Clinical genitourinary cancer最新文献

{"title":"Utilization, Cost, and Subsequent Salvage Treatment of Ablative Therapies for Localized Prostate Cancer in the United States.","authors":"Nikhil T Sebastian, Dattatraya Patil, Pretesh R Patel, Ashesh B Jani, Bruce W Hershatter, Vishal R Dhere, Karen D Godette, Kamran Salari, C Adam Lorentz, Mohammad Hajiha, Aaron D Weiss, Shreyas J Joshi, Martin G Sanda, Sagar A Patel","doi":"10.1016/j.clgc.2026.102556","DOIUrl":"https://doi.org/10.1016/j.clgc.2026.102556","url":null,"abstract":"<p><strong>Introduction: </strong>Ablative therapy (AT) procedures are an emerging first-line treatment of newly diagnosed localized prostate cancer. We studied the trend in utilization and total healthcare and patient-incurred cost of first-line AT in the United States, as well as the receipt of salvage therapies after AT, using two insurance claims-based databases.</p><p><strong>Methods: </strong>We used the Merative MarketScan Commercial (CCAE) and Medicare (MDCR) Databases to identify men with non-metastatic prostate cancer treated with either cryotherapy, laser ablation, or high-intensity focused ultrasound between 2009 and 2022. Multivariable logistic regression was used to measure the association of covariates with receipt of each treatment. Year-to-year utilization between 2009 and 2021 was compared using Spearman's rank correlation test. Median inflation-adjusted total healthcare expenditures and patient out-of-pocket payments within 12 months of AT were calculated. Receipt of salvage therapies after AT was studied using cumulative incidence curves.</p><p><strong>Results: </strong>We identified 2200 men in CCAE and 3205 men in MDCR treated with AT between 2009 and 2022. In CCAE, 1.96 per 100,000 enrollees were treated with AT in 2009, and 1.51 per 100,000 enrollees were treated with AT in 2021 (P = .064). In MDCR, 31.36 per 100,000 enrollees were treated with AT in 2009, and 15.81 per 100,000 enrollees were treated in 2021 (P = .078). In CCAE, median total and patient costs were $24,506 and $1811, respectively. In MDCR, median total and patient costs were $22,094 and $1098, respectively. The 5-year rate of any salvage therapy was 24.5% in the CCAE and 22.3% in the MDCR. Androgen deprivation therapy (ADT) was the most frequently utilized salvage treatment in both the CCAE (33.0%) and MDCR (59.3%).</p><p><strong>Conclusion: </strong>There was a similar utilization of AT across the study period. Over 20% patients received additional therapy, most frequently ADT, within 5 years of AT.</p>","PeriodicalId":93941,"journal":{"name":"Clinical genitourinary cancer","volume":" ","pages":"102556"},"PeriodicalIF":2.7,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147792229","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Digital PCR-Based Uromonitor for Molecular Detection of Bladder Cancer: A Multicenter Validation Study Comparing Quantitative PCR and Urine Cytology.","authors":"Anton Kravchuk, Julio Ruben Rodas Garzaro, Ralph Wirtz, Ingmar Wolff, Stefan Koch, Thorsten Schlomm, Anja Rabien, Christina Meisl, Dezhi Rong, João Paulo Brás, João Vinagre, Thomas Otto, Dimitri Barski, Andreas Gössl, Stephan Siepmann, Christian Gilfrich, Sabine Brookman-May, Thorsten Ecke, Matthias May","doi":"10.1016/j.clgc.2026.102554","DOIUrl":"https://doi.org/10.1016/j.clgc.2026.102554","url":null,"abstract":"<p><strong>Introduction: </strong>Non-invasive urine-based diagnostics for urothelial carcinoma of the bladder remain limited by suboptimal sensitivity. We validated a digital polymerase chain reaction (dPCR) Uromonitor^Ⓡ assay in a multicentre setting and compared it with an earlier quantitative polymerase chain reaction (qPCR) version and urine cytology.</p><p><strong>Patients and methods: </strong>We analyzed 239 archived urine samples from a prospectively assembled biobank, including 123 patients with histologically confirmed urothelial carcinoma of the bladder and 116 with benign findings. The dPCR panel targeted TERT promoter and FGFR3 hotspot mutations. Historical qPCR data and contemporaneous urine cytology served as comparators. Sensitivity, the prespecified primary endpoint, was compared head to head using McNemar's exact test. Receiver operating characteristic curves with area under the curve (AUC) comparisons and multivariable logistic regression were also performed.</p><p><strong>Results: </strong>dPCR showed higher sensitivity than qPCR and urine cytology (75.6% vs 51.2% and 42.3%, respectively; both p < .001) while maintaining 94.0% specificity. Positive and negative predictive values were 93.0% and 78.4%, respectively, and overall accuracy was 84.5%. The AUC for dPCR was 0.848, exceeding qPCR by 0.122 (p = .001) and urine cytology by 0.188 (p < .001). dPCR positivity was independently associated with histologically confirmed disease (odds ratio 38.9, p < .001). Diagnostic performance remained consistent across grade- and stage-based subgroup analyses.