Aktuelle Urologie最新文献

{"title":"[Penile carcinoma: the importance of histological classification and new treatment strategies].","authors":"August Fiegl, Jan Niklas Mink, Kerstin Junker, Johannes Linxweiler, Arndt Hartmann","doi":"10.1055/a-2638-4574","DOIUrl":"https://doi.org/10.1055/a-2638-4574","url":null,"abstract":"<p><p>Penile carcinoma is a rare malignancy, predominantly derived from squamous epithelium, with a partially aggressive clinical course. The 2022 WHO classification distinguishes HPV-associated (HPV(+)) and HPV-independent (HPV(-)) subtypes, a differentiation that bears significant prognostic and therapeutic implications. HPV(-) carcinomas often develop as result of chronic inflammation, e.g. lichen sclerosus. While HPV(+) tumours, such as the warty subtype, often exhibit an indolent course, basaloid and sarcomatoid variants are associated with poor prognosis and an increased risk of metastasis.The prognostic value of HPV status alone is still inconsistent across studies. In contrast, p16 overexpression as surrogate marker for HPV infection, has been linked to improved survival outcomes. A combined assessment of HPV and p16 status is therefore recommended, particularly for therapeutic decision-making. In HPV(-) tumours, additional analysis of p53 expression is advisable, as TP53 mutations - frequently observed in this group - are associated with more aggressive tumour biology.Beyond conventional platinum-based chemotherapy, targeted therapies are gaining attention. Antibody-drug conjugates (ADCs), such as enfortumab vedotin (targeting Nectin-4) and sacituzumab govitecan (targeting Trop-2) have shown promising efficacy in other tumour types. Both targets are also expressed in penile carcinoma, and early clinical trials are underway. HER2 is expressed in a relevant proportion of cases and may be an additional therapeutic target.Immune checkpoint inhibitors like atezolizumab have so far demonstrated limited efficacy in penile cancer, despite high rates of PD-L1 expression. This discrepancy may be attributed to the immunosuppressive tumour microenvironment. EGFR-targeted monoclonal antibody therapies are also a potential treatment option.Accurate histopathological and molecular characterisation is critical for personalised treatment approaches and should become an integral component of the clinical management of penile carcinoma.</p>","PeriodicalId":7513,"journal":{"name":"Aktuelle Urologie","volume":" ","pages":""},"PeriodicalIF":0.4,"publicationDate":"2025-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144726471","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Studies on the expression and function of the PIWI-interacting RNA piRNA-27619 in prostate cancer with a focus on its potential oncogenic role].","authors":"Jenny Mauch, Hubert Kübler, Burkhard Gerhard Kneitz","doi":"10.1055/a-2642-1499","DOIUrl":"https://doi.org/10.1055/a-2642-1499","url":null,"abstract":"<p><p>Prostate cancer is the most common malignancy in men, yet predictive biomarkers for assessing individual risk remain insufficient. Recent research has highlighted PIWI-interacting RNA 26719 (piRNA-26719) as a potential tumor-associated gene 1 2. This study aims to identify and characterize the expression and function of piRNA-26719 in prostate cancer.The expression of piRNA-26719 was analyzed in a high-risk prostate cancer cohort (n=121, PSA preoperative >20ng/ml) and prostate cancer cell lines using quantitative RT-PCR. Functional analyses, including RNA interference (RNAi) and subsequent assays for cell proliferation, apoptosis, and cell cycle distribution, were conducted in prostate cancer cell lines.piRNA-26719 was biochemically validated. Expression analysis revealed a trend toward upregulation of piRNA-26719 in primary high-risk prostate tumors compared to benign hyperplasia, with significant overexpression in lymph node metastases. Functional studies demonstrated that inhibition of piRNA-26719 led to decreased proliferation in prostate cancer cells. Apoptosis assays confirmed the induced activation of caspase-dependent apoptosis, and cell cycle analysis indicated S-phase arrest in piRNA-26719-inhibited cells, but not in the less malignant 22RV1 line.These findings suggest an oncogenic role for piRNA-26719 in high-risk prostate cancer, particularly in aggressive forms, as evidenced by its overexpression in metastatic tissues. The oncogenic function of piRNA-26719 in prostate cancer is supported by its critical role in cellular proliferation, apoptosis, and cell cycle progression. These results warrant further investigation into piRNA-26719's potential as a prognostic biomarker and therapeutic target in prostate cancer management.