Prostate Cancer and Prostatic Diseases最新文献

{"title":"The times have changed. Let the urologists change!","authors":"Luca Cindolo, Feras Al Jaafari, C. de Nunzio","doi":"10.1038/s41391-024-00828-w","DOIUrl":"https://doi.org/10.1038/s41391-024-00828-w","url":null,"abstract":"","PeriodicalId":20727,"journal":{"name":"Prostate Cancer and Prostatic Diseases","volume":null,"pages":null},"PeriodicalIF":4.8,"publicationDate":"2024-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140741383","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Targeting the tumor microenvironment, a new therapeutic approach for prostate cancer","authors":"Bangwei Fang, Ying Lu, Xiaomeng Li, Yu Wei, Dingwei Ye, Gonghong Wei, Yao Zhu","doi":"10.1038/s41391-024-00825-z","DOIUrl":"https://doi.org/10.1038/s41391-024-00825-z","url":null,"abstract":"<h3 data-test=\"abstract-sub-heading\">Background</h3><p>A growing number of studies have shown that in addition to adaptive immune cells such as CD8 + T cells and CD4 + T cells, various other cellular components within prostate cancer (PCa) tumor microenvironment (TME), mainly tumor-associated macrophages (TAMs), cancer-associated fibroblasts (CAFs) and myeloid-derived suppressor cells (MDSCs), have been increasingly recognized as important modulators of tumor progression and promising therapeutic targets.</p><h3 data-test=\"abstract-sub-heading\">Objective</h3><p>In this review, we aim to delineate the mechanisms by which TAMs, CAFs and MDSCs interact with PCa cells in the TME, summarize the therapeutic advancements targeting these cells and discuss potential new therapeutic avenues.</p><h3 data-test=\"abstract-sub-heading\">Methods</h3><p>We searched PubMed for relevant studies published through December 10 2023 on TAMs, CAFs and MDSCs in PCa.</p><h3 data-test=\"abstract-sub-heading\">Results</h3><p>TAMs, CAFs and MDSCs play a critical role in the tumorigenesis, progression, and metastasis of PCa. Moreover, they substantially mediate therapeutic resistance against conventional treatments including anti-androgen therapy, chemotherapy, and immunotherapy. Therapeutic interventions targeting these cellular components have demonstrated promising effects in preclinical models and several clinical trials for PCa, when administrated alone, or combined with other anti-cancer therapies. However, the lack of reliable biomarkers for patient selection and incomplete understanding of the mechanisms underlying the interactions between these cellular components and PCa cells hinder their clinical translation and utility.</p><h3 data-test=\"abstract-sub-heading\">Conclusion</h3><p>New therapeutic strategies targeting TAMs, CAFs, and MDSCs in PCa hold promising prospects. Future research endeavors should focus on a more comprehensive exploration of the specific mechanisms by which these cells contribute to PCa, aiming to identify additional drug targets and conduct more clinical trials to validate the safety and efficacy of these treatment strategies.</p>","PeriodicalId":20727,"journal":{"name":"Prostate Cancer and Prostatic Diseases","volume":null,"pages":null},"PeriodicalIF":4.8,"publicationDate":"2024-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140583277","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Emerging racial disparities among Medicare beneficiaries and Veterans with metastatic castration-sensitive prostate cancer","authors":"Daniel J. George,&nbsp;Neeraj Agarwal,&nbsp;Krishnan Ramaswamy,&nbsp;Zachary Klaassen,&nbsp;Rhonda L. Bitting,&nbsp;David Russell,&nbsp;Rickard Sandin,&nbsp;Birol Emir,&nbsp;Hongbo Yang,&nbsp;Wei Song,&nbsp;Yilu Lin,&nbsp;Agnes Hong,&nbsp;Wei Gao,&nbsp;Stephen J. Freedland","doi":"10.1038/s41391-024-00815-1","DOIUrl":"10.1038/s41391-024-00815-1","url":null,"abstract":"Previous studies have shown that Black men receive worse prostate cancer care than White men. This has not been explored in metastatic castration-sensitive prostate cancer (mCSPC) in the current treatment era. We evaluated treatment intensification (TI) and overall survival (OS) in Medicare (2015–2018) and Veterans Health Administration (VHA; 2015–2019) patients with mCSPC, classifying first-line mCSPC treatment as androgen deprivation therapy (ADT) + novel hormonal therapy; ADT + docetaxel; ADT + first-generation nonsteroidal antiandrogen; or ADT alone. We analyzed 2226 Black and 16,071 White Medicare, and 1020 Black and 2364 White VHA patients. TI was significantly lower for Black vs White Medicare patients overall (adjusted odds ratio [OR] 0.68; 95% confidence interval [CI] 0.58–0.81) and without Medicaid (adjusted OR 0.70; 95% CI 0.57–0.87). Medicaid patients had less TI irrespective of race. OS was worse for Black vs White Medicare patients overall (adjusted hazard ratio [HR] 1.20; 95% CI 1.09–1.31) and without Medicaid (adjusted HR 1.13; 95% CI 1.01–1.27). OS was worse in Medicaid vs without Medicaid, with no significant OS difference between races. TI was significantly lower for Black vs White VHA patients (adjusted OR 0.75; 95% CI 0.61–0.92), with no significant OS difference between races. Guideline-recommended TI was low for all patients with mCSPC, with less TI in Black patients in both Medicare and the VHA. Black race was associated with worse OS in Medicare but not the&nbsp;VHA. Medicaid patients had less TI and worse OS than those without Medicaid, suggesting poverty and race are associated with care and outcomes.","PeriodicalId":20727,"journal":{"name":"Prostate Cancer and Prostatic Diseases","volume":null,"pages":null},"PeriodicalIF":5.1,"publicationDate":"2024-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.nature.com/articles/s41391-024-00815-1.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140583006","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The association of patient and disease characteristics with the overtreatment of low-risk prostate cancer from 2010 to 2016.","authors":"Cooper Desmond, Sumedh Kaul, Aaron Fleishman, Ruslan Korets, Peter Chang, Andrew Wagner, Simon P Kim, Nima Aghdam, Aria F Olumi, Boris Gershman","doi":"10.1038/s41391-024-00822-2","DOIUrl":"https://doi.org/10.1038/s41391-024-00822-2","url":null,"abstract":"<p><strong>Background: </strong>Although active surveillance is the preferred management for low-risk prostate cancer (PCa), some men remain at risk of overtreatment with definitive local therapy. We hypothesized that baseline characteristics may be associated with overtreatment and represent a potential source of health disparities. We therefore examined the associations of patient and disease characteristics with the surgical overtreatment of low-risk PCa.</p><p><strong>Methods: </strong>We identified men aged 45-75 years with cT1 cN0 cM0 prostate adenocarcinoma with biopsy Gleason score 6 and PSA < 10 ng/ml from 2010-2016 in the National Cancer Database (NCDB) and who underwent radical prostatectomy (RP). We evaluated the associations of baseline characteristics with clinically insignificant PCa (iPCa) at RP (i.e., \"overtreatment\"), defined as organ-confined (i.e., pT2) Gleason 3 + 3 disease, using multivariable logistic regression.</p><p><strong>Results: </strong>We identified 36,088 men with low-risk PCa who underwent RP. The unadjusted rate of iPCa decreased during the study period, from 54.7% in 2010 to 40.0% in 2016. In multivariable analyses adjusting for baseline characteristics, older age (OR 0.98, 95% CI 0.97-0.98), later year of diagnosis (OR 0.62, 95% CI 0.57-0.67 for 2016 vs. 2010), Black race (OR 0.85, 95% CI 0.79-0.91), treatment at an academic/research program (OR 0.82, 95% CI 0.73-0.91), higher PSA (OR 0.91, 95% CI 0.90-0.92), and higher number of positive biopsy cores (OR 0.87, 95% CI 0.86-0.88) were independently associated with a lower risk of overtreatment (iPCa) at RP. Conversely, a greater number of biopsy cores sampled (OR 1.01, 95% CI 1.01-1.02) was independently associated with an increased risk of overtreatment (iPCa) at RP.