Urologic Oncology-seminars and Original Investigations最新文献

{"title":"Assessing the uptake of core outcome sets in randomized controlled trials for localized prostate cancer: A cross-sectional study.","authors":"Carson L Wright, Joseph Case, Trevor Magee, Kimberly Magana, Kyle Fitzgerald, Garrett Jones, Jay Modi, Shaelyn Ward, Griffin Hughes, Alicia Ito-Ford, Matt Vassar","doi":"10.1016/j.urolonc.2025.07.008","DOIUrl":"https://doi.org/10.1016/j.urolonc.2025.07.008","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate core outcome set (COS) completion recommended in localized prostate cancer (LPC) randomized controlled trials (RCTs).</p><p><strong>Methods: </strong>We identified the original LPC COS from 2017 established by the Core Outcome Measures in Effectiveness Trials Initiative. We conducted a search of LPC RCT registries between 2013 and 2023 from databases on ClinicalTrials.gov and International Clinical Trials Registry Platform (ICTRP) via who.int. We screened RCTs from our search in a masked, duplicate fashion. We extracted trial characteristics and specific COS outcomes for survival, bodily functions, quality of life, and treatment-specific outcomes again in a masked, duplicate fashion. COS uptake results were analyzed using an interrupted time series analysis.</p><p><strong>Results: </strong>Our initial search of ClinicalTrials.gov and ICTRP yielded 13,909 trials. After exclusions, we extracted data from 82 clinical trials. \"Disease Progression\" (76/82; 92.68%) was the most commonly measured outcome while \"Need for Salvage Therapy\" (27/82; 32.93%) was the least. Limitations include lack of generalization for other COSs and inability to confirm systematic search returned all pertinent trials.</p><p><strong>Conclusion: </strong>A nonsignificant decrease in COS adherence prior to the publication of a COS for LPC in 2017 occurred, then a subsequent nonsignificant increase in COS adherence after. We recommend LPC clinical trialists adhere to the COS outlined in our study and that further uptake studies be done to assess future LPC COS adherence.</p>","PeriodicalId":23408,"journal":{"name":"Urologic Oncology-seminars and Original Investigations","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144761469","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Leveraging DNA repair deficiency to personalize radiopharmaceutical therapy in prostate cancer.","authors":"Panagiotis J Vlachostergios","doi":"10.1016/j.urolonc.2025.07.001","DOIUrl":"https://doi.org/10.1016/j.urolonc.2025.07.001","url":null,"abstract":"<p><p>Radiopharmaceutical therapies targeting prostate-specific membrane antigen (PSMA) have transformed the management of metastatic prostate cancer, yet inter-patient variability in therapeutic response remains a critical challenge. Emerging evidence indicates that defects in DNA repair pathways, including homologous recombination deficiency (HRD) and mismatch repair deficiency (MMRd), sensitize tumor cells to ionizing radiation by impairing damage resolution. Ongoing research explores the potential of integrating genomic profiling of DNA repair defects to optimize patient selection and personalize radiopharmaceutical strategies such as 177Lu-PSMA and alpha-emitting conjugates. Clinical efforts to combine targeted radiation with synthetic lethality approaches are ongoing. Tailoring radiopharmaceutical therapy to individual tumor DNA repair profiles offers a promising paradigm to improve outcomes and expand therapeutic windows in advanced prostate cancer.</p>","PeriodicalId":23408,"journal":{"name":"Urologic Oncology-seminars and Original Investigations","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144745138","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Characterizing obesity: Its' time we address the elephant in the room!","authors":"Rohan Magoon","doi":"10.1016/j.urolonc.2025.06.016","DOIUrl":"https://doi.org/10.1016/j.urolonc.2025.06.016","url":null,"abstract":"","PeriodicalId":23408,"journal":{"name":"Urologic Oncology-seminars and Original Investigations","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144733477","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Early real-world utilization of avelumab switch maintenance among patients with advanced urothelial carcinoma without progression following treatment with first-line platinum-based chemotherapy.","authors":"Helen H Moon, Jeanny B Aragon-Ching, Allison Thompson, Anup Abraham, Anna Vlahiotis, Chiemeka Ike, Darrin Benjumea, Anran Shao, Haiyan Sun, Mairead Kearney, Norbek Gharibian, Sarah Hanson, Benjamin Li, Melissa Kirker, Petros Grivas","doi":"10.1016/j.urolonc.2025.05.014","DOIUrl":"https://doi.org/10.1016/j.urolonc.2025.05.014","url":null,"abstract":"<p><strong>Background: </strong>A standard treatment option for patients with locally advanced/metastatic urothelial carcinoma (la/mUC) is first-line platinum-based chemotherapy (1L PBC) followed by avelumab 1L switch maintenance (1LM) in patients without progression. This study aimed to evaluate the real-world treatment patterns and outcomes in patients with la/mUC in the US treated with 1L PBC and characterize the early adoption of avelumab 1LM following FDA approval in June 2020.