</p>","PeriodicalId":7513,"journal":{"name":"Aktuelle Urologie","volume":" ","pages":""},"PeriodicalIF":0.3,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144688622","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Current and future treatment stratification of metastatic urothelial carcinoma: a great opportunity for true precision oncology].","authors":"Günter Niegisch, Stefanie Zschäbitz, Niklas Klümper, Markus Eckstein","doi":"10.1055/a-2622-6243","DOIUrl":"https://doi.org/10.1055/a-2622-6243","url":null,"abstract":"<p><p>For many decades, the treatment of metastatic urothelial carcinoma (mUC) has been dominated by platinum-containing chemotherapies. The latest version is the introduction of immune checkpoint inhibitors, especially in combination with modern antibody-drug conjugates (ADC) and FGFR3 inhibitors, but this therapeutic standard has been overtaken in some indications. Nevertheless, biomarker-guided therapy decisions have rarely been used to date. However, the biomarkers available to date have only helped in isolated therapeutic situations. For ADCs, however, this could change substantially when there is high expression variability of various targets such as NECTIN-4, Her2neu, EGFR and TROP2. The presence of activating FGFR3 mutations or fusions also opens up a clearly defined, albeit small, therapeutic niche that could possibly become larger in the future for localised stages of urothelial carcinoma. Biomarker stratification of tumours will presumably become indispensable in the future if we are to control and use these therapeutic innovations in a targeted and precise manner. Current developments therefore possess great potential for genuine precision oncology.</p>","PeriodicalId":7513,"journal":{"name":"Aktuelle Urologie","volume":" ","pages":""},"PeriodicalIF":0.3,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144537703","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Androgen receptor-targeted therapies - avoid clinically relevant interactions].","authors":"Hans-Peter Lipp, Gunhild von Amsberg, Axel S Merseburger, Steffen Rausch, Tilman Schöning, Jörg Klier, Peter J Goebell","doi":"10.1055/a-2593-1605","DOIUrl":"10.1055/a-2593-1605","url":null,"abstract":"<p><p>Pharmacotherapy of older patients requires special attention to drug interactions, based on an increase in morbidity and elevated need for polypharmacy. Especially for drugs with a narrow therapeutic index, interactions may require dose adjustments, discontinuation or switching of co-medication. These interactions are frequently based on pharmacokinetic alterations of drug metabolism via the cytochrome P450 (CYP) enzyme system, mainly via CYP3A4. This isoform is involved in the metabolism of about half of therapeutically applied drugs, including many agents commonly used in patients with prostate cancer. As a consequence, an impressive decrease in plasma levels of coadministered drugs has to be expected during the use of the potent CYP3A4 inducers apalutamide as well as enzalutamide, in contrast to the mild CYP3A4 inducer darolutamide. Abiraterone is classified as a moderate inhibitor of the CYP2D6 isozyme, which catalyses the biotransformation of fewer drugs. As a consequence, abiraterone's spectrum of interaction has to be interpreted differently. As pharmacotherapy approaches, it is helpful to understand the drug biotransformation pathways in more detail, in order to assess the extent of possible interactions that may necessitate the intensification of therapeutic monitoring, or dose modification or any therapeutic switch in time.</p>","PeriodicalId":7513,"journal":{"name":"Aktuelle Urologie","volume":" ","pages":""},"PeriodicalIF":0.4,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144224001","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[mpMRI of the Urinary Bladder: Significance and Clinical Use].","authors":"Kristina Tuchenhagen, Tibor Vag, Maximilian Christian Kriegmair","doi":"10.1055/a-2528-0195","DOIUrl":"10.1055/a-2528-0195","url":null,"abstract":"<p><p>The diagnosis and staging of bladder cancer is challenging. TUR-B and CT diagnostics bear limitations in detecting muscle invasion and perivesical fat invasion. Thus, second TUR-B is required to ensure more reliable pathological staging. The mpMRI of the urinary bladder is a new diagnostic tool in evaluation of tumor muscle invasion. Numerous retrospective and prospective studies indicate high diagnostic accuracy of the mpMRI