</p><p><strong>Conclusions: </strong>We observed an ~27% reduction in rates of overtreatment of men with low-risk PCa over the study period. Several patient, disease, and structural characteristics are associated with detection of iPCa at RP and can inform the management of men with low-risk PCa to reduce potential overtreatment.</p>","PeriodicalId":20727,"journal":{"name":"Prostate Cancer and Prostatic Diseases","volume":null,"pages":null},"PeriodicalIF":4.8,"publicationDate":"2024-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140330097","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The diagnostic yield of the Meares & Stamey test can be significantly improved by symptom-based patient selection and the experience of the test performer","authors":"Tommaso Cai,&nbsp;Irene Tamanini,&nbsp;Katia Odorizzi,&nbsp;Luca Gallelli,&nbsp;Massimiliano Lanzafame,&nbsp;Sandra Mazzoli,&nbsp;Paolo Lanzafame,&nbsp;Orietta Massidda,&nbsp;Alessandro Palmieri,&nbsp;Florian M. E. Wagenlehner,&nbsp;Truls E. Bjerklund Johansen,&nbsp;Cosimo De Nunzio","doi":"10.1038/s41391-024-00824-0","DOIUrl":"10.1038/s41391-024-00824-0","url":null,"abstract":"Even if Meares-Stamey 4-glass (M&amp;S) test is regarded a decisive tool for diagnosing prostatitis its use is only rarely performed in everyday clinical practice. Here, we analyze if the diagnostic yield of the M&amp;S test could be improved by a pre-test categorization of patients due to undergo a M&amp;S test. All clinical and microbiological data of patients who underwent M&amp;S test in two urological centers from January 2004 to December 2021 were analyzed in this retrospective cohort study. One center has a dedicated staff member for the study of prostatitis (Cohort I), while the other center is a general urological unit (Cohort II). All patients were divided into 3 groups on the basis of the assembled data: patients with symptoms related to prostatitis only (Group I), patients with symptoms related to both prostatitis and BPH (Group II), patients with symptoms related to BPH only (Group III). The rates of positive microbiological results in each group were compared. In the whole period, 9347 patients were analyzed and categorized as follows: Group I, 1884; Group II, 5151; Group III, 2312. Three-thousand and eight-hundred twenty-three patients showed positive culture results (40.9%). The most common isolated species was Escherichia coli (49.7%), followed by Enteroccus spp. (31.8%). The rates of positive M&amp;S tests in the different symptom groups were: Group I, 1532 (81.4%); Group II, 1494 (29.0%); Group III, 797 (34.4%). The overall rate of positive M&amp;S tests in each urology center showed that the center with a staff member who is dedicated to prostatitis studies (Cohort I) had a significantly higher rate of positive M&amp;S tests than the general urological department (Cohort II) (64.3% vs 31.4%; p &lt; 0.001). Symptom-based patient selection and dedicated staff members will increase the diagnostic yield of the M&amp;S test and reduce the number of unnecessary tests.","PeriodicalId":20727,"journal":{"name":"Prostate Cancer and Prostatic Diseases","volume":null,"pages":null},"PeriodicalIF":4.8,"publicationDate":"2024-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140330098","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A randomized controlled trial evaluating low-intensity shockwave therapy for treatment of persistent storage symptoms following transurethral surgery for benign prostatic obstruction","authors":"Mohammed Hegazy,&nbsp;Khaled Z. Sheir,&nbsp;Mohamed A. Gaballah,&nbsp;Ahmed M. Elshal","doi":"10.1038/s41391-024-00820-4","DOIUrl":"10.1038/s41391-024-00820-4","url":null,"abstract":"Low-intensity shockwave therapy (Li-SWT) can improve bladder function through enhancement of angiogenesis and nerve regeneration and suppression of inflammation and overactivity. In this trial, we aimed to evaluate the efficacy of Li-SWT on persistent storage symptoms after transurethral surgery (TUS) for benign prostatic obstruction (BPO). Between July 2020 and July 2022, 137 patients with persistent