</p><p><strong>Methods: </strong>This retrospective cohort study identified adults diagnosed with la/mUC between January 2017 and September 2021 using electronic health records from the Flatiron Health database. Patients were grouped based on real-world response to 1L PBC: complete or partial response (rwCR/PR) or stable disease (rwSD). Baseline characteristics and treatment patterns were described. Clinical outcomes, including real-world overall survival (rwOS) and progression-free survival (rwPFS), were analyzed using the Kaplan-Meier method.</p><p><strong>Results: </strong>Of 1,703 identified patients with la/mUC treated with 1L PBC, 1,245 (73%) had response data available during the study period, with 998 (80%) having a best response of rwCR/PR (60%) or rwSD (20%). Demographic and clinical characteristics were similar between patients with rwCR/PR and rwSD. Patients with rwCR/PR had longer median rwOS and rwPFS from 1L PBC initiation vs patients with rwSD. Of patients evaluated after FDA approval of avelumab 1LM on June 30, 2020, 435 discontinued 1L PBC. Of these patients, 339 had response data, and 138 of those without progression were considered avelumab 1LM eligible. Of these, 97 (70%) initiated avelumab 1LM within 180 days following last administration of 1L PBC, with 40 patients receiving second-line (2L) treatment, most commonly enfortumab vedotin (60%).</p><p><strong>Conclusion: </strong>In the post-FDA approval period, uptake of avelumab 1LM was high (70%) in patients with rwSD or rwCR/PR following 1L PBC, and 41% of these patients received 2L treatment, most commonly with enfortumab vedotin.</p>","PeriodicalId":23408,"journal":{"name":"Urologic Oncology-seminars and Original Investigations","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144660391","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cover 2 - Masthead","authors":"","doi":"10.1016/S1078-1439(25)00230-3","DOIUrl":"10.1016/S1078-1439(25)00230-3","url":null,"abstract":"","PeriodicalId":23408,"journal":{"name":"Urologic Oncology-seminars and Original Investigations","volume":"43 8","pages":"Page IFC"},"PeriodicalIF":2.4,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144580331","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tumor profiling of advanced urothelial carcinoma: Comparative analysis based on social determinants of health.","authors":"Lacey J Hart, Kenny Barker, Denis Ruzdija, Aaron Bertolo, Irasema Concepcion Paster, Ricardo J Estrada-Mendizabal, Jose Manuel Guillen, Alejandro Recio-Boiles, Juan Chipollini","doi":"10.1016/j.urolonc.2025.06.008","DOIUrl":"https://doi.org/10.1016/j.urolonc.2025.06.008","url":null,"abstract":"<p><strong>Background: </strong>Studies on the genomic characteristics of urothelial carcinoma (UC) patients from diverse backgrounds are scarce. Herein, we sought to characterize genomic landscapes of advanced UC in a regional representative cohort to examine the possibility that patients from different backgrounds may have socioeconomic-influenced molecular changes.</p><p><strong>Methods: </strong>We retrospectively evaluated clinical and genomic findings of UC patients presenting to the University of Arizona Cancer Center (Tucson, AZ) from 2016 to 2023. Molecular profiles were obtained using DNA next-generation sequencing (Caris Life Sciences) and stratified based on Area Deprivation Index (ADI) collected from each patient residential address. Patients were categorized as living in low (1-49) or high (50-100) ADI residences, with increasing scores indicating higher socioeconomic disadvantage.</p><p><strong>Results: </strong>Among 97 patients, 43 resided in low ADI areas and 54 in high ADI areas. Higher Hispanic ethnicity (P = 0.011) and lower mean household income (P < 0.001) were seen in high ADI areas. There were no differences in microsatellite instability, loss of heterozygosity or PD-L1 expression. Patients from high ADI neighborhoods had lower TMB scores (62.7 % vs. 51.3%) when compared to low ADI neighborhoods (P = 0.291). The genes with higher rates of alterations when comparing low vs high ADI areas were PIK3CA (20.9% vs. 16.7%, P = 0.610), TP53 (62.8% vs. 40.7%, P = 0.041), KDM (18.6% vs. 22.2%, P = 0.802), ARID1A (20.9% vs. 25.9%, P = 0.636), and TERT (41.9% vs. 35.2%, P = 0.674). A high rate of immunotherapy use (66.7%) and clinic trial enrollment (73.3%) was noted in high ADI patients. There were no overall survival differences between the groups.