</p><p><strong>Conclusion: </strong>These findings support dPCR as a robust non-invasive diagnostic adjunct under conservative analytical conditions and justify further large-scale prospective multicentre validation in clinically representative populations undergoing bladder cancer surveillance to define its role in risk=adapted evidence-based diagnostic pathways and inform future implementation studies in clinical practice.</p>","PeriodicalId":93941,"journal":{"name":"Clinical genitourinary cancer","volume":" ","pages":"102554"},"PeriodicalIF":2.7,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147792235","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association Between Proto-Oncogene N-RAS Transcript Level and Overall Survival in Node-Negative Muscle-Invasive Bladder Cancer.","authors":"Donghyun Kim, Yasser Ged, Petros Grivas, Parminder Singh, Bilal Rahim, Yousef Zakharia","doi":"10.1016/j.clgc.2026.102557","DOIUrl":"https://doi.org/10.1016/j.clgc.2026.102557","url":null,"abstract":"<p><strong>Introduction: </strong>Despite the unprecedented advancement in the treatment landscape of muscle-invasive bladder cancer (MIBC), prognostic biomarkers remain investigational. In bladder cancer, oncogenic rat sarcoma (RAS) mutations mostly occur in H-RAS or K-RAS, whereas N-RAS mutations are rare. Overexpression of N-RAS has been previously reported, although its clinical implications remain uncertain. This study aimed to investigate the prognostic implications of N-RAS expression in MIBC.</p><p><strong>Patients and methods: </strong>Batch-corrected normalized transcript counts of The Cancer Genome Atlas Bladder Cancer project (n = 411) were analyzed, where 218 patients had non-metastatic node-negative MIBC. Tumor N-RAS transcript level of individual patients was classified as \"high\" or \"low\" using the cohort median as a reference value, and survival analyses were performed according to this stratification.</p><p><strong>Results: </strong>High N-RAS expression was associated with inferior 5-year overall survival in node-negative MIBC (pT2-4a pN0 M0/x) compared to the low N-RAS expression, with a hazard ratio (HR) 1.91 (95% CI, 1.17-3.11, P = .007), although N-RAS expression did not emerge as a significant factor associated with overall survival upon multivariable adjustment for other clinicopathologic variables. Significant overall survival benefit with cisplatin-based chemotherapy was present in the low N-RAS group with HR 0.28 (95% CI, 0.10-0.81, P = .019), but not in the high N-RAS group. The high N-RAS group was associated with higher CD274 (PD-L1) transcript levels compared to the low N-RAS group (median 62.6 vs. 9.2, P < .0001).</p><p><strong>Conclusion: </strong>This retrospective study demonstrates that N-RAS transcript levels may be prognostic for node-negative MIBC. Low N-RAS transcript levels may also be associated with an overall survival benefit with cisplatin-based chemotherapy.</p>","PeriodicalId":93941,"journal":{"name":"Clinical genitourinary cancer","volume":" ","pages":"102557"},"PeriodicalIF":2.7,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147792249","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-Term Risk of Alcohol Use Disorder in Testicular Cancer Survivors: A National Veterans Affairs Cohort Study.","authors":"Mai Dabbas, Kylie Morgan, Kshitij Pandit, Sakshith Chintala, Paul Riviere, Margaret Meagher, Dhruv Puri, Tyler Nelson, Krinio Giannikou, Daniel Sabater Minarim, Frederick Millard, Rana R Mckay, Brent Rose, Aditya Bagrodia","doi":"10.1016/j.clgc.2026.102544","DOIUrl":"https://doi.org/10.1016/j.clgc.2026.102544","url":null,"abstract":"<p><strong>Purpose: </strong>Testicular germ cell tumors are the most common solid malignancy in young men and are associated with high cure rates. Given the young age at diagnosis and prolonged survivorship, testicular cancer survivors (TCS) may be vulnerable to alcohol use disorder (AUD). We evaluated the incidence and predictors of AUD and examined whether chemotherapy increased risk.</p><p><strong>Material and methods: </strong>We conducted a retrospective cohort study using the VA national healthcare system through the Veterans Informatics and Computing Infrastructure, identifying patients with testicular germ cell tumors from 1990-2021. A cancer-free comparison group was created using 1:5 exact matching on birth year and race, with assigned index dates. Patients with preexisting AUD were excluded. AUD was defined using ICD-9/10 diagnosis codes and alcohol-related CPT codes. Cox proportional hazards models assessed associations, adjusting for demographic and clinical variables. Cumulative incidence was estimated using Kaplan-Meier methods.