storage symptoms; urgency episodes/24 h ≥ 1 and daytime frequency ≥8, for at least three months after TUS for BPO were randomly allocated to Li-SWT versus sham versus solifenacin 10 mg/day in 3:1:1 ratio. The primary end point was the percent reduction from baseline in overactive bladder symptom score (OABSS) at 3-month follow-up. The changes in 3-day voiding diary parameters, quality of life (QoL) score, peak flow rate and residual urine at 3 and 6-month follow-up were compared. Treatment-related adverse effects were also evaluated. Baseline data were comparable between groups. The percent reduction from baseline in OABSS at 3-month follow-up was significantly higher in Li-SWT compared to sham (−55% versus −11%), and it was comparable between Li-SWT and solifenacin-10 (−55% versus −60%). Li-SWT achieved significant improvement like solifenacin-10 in 3-day voiding diary parameters and QoL score at 3-month follow-up. This improvement remained comparable between Li-SWT and solifenacin-10 at 6-month follow-up. No adverse effects related to Li-SWT were noted apart from tolerable pain during the procedure. Solifenacin-10 was associated with bothersome adverse effects in 73% of the patients with 11.5% discontinuation rate. Li-SWT ameliorates persistent storage symptoms and promotes QoL after TUS for BPO, with comparable efficacy and better tolerance compared to solifenacin.","PeriodicalId":20727,"journal":{"name":"Prostate Cancer and Prostatic Diseases","volume":null,"pages":null},"PeriodicalIF":4.8,"publicationDate":"2024-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.nature.com/articles/s41391-024-00820-4.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140327071","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Real-world overall survival with abiraterone acetate versus enzalutamide in chemotherapy-naïve patients with metastatic castration-resistant prostate cancer","authors":"Daniel J. George,&nbsp;Krishnan Ramaswamy,&nbsp;Hongbo Yang,&nbsp;Qing Liu,&nbsp;Adina Zhang,&nbsp;Alexandra Greatsinger,&nbsp;Jasmina Ivanova,&nbsp;Betty Thompson,&nbsp;Birol Emir,&nbsp;Agnes Hong,&nbsp;Stephen J. Freedland","doi":"10.1038/s41391-024-00816-0","DOIUrl":"10.1038/s41391-024-00816-0","url":null,"abstract":"There are no large head-to-head phase 3 clinical trials comparing overall survival (OS) for abiraterone and enzalutamide. This study used Medicare claims data to compare OS in patients with chemotherapy-naïve metastatic castration-resistant prostate cancer (mCRPC) who initiated abiraterone or enzalutamide. This retrospective analysis of the Medicare database (2009–2020) included adult men with ≥1 claim for prostate cancer, metastatic diagnosis, and no prior chemotherapy or novel hormone therapy who initiated first-line (1L) abiraterone or enzalutamide in the index period (September 10, 2014 to May 31, 2017). Cox proportional-hazards models with inverse probability treatment-weighting (IPTW) were used to compare OS between abiraterone- and enzalutamide-treated patients, adjusting for baseline characteristics. Subgroup analyses by baseline characteristics were also conducted. Overall, 5506 patients who received 1L abiraterone (n = 2911) or enzalutamide (n = 2595) were included. Median follow-up was comparable in both cohorts (abiraterone, 19.1 months; enzalutamide, 20.3 months). IPTW-adjusted median OS (95% CI) was 20.6 months (19.7‒21.4) for abiraterone and 22.5 months (21.2‒23.8) for enzalutamide, with an IPTW-adjusted hazard ratio (95% CI) of 1.10 (1.04–1.16). Median OS was significantly shorter for abiraterone versus enzalutamide in patients ≥75 years old; White patients; patients with baseline diabetes, cardiovascular disease, both diabetes and cardiovascular disease, and renal disease; and across all socioeconomic strata. In the Medicare chemotherapy-naïve mCRPC population, 1L abiraterone was associated with worse OS versus enzalutamide in the overall population and among subgroups with older age and comorbidities, supporting findings from previous real-world studies and demonstrating a disparity in outcomes.","PeriodicalId":20727,"journal":{"name":"Prostate Cancer and Prostatic Diseases","volume":null,"pages":null},"PeriodicalIF":5.1,"publicationDate":"2024-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.nature.com/articles/s41391-024-00816-0.