</p><p><strong>Conclusion: </strong>Few genomic differences were seen based on socioeconomic status. Lower rates of TP53 alterations and low TMB were seen in patients from disadvantaged neighborhoods. Neighborhood-level factors potentially leading to cancer disparities warrant investigation.</p>","PeriodicalId":23408,"journal":{"name":"Urologic Oncology-seminars and Original Investigations","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144601667","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Survival outcomes for men with metastatic castration-resistant prostate cancer (mCRPC) with and without homologous recombination deficiencies (HRD) treated with radium 223: Princess Margaret Cancer Centre (PMCC) experience.","authors":"Esmail M Al-Ezzi, Osama Abdeljalil, Katherine Lajkosz, Shreya S Gramolini, Husam Alqaisi, Jenny Peng, Richard Odwyer, Mohammed Alghamdi, Sulaiman Almuthri, Vikaash Kumar, Di Maria Jiang, Nazanin Fallah-Rad, Neil Fleshner, Srikala S Sridhar","doi":"10.1016/j.urolonc.2025.06.004","DOIUrl":"https://doi.org/10.1016/j.urolonc.2025.06.004","url":null,"abstract":"<p><strong>Background: </strong>Radium-223 (²²³Ra) targets bone metastases in metastatic castration resistant prostate cancer (mCRPC) and induces double-strand DNA breaks. We hypothesized that patients with homologous recombination deficiencies (HRD) may exhibit heightened sensitivity to ²²³Ra, resulting in improved survival outcomes.</p><p><strong>Methods: </strong>This retrospective analysis was performed in men with mCRPC and bone metastases, with and without HRD, treated with androgen deprivation therapy (ADT) and ²²³Ra at the PMCC. Demographics, disease characteristics, and/or somatic DNA sequencing data were collected.</p><p><strong>Results: </strong>Between 2015 and 2022, we identified 40 mCRPC patients who underwent ²²³Ra therapy and had germline and/or somatic DNA sequencing data available. HRD mutations were found in 9/40 (22.5%) patients. Median overall survival was longer in the HRD group vs. non-HRD group (24 vs 12 months; p = 0.038). Median progression-free survival was 5.7 vs. 3.3 months (P = 0.74). PSA response was also higher in the HRD group (33.3% vs. 9.7%; P = 0.11), as was ALP response (66.7% vs. 58.1%; p = 0.72). Among patients with an ALP response, 3-year survival probability was 33% in the HRD group vs 11% in the non-HRD group (P = 0.03).</p><p><strong>Conclusions: </strong>Despite the small size, these findings suggest that patient with HRD may have a slight improvement in survival outcomes after ²²³Ra treatment, but prospective validation is required.</p>","PeriodicalId":23408,"journal":{"name":"Urologic Oncology-seminars and Original Investigations","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144601666","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Vigorous physical activity as a potential environmental risk factor in renal medullary carcinoma.","authors":"Daniel D Shapiro, Sagar S Mukhida, Andrew W Hahn, Ayman Isahaku, Schyler M Turner, Jessica P Cheng, Pankaj K Chauhan, Susan S Thomas, Beei Chan, Zita D Lim, Nizar M Tannir, Maria Chang Swartz, Pavlos Msaouel","doi":"10.1016/j.urolonc.2025.06.012","DOIUrl":"10.1016/j.urolonc.2025.06.012","url":null,"abstract":"<p><strong>Purpose: </strong>Renal medullary carcinoma (RMC) is a rare but aggressive kidney cancer affecting young individuals with sickle hemoglobinopathies. Prior retrospective case-control and mouse modeling studies suggest a mechanism linking vigorous intensity physical activity to increased RMC risk in individuals with sickle hemoglobinopathies. This study aimed to prospectively investigate the association between vigorous intensity exercise and RMC.</p><p><strong>Materials and methods: </strong>This study used a validated questionnaire to prospectively assess reported physical activity in a large cohort of patients with RMC compared to the activity of individuals without RMC. Between 2022 and 2024, patients with RMC (N = 39) were prospectively surveyed using the validated Physical Activity Questionnaire from the National Health and Nutritional Examination Survey and compared to responses of a national cohort of healthy individuals (N = 7148). This questionnaire is designed to distinguish between vigorous, moderate, and sedentary activity. To further validate the questionnaire, we performed body-composition analysis to determine if patients reporting vigorous activity had increased skeletal muscle mass and decreased subcutaneous adipose tissue.