European urology oncology最新文献

{"title":"Reply to Selcuk Guven, Selim Soyturk, and Thomas Herrmann’s Letter to the Editor re: Jeremy Y. Teoh, Francesco M. Bracco, Julius H. Wong, et al. A Novel Transurethral Robotic Platform for Performing En Bloc Resection of Bladder Tumour: Results from the First Phase of the VIABLE Trial. Eur Urol Oncol. 2026;9:111–115. https://doi.org/10.1016/j.euo.2025.11.005","authors":"Jeremy Yuen-Chun Teoh","doi":"10.1016/j.euo.2026.05.016","DOIUrl":"10.1016/j.euo.2026.05.016","url":null,"abstract":"","PeriodicalId":12256,"journal":{"name":"European urology oncology","volume":"9 4","pages":"Pages 1016-1017"},"PeriodicalIF":8.5,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148162290","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":"Predicting the Development of BCG-unresponsive Disease Among Patients with High-grade Non–muscle-invasive Bladder Cancer: An International Multicenter Analysis","authors":"Aleksander Ślusarczyk,&nbsp;Marco Moschini,&nbsp;Wojciech Krajewski,&nbsp;Pietro Scilipoti,&nbsp;Roberto Contieri,&nbsp;Francesco Claps,&nbsp;José Daniel Subiela,&nbsp;Laura S. Mertens,&nbsp;Keiichiro Mori,&nbsp;Jorge Caño Velasco,&nbsp;Francesco Soria,&nbsp;Elisabeth Grobet-Jeandin,&nbsp;Karl Tully,&nbsp;Karolina Garbas,&nbsp;Pedro Del Olmo Durán,&nbsp;Renee A.G. Lijnen,&nbsp;Giorgia Fertitta,&nbsp;Maxence Reynard,&nbsp;Olga Katzendorn,&nbsp;Alfonso Lafuente Puentedura,&nbsp;Benjamin Pradere","doi":"10.1016/j.euo.2026.06.005","DOIUrl":"10.1016/j.euo.2026.06.005","url":null,"abstract":"<div><h3>Background</h3><div>Dedicated tools estimating the risk of Bacillus Calmette-Guérin (BCG) failure among patients with high-grade (HG) non–muscle-invasive bladder cancer (NMIBC) are lacking.</div></div><div><h3>Objective</h3><div>To develop a risk model predicting the development of BCG-unresponsive disease (defined according to the International Bladder Cancer Group and European Association of Urology [EAU] guidelines) or progression in patients with HG NMIBC receiving adequate BCG therapy.</div></div><div><h3>Design, setting, and participants</h3><div>This retrospective multicenter study included 2211 patients who were BCG naïve with HG Ta/T1 NMIBC (±carcinoma in situ [CIS]) treated with adequate BCG therapy between January 2003 and December 2024 at 13 academic centers.</div></div><div><h3>Outcome measurements and statistical analysis</h3><div>The primary end point was time to BCG-unresponsive disease or progression to muscle-invasive/metastatic cancer. Multivariable Cox regression identified independent predictors, and a weighted clinical risk score stratified patients into four risk groups.</div></div><div><h3>Results and limitations</h3><div>Independent risk factors included T1 stage (adjusted hazard ratio [aHR] 1.52, 95% confidence interval [CI] 1.10–2.11), persistent HG or T1 tumor at restaging transurethral resection (aHR 2.51, 95% CI 2.06–3.06), multifocality (aHR 1.46, 95% CI 1.22–1.74), concomitant CIS (aHR 1.46, 95% CI 1.21–1.77), and World Health Organization 1973/2004/2016 HG/grade 3 (aHR 1.56, 95% CI 1.24–1.94). Internal validation via 1000 bootstrap samples revealed minimal optimism (0.01) and good calibration. The model demonstrated superior discrimination compared with the European Organization for Research and Treatment of Cancer progression score and EAU 2021 stratification (Harrell concordance index 0.68 vs 0.61 vs 0.56); 5-yr BCG-unresponsive–free survival was 88%, 79%, 60%, and 49%, respectively, across increasing risk groups.</div></div><div><h3>Conclusions</h3><div>We developed a risk stratification model for patients with HG Ta/T1 treated with adequate BCG therapy. This tool enables individualized assessment of BCG failure risk and may support clinical decision-making.