in this setting. Current meta-analyses show sensitivities of up to 90% with a high specificity of >85%. The \"Vesical Imaging-Reporting and Data System\" (VI-RADS) is a standardized and clinically easy-to-use reporting system for mpMRI of the urinary bladder. The EAU guidelines recommend the mpMRI and the VI-RADS system for local staging of urinary bladder cancer. A recently published consensus statement based on a Delphi conference of 92 international experts favors the use of the mpMRI in various clinical situations. This includes imaging before and after TUR-B when muscle invasion is possible or during neoadjuvant chemotherapy.Based on good evidence, the mpMRI of the bladder emerges as a useful imaging tool in the evaluation of urinary bladder cancer in various clinical scenarios. Availability, costs and limited experience currently stand in the way of widespread use.</p>","PeriodicalId":7513,"journal":{"name":"Aktuelle Urologie","volume":" ","pages":"248-257"},"PeriodicalIF":0.3,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143953541","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Kommentar.","authors":"","doi":"10.1055/a-2520-0009","DOIUrl":"https://doi.org/10.1055/a-2520-0009","url":null,"abstract":"","PeriodicalId":7513,"journal":{"name":"Aktuelle Urologie","volume":"56 3","pages":"212-214"},"PeriodicalIF":0.3,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144172144","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Blasentagebücher erhöhen Ansprechrate auf Enuresis-Behandlung.","authors":"","doi":"10.1055/a-2438-3570","DOIUrl":"https://doi.org/10.1055/a-2438-3570","url":null,"abstract":"","PeriodicalId":7513,"journal":{"name":"Aktuelle Urologie","volume":"56 3","pages":"214-216"},"PeriodicalIF":0.3,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144172180","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Harnröhrenstrikturen gehen häufig mit Plattenepithelmetaplasien einher.","authors":"","doi":"10.1055/a-2438-3818","DOIUrl":"https://doi.org/10.1055/a-2438-3818","url":null,"abstract":"","PeriodicalId":7513,"journal":{"name":"Aktuelle Urologie","volume":"56 3","pages":"208"},"PeriodicalIF":0.3,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144172194","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[How many MRI sequences are required for prostate cancer detection?]","authors":"Fabian Falkenbach, Tim Inderhees, Lars Budäus","doi":"10.1055/a-2523-6010","DOIUrl":"10.1055/a-2523-6010","url":null,"abstract":"<p><p>Multiparametric magnetic resonance imaging (mpMRI) is an established imaging modality for prostate cancer. In this context, \"multiparametric\" refers to the combination of anatomical sequences (T1- and T2-weighted) with functional (diffusion-weighted) and contrast-enhanced sequences. Anatomical sequences offer high spatial resolution, while diffusion-weighted imaging (DWI) assesses the movement of water molecules within tissues, providing information on tissue composition. The contrast-enhanced sequence (Dynamic Contrast-Enhanced, DCE) evaluates tissue perfusion to identify potential tumour angiogenesis. This combination of sequences allows a comprehensive assessment of various aspects of prostate tissue. However, growing evidence suggests that not all sequences are always required. For early detection of prostate cancer, MRI without DCE (=biparametric MRI, bpMRI) should be the standard, because it exhibits similar detection rates for clinically significant prostate cancer. In special cases, such as after previous prostate treatments (e.g., after focal therapy), radiological challenges (e.g., hip replacement), or in cases of negative bpMRI findings with persistent suspicion of prostate cancer, adding DCE may be helpful. MRI screening without DCE is safer, less expensive, and reduces gadolinium emissions. The final results from the prospective, multicentre PRIME study (bpMRI vs. mpMRI before biopsy) are still pending and will further clarify the role of DCE in early detection.</p>","PeriodicalId":7513,"journal":{"name":"Aktuelle Urologie","volume":" ","pages":"258-262"},"PeriodicalIF":0.3,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143963023","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Kommentar.","authors":"","doi":"10.1055/a-2503-0581","DOIUrl":"https://doi.org/10.1055/a-2503-0581","url":null,"abstract":"","PeriodicalId":7513,"journal":{"name":"Aktuelle Urologie","volume":"56 3","pages":"216-217"},"PeriodicalIF":0.3,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144172122","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}