should be considered rather than grade. If the primary objective is to ensure prompt detection of recurrence, follow-up schedules should be tailored according to the risk of recurrence, with more stringent protocols for patients with IR-NMIBC at higher risk of recurrence.</div></div>","PeriodicalId":12256,"journal":{"name":"European urology oncology","volume":"8 4","pages":"Pages 977-985"},"PeriodicalIF":9.3,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144119267","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: Gerhardt Attard, Neeraj Agarwal, Julie Graff, et al. Niraparib plus Abiraterone Acetate and Prednisone for HRR-mutated Metastatic Castration-sensitive Prostate Cancer: Results from the AMPLITUDE Phase 3 Trial. J Clin Oncol 2025;43(17 Suppl):LBA5006","authors":"Giuseppe Di Lorenzo ,&nbsp;Francesco Montorsi ,&nbsp;Carlo Buonerba","doi":"10.1016/j.euo.2025.06.006","DOIUrl":"10.1016/j.euo.2025.06.006","url":null,"abstract":"","PeriodicalId":12256,"journal":{"name":"European urology oncology","volume":"8 4","pages":"Pages 1215-1216"},"PeriodicalIF":9.3,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144505282","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":"Radium-223 in Men with Metastatic Castration-resistant Prostate Cancer: A Systematic Literature Review of Real-world Outcomes in Observational Studies","authors":"Michaela Lunan-Taylor ,&nbsp;Amit D. Raval ,&nbsp;Nguyen Thi Nhan Phan ,&nbsp;Matthew J. Korn ,&nbsp;Vanessa Quintero ,&nbsp;Rana R. McKay","doi":"10.1016/j.euo.2025.06.002","DOIUrl":"10.1016/j.euo.2025.06.002","url":null,"abstract":"<div><h3>Background and objective</h3><div>Radium-223 (Ra-223) has been approved since 2013 for men with metastatic castration-resistant prostate cancer (mCRPC) with bone metastases. Since then, the treatment landscape has changed dramatically, and a comprehensive understanding of the real-world outcomes of Ra-223 use is needed. This systematic literature review summarizes the real-world effectiveness and safety of Ra-223 in men with mCRPC.</div></div><div><h3>Methods</h3><div>Electronic databases were searched systematically for real-world observational studies from the past 10 yr examining the outcomes in men with mCRPC treated with Ra-223.</div></div><div><h3>Key findings and limitations</h3><div>Forty-eight studies including 15 368 men with mCRPC met the inclusion criteria. Most studies were from Europe (<em>n</em> = 22) and North America (<em>n</em> = 18; sample size range, 104–1628). Studies in Europe and North America reported ≥60% and 55% completing five or more cycles of Ra-223, respectively. First-line therapy, no prior chemotherapy or immunotherapy, and high hemoglobin and neutrophil levels were the key factors associated with completing five or more cycles. The median real-world overall survival varied (11–24 mo), with one exception. Completion of five or more cycles was associated with a two- to five-fold increase in the median real-world overall survival. Of 14 studies reporting fractures, incidence was &lt;10% in most studies (<em>n</em> = 12), with trends toward lower rates using bone health agents (BHAs).</div></div><div><h3>Conclusions and clinical implications</h3><div>This is the most comprehensive review of the effectiveness and safety of the use of Ra-223 in a population after the adoption of androgen-receptor pathway inhibitors. The findings highlight the survival benefits of the early use of Ra-223 with completion of five or more cycles, a favorable safety profile, and low rates of fracture when guideline-recommended BHAs are used.</div></div>","PeriodicalId":12256,"journal":{"name":"European urology oncology","volume":"8 4","pages":"Pages 1150-1164"},"PeriodicalIF":9.3,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144511758","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":"Hall of Fame","authors":"","doi":"10.1016/S2588-9311(25)00234-2","DOIUrl":"10.1016/S2588-9311(25)00234-2","url":null,"abstract":"","PeriodicalId":12256,"journal":{"name":"European urology oncology","volume":"8 4","pages":"Page xi"},"PeriodicalIF":9.3,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145098101","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":"Multivitamin Use After Prostate Cancer Diagnosis Is Associated with Lower Risk of Recurrence: A Prospective Cohort Study from the Cancer of the Prostate Strategic Urologic Research Endeavor (CaPSURE)","authors":"Kevin Shee ,&nbsp;Benjamin E. Cedars ,&nbsp;Lufan Wang ,&nbsp;Stacey A. Kenfield ,&nbsp;Janet E. Cowan ,&nbsp;Irina Tolstykh ,&nbsp;Crystal S. Langlais ,&nbsp;William A. Pace ,&nbsp;Jeanette M. Broering ,&nbsp;Peter R. Carroll ,&nbsp;June M. Chan ,&nbsp;Erin L. Van Blarigan","doi":"10.1016/j.euo.2025.04.014","DOIUrl":"10.1016/j.euo.2025.04.014","url":null,"abstract":"<div><h3>Background and objective</h3><div>Multivitamin (MV) use is common among men with prostate cancer (PC). However, data on MV use in relation to the risk of PC recurrence are limited.</div></div><div><h3>Methods</h3><div>We conducted a longitudinal observational cohort study in 1396 men with nonmetastatic PC who underwent radical prostatectomy (RP) or radiation therapy (RT) and enrolled in the Cancer of the Prostate Strategic Urologic Research Endeavor (CaPSURE) study between 1999 and 2018. The primary outcome was PC recurrence, defined as biochemical recurrence or initiation of secondary treatment. Postdiagnostic MV use was ascertained via a questionnaire after diagnosis and before any recurrence. Multivariable Cox proportional-hazards regression models controlled for sociodemographic factors, clinical factors, and health behaviors and were used to calculate adjusted hazards ratios (HRs) and 95% confidence intervals (CIs).</div></div><div><h3>Key findings and limitations</h3><div>In the study cohort there were 858 (62%) current MV users, 227 (16%) past MV users, and 311 (22%) never users. We observed 119 PC recurrence events over a median follow-up of 4.7 (interquartile range 1.9–9.2) yrs after survey completion. Current MV use was associated with lower risk of PC recurrence (basic model: HR 0.52, 95% CI 0.35–0.78; adjusted model: HR 0.51, 95% CI 0.33–0.78). In stratified analyses, the inverse association between current MV use and PC recurrence was stronger for men with grade group 2 (Gleason 3 + 4) or greater PC (<em>n</em> = 430; HR 0.27, 95% CI 0.13–0.55; <em>p</em> &lt; 0.001) and was not statistically significant for men with grade group 1 (Gleason 3 + 3) PC (<em>n</em> = 966).</div></div><div><h3>Conclusions and clinical implications</h3><div>MV use after PC diagnosis was associated with lower risk of PC recurrence, particularly in patients with higher-grade disease. This finding warrants validation and further investigation.</div></div>","PeriodicalId":12256,"journal":{"name":"European urology oncology","volume":"8 4","pages":"Pages 1003-1009"},"PeriodicalIF":9.3,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143979202","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}