</div></div>","PeriodicalId":12256,"journal":{"name":"European urology oncology","volume":"9 4","pages":"Pages 946-957"},"PeriodicalIF":8.5,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148316490","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":"Doublet Versus Triplet Therapy in High-volume Metastatic Hormone-sensitive Prostate Cancer Patients with Bone Metastases: Results from the ARON-3 Study","authors":"Philipp Cornelius Mandel,&nbsp;Mike Wenzel,&nbsp;María Natalia Gandur Quiroga,&nbsp;Maria T. Bourlon,&nbsp;Felix Chun,&nbsp;Zin W. Myint,&nbsp;Laura Bernal,&nbsp;Ray Manneh Kopp,&nbsp;Maria José Juan Fita,&nbsp;Thomas Büttner,&nbsp;Ondrej Fiala,&nbsp;Haoran Li,&nbsp;Martin Bögemann,&nbsp;Tomas Buchler,&nbsp;Diana Matthews,&nbsp;Alessandro Rizzo,&nbsp;Francesco Ciccimarra,&nbsp;Fernando Sabino Marques Monteiro,&nbsp;Andrey Soares,&nbsp;Francesco Massari,&nbsp;Matteo Santoni","doi":"10.1016/j.euo.2026.05.010","DOIUrl":"10.1016/j.euo.2026.05.010","url":null,"abstract":"<div><h3>Background and objective</h3><div>Data for direct comparison of the outcomes for androgen-deprivation therapy (ADT) + androgen signaling pathway-inhibitors (ARPI) versus ADT + ARPI + docetaxel are scant, especially in patients with high-volume metastatic hormone-sensitive prostate cancer (mHSPC), according to CHAARTED classification and regarding to the number of bone metastases.</div></div><div><h3>Design, setting and paticipants</h3><div>Relying on the multicentric international ARON-3 database, patients with high-volume mHSPC with bone metastases undergoing doublet versus triplet therapy were selected and stratified according to the number of bone metastases (≤10 vs &gt;10). Primary endpoints consisted of time to treatment failure (TTF), prostate-specific antigen-response, and overall survival (OS).</div></div><div><h3>Results and Limitations</h3><div>Overall, 841 patients treated with doublet (75%) or triplet (25%) therapy were included. At 12 wk, triplet therapy was associated with changes in opioid use and in Eastern Cooperative Oncology Group performance status. Median OS was 63.0 mo for ADT + abiraterone acetate and was not reached for ADT + apalutamide, ADT + enzalutamide, and ADT + docetaxel + darolutamide. Differences in adjusted TTF estimates between treatment groups were observed in patients with &gt;10 bone metastases (hazard ratio [HR] 0.49, 95% confidence interval [CI] 0.28–0.87; <em>p</em> = 0.02), whereas adjusted OS estimates also differed numerically but were not statistically significant (HR 0.48, 95% CI 0.21–1.07; <em>p</em> = 0.1). In patients with concomitant visceral metastases, TTF and OS estimates also differed numerically by treatment group; however, these differences were not statistically significant.</div></div><div><h3>Conclusions</h3><div>In exploratory subgroup analyses, TTF and OS estimates varied by bone metastatic burden, but formal interaction testing did not show evidence of heterogeneity. These findings require prospective validation.</div></div>","PeriodicalId":12256,"journal":{"name":"European urology oncology","volume":"9 4","pages":"Pages 911-920"},"PeriodicalIF":8.5,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148162302","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":"Endoscopic Kidney-sparing Surgery for Upper Tract Urothelial Carcinoma: Long-term Oncological and Functional Outcomes from a Large Single-center Cohort","authors":"Pietro Scilipoti,&nbsp;Federico Zorzi,&nbsp;Letizia Maria Ippolita Jannello,&nbsp;Stefano Moretto,&nbsp;Alejandra Bravo-Balado,&nbsp;Alberto Quarà,&nbsp;George Abi Tayeh,&nbsp;Ahmed Alanazi,&nbsp;Ugo Gradilone,&nbsp;Hubert Werth,&nbsp;Marie Chicaud,&nbsp;Laurent Berthe,&nbsp;Luigi Candela,&nbsp;Steeve Doizi,&nbsp;Frédéric Panthier,&nbsp;Olivier Traxer","doi":"10.1016/j.euo.2026.05.011","DOIUrl":"10.1016/j.euo.2026.05.011","url":null,"abstract":"<div><h3>Background</h3><div>Long-term benchmark data on endoscopic kidney-sparing surgery (eKSS) for upper tract urothelial carcinoma (UTUC) remain limited.