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140306632","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Is extended pelvic lymph node dissection REALLY required for staging of prostate cancer in the PSMA-PET era?","authors":"Matthew J Roberts, John W Yaxley, Johan Stranne, Inge M van Oort, Derya Tilki","doi":"10.1038/s41391-024-00821-3","DOIUrl":"https://doi.org/10.1038/s41391-024-00821-3","url":null,"abstract":"","PeriodicalId":20727,"journal":{"name":"Prostate Cancer and Prostatic Diseases","volume":null,"pages":null},"PeriodicalIF":4.8,"publicationDate":"2024-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140194429","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Extraperitoneal robot assisted laparoscopic prostatectomy with Versius system: single centre experience","authors":"F. Dibitetto,&nbsp;C. Fede Spicchiale,&nbsp;R. Castellucci,&nbsp;S. Sansalone,&nbsp;A. Akhundov,&nbsp;L. Defidio,&nbsp;M. De Dominicis","doi":"10.1038/s41391-024-00810-6","DOIUrl":"10.1038/s41391-024-00810-6","url":null,"abstract":"Versius Surgical System (CMR Surgical, Cambridge, UK) is a novel tele-operated robotic surgical system designed to assist surgeons for minimally invasive surgery which is gaining momentum in the world of robotic surgery. We describe our single centre experience with Versius and report the advantages and challenges posed by this new robotic system in a series of 53 extraperitoneal robotic assisted laparoscopic prostatectomies (eRALP) for prostate cancer (PCa). Data of 53 eRALP performed with Versius in our centre were collected and analysed, Descriptive statistics were used to report our results. In 16 months we performed 53 eRALP: 18 (34%) with PLND, 33 (62%) nerve sparing&nbsp;cases. Mean setup time was 15 min, mean console time was 100 min and mean operative time was 130 min. We observed a substantial reduction of console time and set-up time after only 5 procedures. In the first 4 procedures, the dissection of the neurovascular bundle was performed laparoscopically, to switch back to robotic assisted approach afterwards. No major system failures were observed. No major intra-operative and post-operative complications occurred. Mean follow-up time was 9 months (range 3–15 months); no patients experienced biochemical recurrence or metastatic progression over this period, 8 (15%) patients had adjuvant radiotherapy based on unfavourable pathology report (positive surgical margins or positive limphnodes). This represents to our knowledge the largest extraperitoneal RALP case series with Versius, and it aims to provide solid clinical proof of the safety, effectiveness and versatility of this innovative system. In our experience, this platform represents a good option for every urologic surgeon who wants to start a robotic programme and it appears particularly suitable for urologists with a large laparoscopic expertise.","PeriodicalId":20727,"journal":{"name":"Prostate Cancer and Prostatic Diseases","volume":null,"pages":null},"PeriodicalIF":4.8,"publicationDate":"2024-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140140628","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"TRexit is going one step further","authors":"Roberto Miano,&nbsp;Guglielmo Manenti,&nbsp;Luca Orecchia","doi":"10.1038/s41391-024-00819-x","DOIUrl":"10.1038/s41391-024-00819-x","url":null,"abstract":"","PeriodicalId":20727,"journal":{"name":"Prostate Cancer and Prostatic Diseases","volume":null,"pages":null},"PeriodicalIF":5.1,"publicationDate":"2024-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.nature.com/articles/s41391-024-00819-x.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140120434","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}