</p><p><strong>Results: </strong>Individuals had higher odds of RMC diagnosis if reporting vigorous intensity physical activity at work (OR 2.91, 95% CI 1.50-5.66; P = 0.002) or recreationally (OR 4.02, 95% CI 1.85-8.74; P < 0.001) after adjusting for age, biologic sex, and race. Body composition analysis confirmed that patients reporting vigorous physical activity were more likely to have a higher skeletal muscle mass index (median 54.3 vs. 41.2 cm²/m²; P = 0.01) compared to patients not reporting vigorous physical activity.</p><p><strong>Conclusion: </strong>These results prospectively support the association between vigorous physical activity and RMC in individuals with sickle hemoglobinopathies.</p>","PeriodicalId":23408,"journal":{"name":"Urologic Oncology-seminars and Original Investigations","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12257618/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144567891","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"National trends in diagnoses of subtype histologies in bladder cancer: A population-based study based on the SEER database.","authors":"Brendan K Wallace, Zhuo Tony Su, James P Flynn, Tyler S Garman, Aidan Weitzner, Michael E Rezaee, Ezra G Baraban, Andres Matoso, Armine K Smith, Sunil H Patel, Max R Kates","doi":"10.1016/j.urolonc.2025.06.010","DOIUrl":"https://doi.org/10.1016/j.urolonc.2025.06.010","url":null,"abstract":"<p><strong>Objective: </strong>Accurate diagnosis of histological subtypes is critical to inform optimal clinical management of patients with bladder cancer. However, the diagnosis of histological subtypes remains a challenge and significant interobserver variability persists. We analyzed temporal trends in the diagnosis of histological subtypes in bladder cancer in the US.</p><p><strong>Methods: </strong>Utilizing the Surveillance, Epidemiology, and End Results (SEER) 17 registry, we evaluated squamous cell carcinoma (SCC), adenocarcinoma (AC), neuroendocrine carcinoma (NC), and other histological subtypes including micropapillary, sarcomatoid, and plasmacytoid variants, diagnosed in cystectomy specimens for patients with pT2-4 primary bladder carcinoma during 2000-2020. We performed Spearman's rank-order correlation to assess temporal trends in the proportions of patients diagnosed with each histology category. We divided the 21-year analysis period into seven 3-year intervals and aggregated data over each interval to improve the precision of proportion estimates. We conducted multivariable logistic regression to adjust for covariates.</p><p><strong>Results: </strong>We identified 28,160 patients. In unadjusted analysis, the proportion of patients diagnosed with SCC decreased significantly over time (ρ -0.86, P = 0.02). The proportion diagnosed with other histological subtypes increased significantly over time (ρ 1.00, P = 0.001). After adjusting for covariates, a later year of diagnosis was associated with significantly increased odds of NC (OR 1.07, P= 0.001) and other histological subtype diagnoses (OR 1.16, P < 0.001).</p><p><strong>Conclusions: </strong>Variant histological subtypes of muscle-invasive bladder cancer in cystectomy specimens from patients in the US have increased over time. These trends could reflect increasing awareness of histological subtypes among pathologists.</p>","PeriodicalId":23408,"journal":{"name":"Urologic Oncology-seminars and Original Investigations","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144567879","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Robot-assisted nephroureterectomy.","authors":"Mohit Butaney, Michael Wang, Craig G Rogers, Johar Raza","doi":"10.1016/j.urolonc.2025.06.002","DOIUrl":"https://doi.org/10.1016/j.urolonc.2025.06.002","url":null,"abstract":"<p><p>Nephroureterectomy is the standard of care for high grade and recurrent low grade upper urinary tract urothelial cell carcinoma (UTUC). Robot-assisted nephroureterectomy (RANU) is an established technique for the minimally invasive performance of nephroureterectomy and has grown to be the favored approach over the past decade. The 3-dimensional vision, efficient wristed suturing, and precise movements of RANU offer advantages over laparoscopic nephroureterectomy (LNU). In addition to the expected benefits with reduced perioperative morbidity, available oncological outcomes are comparable to data associated with other published series. In this review we discuss the indications, preparation, technique, and oncologic outcomes of transperitoneal RANU.</p>","PeriodicalId":23408,"journal":{"name":"Urologic Oncology-seminars and Original Investigations","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144561302","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}