</div></div><div><h3>Objective</h3><div>To report long-term oncological and functional outcomes from a large single-center cohort using contemporary risk stratification.</div></div><div><h3>Design, setting, and participants</h3><div>We retrospectively analyzed a prospectively maintained cohort (August 1996–September 2024). After excluding patients with upfront radical nephroureterectomy (RNU) after diagnostic ureteroscopy, missing index pathology, or lacking oncologic follow-up, 254 eKSS-treated patients were included.</div></div><div><h3>Intervention</h3><div>Endoscopic kidney-sparing surgery, with patients classified as low- (LR) or high-risk (HR) per EAU criteria and undergoing standardized surveillance including second-look ureteroscopy at 4–6 weeks and long-term ureteroscopic follow-up.</div></div><div><h3>Outcome measurements and statistical analysis</h3><div>Outcomes included UTUC recurrence, RNU, metastases, cancer-specific mortality (CSM), and chronic kidney disease (CKD) ≥IIIB. Cumulative incidence functions and Fine–Gray competing-risk regression were used.</div></div><div><h3>Results and limitations</h3><div>Median age was 71 years (IQR 62–77); 74% were male and 46% were LR. After a median follow-up of 67 months (IQR 24–131) for survivors, 5- and 7-yr recurrence incidence was 49% (95% CI 42–57%) and 55% (95% CI 47–63%), without statistically significant differences between risk groups (subdistribution hazard ratio [sHR] 0.74, 95% CI 0.51–1.08, p=0.12). High-risk disease was associated with higher hazards of RNU (sHR 2.30, 95% CI 1.34–3.94; 7-yr risk 35% vs. 13%), metastatic progression (7-yr incidence 17% vs. 5.0%; sHR 2.79, 95% CI 1.10–7.08), and CSM (7-yr incidence 23% vs. 11%, 95% CI 9.2–23%; sHR 2.24, 95% CI 1.10–4.55) compared to LR patients. Median eGFR decline was −9 mL/min/1.73 m² (IQR −11 - -2); 5-yr CKD ≥IIIB incidence was 15% (95% CI 8–21%), with no risk-group statistically significant differences (sHR 1.63, 95% CI 0.72–3.70; <em>p</em> = 0.2).</div></div><div><h3>Conclusions</h3><div>These long-term data provide real-world benchmarks for clinicians counseling patients undergoing eKSS. High-risk disease is associated with higher hazards of RNU conversion, metastatic progression, and CSM, reinforcing the prognostic value of EAU risk stratification and the need for risk-adapted, prolonged endoscopic surveillance after eKSS.</div></div>","PeriodicalId":12256,"journal":{"name":"European urology oncology","volume":"9 4","pages":"Pages 921-929"},"PeriodicalIF":8.5,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148381922","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":"FGFR3 Testing in Urothelial Carcinoma: An Expert Commentary on Best Practices From Patient Identification to Result Reporting","authors":"Eva M. Compérat,&nbsp;Arndt Hartmann,&nbsp;Yves Allory,&nbsp;Beatriz Bellosillo,&nbsp;Rui Pedro Caetano Moreira Oliveira,&nbsp;Caterina Chiappetta,&nbsp;Farah Hodeib,&nbsp;Michael Hubank,&nbsp;Niklas Klümper,&nbsp;Yohann Loriot,&nbsp;Frédérique Penault-Llorca,&nbsp;Astrid Rijken,&nbsp;Ernst-Jan M. Speel,&nbsp;Bernadett Szabados,&nbsp;Isabelle Vanden Bempt,&nbsp;Geert J.L.H. Van Leenders,&nbsp;Mariavittoria Vescovo,&nbsp;Markus Eckstein","doi":"10.1016/j.euo.2026.06.003","DOIUrl":"10.1016/j.euo.2026.06.003","url":null,"abstract":"<div><h3>Context</h3><div>Metastatic urothelial cancer (mUC) is associated with diverse genomic alterations, including frequent <em>FGFR3</em> mutations that influence survival outcomes and treatment responses. Erdafitinib, a targeted therapy, has shown improved survival in patients with locally advanced (LA) or mUC harbouring <em>FGFR3</em> alterations, reinforcing the importance of timely <em>FGFR3</em> testing.</div></div><div><h3>Objective</h3><div>This article aims to provide practical guidance for step-by-step best practices in <em>FGFR3</em> testing in mUC from sample acquisition to result reporting.</div></div><div><h3>Evidence acquisition</h3><div>This narrative review presents practical recommendations for <em>FGFR3</em> testing in mUC, developed by a multidisciplinary European panel of pathologists, molecular biologists, oncologists, and urologists, based on critical appraisal of current evidence and collective clinical experience.</div></div><div><h3>Evidence synthesis</h3><div>Patients with LA/mUC should undergo <em>FGFR3</em> testing at diagnosis, as supported by the current guidelines. Other factors to consider include age, frailty, fitness for treatment, and quality of life. <em>FGFR3</em> testing should be performed using validated quantitative polymerase chain reaction (PCR) assays or next-generation sequencing (NGS) methods. While liquid biopsy analysis on circulating tumour deoxyribonucleic acid (ctDNA) via PCR and NGS may offer a complementary approach to tissue testing, further research is needed to determine its value in detecting <em>FGFR3</em> alterations in mUC. The molecular laboratory report should contain details of all detected genetic alterations by the European Society for Medical Oncology Scale for Clinical Actionability of molecular Targets tier to indicate potential actionability.</div></div><div><h3>Conclusions</h3><div>Early <em>FGFR3</em> testing at diagnosis in patients with LA/mUC is clinically essential to ensure timely access to targeted therapies. Multidisciplinary collaboration is key to integrating molecular testing into patient care, supporting effective and personalised disease management.</div></div>","PeriodicalId":12256,"journal":{"name":"European urology oncology","volume":"9 4","pages":"Pages 977-985"},"PeriodicalIF":8.5,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148444793","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":"Metformin in Prostate Cancer: A Negative Repurposing Story Across the Disease Continuum","authors":"Dries Develtere,&nbsp;Gaëtan Devos","doi":"10.1016/j.euo.2026.04.014","DOIUrl":"10.1016/j.euo.2026.04.014","url":null,"abstract":"","PeriodicalId":12256,"journal":{"name":"European urology oncology","volume":"9 4","pages":"Pages 758-760"},"PeriodicalIF":8.5,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147863824","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":"A High Decipher Genomic Risk Score Is Associated with Major Pathological Progression in Patients Undergoing Active Surveillance for Prostate Cancer","authors":"Kevin Shee,&nbsp;William A. Pace,&nbsp;Jonathan J. Song,&nbsp;Brendan L. Raizenne,&nbsp;Janet E. Cowan,&nbsp;Lufan Wang,&nbsp;Samuel L. Washington,&nbsp;Katsuto Shinohara,&nbsp;Hao G. Nguyen,&nbsp;Peter R. Carroll,&nbsp;Matthew R. Cooperberg","doi":"10.1016/j.euo.2026.01.006","DOIUrl":"10.1016/j.euo.2026.01.006","url":null,"abstract":"<div><div>Genomic testing has potential to improve clinical decision-making for men with prostate cancer, but is understudied for active surveillance (AS), the standard management option for favorable-risk disease. We investigated whether Decipher scores are associated with AS outcomes in a cohort of patients on AS with at least two biopsies and a Decipher test. Decipher high-risk was defined as a score ≥0.6. Primary outcomes were any upgrading (any increase in grade group [GG]), major upgrading (GG ≥3), and unfavorable histology on subsequent biopsy. Multivariable Cox proportional-hazards regression models were generated for the cohort of 486 patients. On diagnostic biopsy, 78% had low risk and 22% had intermediate risk according to Cancer of the Prostate Risk Assessment (CAPRA) scores, and 12% had high risk according to Decipher. Decipher scores were associated with major upgrading after adjusting for CAPRA scores (hazard ratio [HR] 3.37, 95% confidence interval [CI] 1.17-9.69); high Decipher risk was associated with major upgrading after adjustment for either the CAPRA score (HR 2.00, 95% CI 1.14–3.49) or clinicodemographic variables (HR 2.65, 95% CI 1.36–5.17). The Decipher score was associated with unfavorable histology after adjustment for the CAPRA score (HR 3.68, 95% CI 1.03–13.08); high Decipher risk was associated with unfavorable histology after adjustment for clinicodemographic variables (HR 4.53, 95% CI 2.03–10.15) but not after adjustment for the CAPRA score. No association was observed for any upgrading. Deintensification of surveillance may be warranted for patients with lower Decipher risk.</div></div>","PeriodicalId":12256,"journal":{"name":"European urology oncology","volume":"9 4","pages":"Pages 772-776"},"PeriodicalIF":8.5,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146097047","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":"Enzalutamide Plus Metformin Versus Enzalutamide Alone in Metastatic Castration-resistant Prostate Cancer: A Randomized Phase 2 Trial (SAKK 08/14)","authors":"S. Gillessen,&nbsp;K. Gobat,&nbsp;R. Cathomas,&nbsp;N. Fischer,&nbsp;R. Pereira Mestre,&nbsp;T. Hermanns,&nbsp;S.I. Rothschild,&nbsp;N. Mach,&nbsp;W. Mingrone,&nbsp;M. Ciriolo,&nbsp;B. Müller,&nbsp;A. Erdmann,&nbsp;C. Schär,&nbsp;C. Mamot,&nbsp;P. Bohanes,&nbsp;A. Omlin,&nbsp;S. Bastian,&nbsp;K. Ribi,&nbsp;L. Mazzucchelli,&nbsp;J. Barizzi,&nbsp;C. Rothermundt","doi":"10.1016/j.euo.2026.03.001","DOIUrl":"10.1016/j.euo.2026.03.001","url":null,"abstract":"<div><h3>Background and objective</h3><div>The aim of our study is to determine whether the addition of metformin to enzalutamide can improve the outcomes of men with metastatic castration-resistant prostate cancer (mCRPC).</div></div><div><h3>Methods</h3><div>From 2016 to 2021, patients with mCRPC were randomized to receive enzalutamide plus metformin or enzalutamide alone, with body mass index (BMI) as a stratification factor. Primary end point was disease-control rate (DCR) at 15 mo. Secondary end points included event-free survival (EFS), time to prostate-specific antigen progression (TTPSAP) or radiologic progression (TTRP), and overall survival (OS). Post hoc analyses include tumor phosphatase and tensin homolog (PTEN)–protein expression.</div></div><div><h3>Key findings and limitations</h3><div>Enzalutamide plus metformin (<em>n =</em> 84) did not increase DCR or secondary end points compared with enzalutamide alone (<em>n =</em> 82; DCR 52% vs 56%, <em>p =</em> 0.64). Post hoc analysis suggests that addition of metformin to enzalutamide may improve TTPSAP (<em>p =</em> 0.0074) in patients with PTEN-expressing tumor (<em>n =</em> 64), but not in patients with PTEN-negative tumor (<em>n =</em> 65, <em>p</em> &gt; 0.6). Patients who were overweight/obese at baseline (BMI ≥25 kg/m²) had better DCR, OS, EFS, TTPSAP, and TTRP than patients with BMI &lt;25 kg/m², independent of treatment arm (<em>p &lt;</em> 0.009).</div></div><div><h3>Conclusions and clinical implications</h3><div>The addition of metformin to enzalutamide did not improve the study end points in the whole study cohort. PTEN status as a potential predictive biomarker and the obesity paradox warrant further investigation.</div></div><div><h3>Patient summary</h3><div>This study found that adding the diabetes drug metformin to standard treatment with enzalutamide did not improve outcomes in men with advanced prostate cancer. However, men whose tumors express PTEN protein seemed to benefit from metformin. Interestingly, overweight/obese men lived longer than those of normal weight.</div></div>","PeriodicalId":12256,"journal":{"name":"European urology oncology","volume":"9 4","pages":"Pages 822-832"},"PeriodicalIF":8.5,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147491010","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":"Extended Follow-up from the Stereotactic Body Radiotherapy for High-risk Localized Carcinoma of the Prostate (SHARP) Consortium: Updated Analysis of 440 Patients","authors":"Luca F. Valle,&nbsp;Tahmineh Romero-Kalbasi,&nbsp;Tommy Jiang,&nbsp;Ritchell van Dams,&nbsp;Donald B. Fuller,&nbsp;Andrew Loblaw,&nbsp;Thomas Kennedy,&nbsp;Sean P. Collins,&nbsp;Vaibhav Sharma,&nbsp;Simeng Suy,&nbsp;Vedang Murthy,&nbsp;Indranil Mallick,&nbsp;Nicholas G. Nickols,&nbsp;Neil Desai,&nbsp;Raquibul Hannan,&nbsp;Nima Aghdam,&nbsp;Irving David Kaplan,&nbsp;Kevin Stephans,&nbsp;Rahul Tendulkar,&nbsp;Steven Lau,&nbsp;Amar U. Kishan","doi":"10.1016/j.euo.2026.03.019","DOIUrl":"10.1016/j.euo.2026.03.019","url":null,"abstract":"<div><h3>Background and objective</h3><div>Most patients with high-risk localized prostate cancer (HRLPC) do not undergo stereotactic body radiotherapy (SBRT) in part because of the limited evidence of long-term outcomes. We report long-term efficacy and toxicity outcomes for men treated with SBRT for HRLPC.</div></div><div><h3>Methods</h3><div>Individual patient data from ten prospective clinical studies evaluating SBRT for HRLPC across nine institutions were pooled in the Stereotactic Body Radiotherapy for High-Risk Localized Carcinoma of the Prostate consortium. The Kaplan-Meier method was used to estimate 5-yr biochemical recurrence (BCR) and distant metastasis (DM), stratified by receipt of intensified treatment (≥12 mo of androgen deprivation therapy [ADT] with extremely dose-escalated [≥8 Gy/fraction] prostate-directed SBRT). The impact of intensified treatment on BCR-free survival and DM-free survival was evaluated using multivariable Cox proportional hazards models. Late Common Terminology Criteria for Adverse Events grade ≥2 gastrointestinal (GI) and genitourinary (GU) toxicity was analyzed using time-to-event models.</div></div><div><h3>Key findings and limitations</h3><div>In 440 patients with a median follow-up time of 60.4 mo, 5-yr BCR and DM rates were 22% (95% confidence interval [CI] = 17–26%] and 9.2% (95% CI = 6.2–12%), respectively. In the 93 patients (21%) who received intensified treatment, 5-yr BCR and DM rates were 7.4% (95% CI = 1.7–13%) and 3.7% (95% CI = 0–7.9%), respectively. Receipt of intensified therapy was associated with a significant reduction in both BCR (hazard ratio [HR] = 0.38 [95% CI = 0.20–0.74], <em>p</em> = 0.005) and DM (HR = 0.43 [95% CI = 0.18–0.99], <em>p</em> = 0.049). For the overall cohort, 5-yr rates of grade ≥2 GU and GI toxicity were 23% (95% CI = 19–27%) and 10% (95% CI = 7–13%), respectively. Limitations include heterogeneous treatment techniques and the nonrandomized nature of the study.</div></div><div><h3>Conclusions and clinical implications</h3><div>The safety and efficacy profile of SBRT for HRLPC remains favorable at long-term follow-up, and SBRT should be integrated into shared decision-making for treatment of HRLPC.</div></div>","PeriodicalId":12256,"journal":{"name":"European urology oncology","volume":"9 4","pages":"Pages 860-867"},"PeriodicalIF":8.5,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147671590","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":"Molecular Profiling of Urothelial Bladder Cancer: Bridging Tumor Biology and Clinical Decision-making","authors":"Constance Thibault,&nbsp;Hélène Blons,&nbsp;Yves Allory,&nbsp;Alia Harba,&nbsp;Mathieu Roumiguié,&nbsp;Thomas Seisen,&nbsp;Gautier Marcq,&nbsp;Anne Sophie Bajeot,&nbsp;Priscilla Leon,&nbsp;Alexandra Masson-Lecomte,&nbsp;Benjamin Pradère,&nbsp;Evanguelos Xylinas,&nbsp;Doriane Prost,&nbsp;Pierre-Etienne Gabriel,&nbsp;Pierre Laurent-Puig,&nbsp;Morgan Rouprêt,&nbsp;Francois Audenet,&nbsp;for the Cancer Committee of The French Association of Urology (CC-AFU)","doi":"10.1016/j.euo.2026.06.012","DOIUrl":"10.1016/j.euo.2026.06.012","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Context&lt;/h3&gt;&lt;div&gt;Bladder cancer ranks among the most common malignancies worldwide, with urothelial carcinoma as the predominant histological type. Its development from normal urothelium to non–muscle-invasive bladder cancer (NMIBC) or muscle-invasive bladder cancer (MIBC) is driven by complex molecular events, including chromosomal aberrations, somatic mutations, and epigenetic dysregulation. Advances in next-generation sequencing (NGS) and transcriptomic profiling have transformed the understanding of urothelial tumor biology and opened new perspectives for precision oncology.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Objective&lt;/h3&gt;&lt;div&gt;To provide an updated synthesis of molecular profiling in urothelial bladder cancer across disease stages and to discuss its diagnostic, prognostic, and therapeutic relevance.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Evidence acquisition&lt;/h3&gt;&lt;div&gt;We conducted a targeted narrative review based on a structured PubMed search of studies published between January 2000 and February 2026 using the keywords “genomic,” “epigenetic,” “transcriptomic,” and “urothelial bladder cancer.” Eligible publications included original research articles, reviews, and meta-analyses in English. Evidence was synthesized across NMIBC, MIBC, and metastatic disease, focusing on molecular alterations and their clinical relevance.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Evidence synthesis&lt;/h3&gt;&lt;div&gt;Both NMIBC and MIBC present frequent &lt;em&gt;TERT&lt;/em&gt; promoter mutations. NMIBC is further characterized by frequent &lt;em&gt;FGFR3&lt;/em&gt; and &lt;em&gt;PIK3CA&lt;/em&gt; mutations, loss of chromosome 9, and widespread chromatin-remodeling gene alterations. MIBC displays high genomic instability, with recurrent mutations in &lt;em&gt;TP53&lt;/em&gt;, &lt;em&gt;RB1&lt;/em&gt;, and chromatin modifiers, as well as frequent alterations in the RTK/RAS/PI3K pathway. Consensus transcriptomic classifications identify reproducible molecular subtypes (luminal, basal/squamous, stroma rich, and neuroendocrine like), each with distinct biological and clinical behaviors. In metastatic disease, NGS and whole-exome analyses reveal strong concordance with localized tumors, with frequent &lt;em&gt;TP53&lt;/em&gt;, &lt;em&gt;ARID1A&lt;/em&gt;, &lt;em&gt;KMT2D&lt;/em&gt;, &lt;em&gt;RB1&lt;/em&gt;, and &lt;em&gt;FGFR3&lt;/em&gt; alterations and APOBEC mutational signatures. Transcriptomic profiling shows subtype heterogeneity and therapy-induced remodeling. Clinically, only &lt;em&gt;FGFR3&lt;/em&gt; alterations currently guide therapy, with erdafitinib approved by the US Food and Drug Administration and the European Medicines Agency for &lt;em&gt;FGFR3&lt;/em&gt;-altered metastatic disease. Beyond tumor testing, circulating tumor DNA assays show promise for molecular residual disease detection and adjuvant treatment stratification.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusions&lt;/h3&gt;&lt;div&gt;Molecular profiling has deepened the understanding of bladder cancer biology and identified potential biomarkers for diagnosis, prognosis, and treatment. However, clinical implementation remains limited, and prospective biomarker-driven trials are needed to establish the role of ge","PeriodicalId":12256,"journal":{"name":"European urology oncology","volume":"9 4","pages":"Pages 986-996"},"PeriodicalIF":8.5,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148410739","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}