</p><p><strong>Results: </strong>We identified 1,774 TCS and 3,224 matched controls. At 10 years, cumulative AUD incidence was 21.6% in TCS vs 1.5% in controls (HR 13.8, 95% CI 9.2-20.8, P < .001). Chemotherapy was not independently associated with AUD (HR 1.16, P = .26). Higher risk was observed with unemployment (HR 1.43, P = .001) and Black race (HR 1.60, P = .01), while never smoking was protective (HR 0.46, P < .001).</p><p><strong>Conclusion: </strong>AUD risk is markedly elevated in TCS and is driven by sociodemographic factors rather than treatment exposure, highlighting the need for targeted screening and survivorship interventions.</p>","PeriodicalId":93941,"journal":{"name":"Clinical genitourinary cancer","volume":" ","pages":"102544"},"PeriodicalIF":2.7,"publicationDate":"2026-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147824546","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"LuRa: Efficacy and Safety of Radium-223 Following [¹⁷⁷Lu]Lu-PSMA-617 in Patients With Metastatic Castration-Resistant Prostate Cancer.","authors":"Jabra Zarka, Ronit Juthani, Oliver Sartor, Miguel Muniz, Adam M Kase, Irbaz B Riaz, Arsalan Naqvi, Elisabeth Heath, Jacob J Orme, Zachary Scharf, Gokce Belge Bilgin, Eugene D Kwon, Albert Jang, Ali Tarhini, Geoffrey B Johnson, Ayse Tuba Kendi, Matthew P Thorpe, Mrinal S Patnaik, Yael Kusne, Heather Jacene, Praful Ravi, Daniel S Childs","doi":"10.1016/j.clgc.2026.102552","DOIUrl":"https://doi.org/10.1016/j.clgc.2026.102552","url":null,"abstract":"<p><strong>Introduction/background: </strong>Approval of [177Lu]Lu-PSMA-617 has changed the usual sequencing of treatments for metastatic castration-resistant prostate cancer (mCRPC). There is limited data on outcomes and safety of therapies used after its administration.</p><p><strong>Methods: </strong>We conducted a retrospective, multi-institutional analysis including patients with mCRPC who received Radium-223 (Ra-223) after [177Lu]Lu-PSMA-617. Patients from Mayo Clinic and Dana-Farber Cancer Institute were evaluated for multiple efficacy and tolerability endpoints, with particular attention given to hematologic toxicities and skeletal-related events.</p><p><strong>Results: </strong>Among 21 patients analyzed, 19% (n = 4) completed all 6 planned Ra-223 cycles. Reasons for early treatment discontinuation included: disease progression (n = 13, 62%) and toxicity (n = 2, 10%). Hematologic toxicity included grade ≥ 3 anemia and thrombocytopenia in 33% (n = 7) and 19% (n = 4) of patients, respectively, and 38% (n = 8) required transfusions, all of which occurred within 30 days following the final Ra-223 cycle. Four patients (19%) developed new skeletal-related events after starting Ra-223. One PSA50 response was observed and ≥ % reduction in alkaline phosphatase levels occurred in 42% of patients (n=9). The median PSA progression-free survival was 2.5 months (95% CI; 1.4 - 3.8 months). The median overall survival was 10.6 months (95% CI; 5.2 - 20.4 months) and 76% (n = 16) of patients survived six months beyond their first dose of Ra-223.</p><p><strong>Conclusion: </strong>These data suggest that Ra-223 after [177Lu]Lu-PSMA-617 is feasible with efficacy even amongst heavily pre-treated patients. The observed hematologic toxicities and fractures underscore the need for careful patient selection and monitoring.</p>","PeriodicalId":93941,"journal":{"name":"Clinical genitourinary cancer","volume":" ","pages":"102552"},"PeriodicalIF":2.7,"publicationDate":"2026-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147719259","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bone Metastases and Use of Bone Protective Agents for Metastatic Clear Cell Renal Cell Carcinoma: A Contemporary National Real-World Analysis.","authors":"Braden Millan, Sunita Ghosh, Naveen S Basappa, Lori Wood, Bimal Bhindi, Frederic Pouliot, Rodney H Breau, Antonio Finelli, Rahul K Bansal, Jeffrey Graham, Georg A Bjarnason, Dominick Bosse, Vincent Castonguay, Eric Winquist, Daniel Yick Chin Heng, Christian K Kollmannsberger, Aly-Khan A Lalani","doi":"10.1016/j.clgc.2026.102539","DOIUrl":"https://doi.org/10.1016/j.clgc.2026.102539","url":null,"abstract":"<p><strong>Background: </strong>Bone Metastases (BM) are associated with a poor prognosis in metastatic clear-cell renal cell carcinoma (mccRCC). In the immune checkpoint inhibitor (IO) era, evidence for and use of bone-protective agents (BPAs) is limited. We investigated oncologic outcomes in mccRCC patients with BM at diagnosis and the use of BPA in a contemporary real-world cohort.</p><p><strong>Methods: </strong>We identified patients with mccRCC treated between 2011 and 2023. Adjusted Kaplan-Meier estimates were used to estimate time to treatment failure (TTF) and overall survival (OS), and cohort comparisons were performed using Cox proportional hazards model.</p><p><strong>Results: </strong>Of 2482 patients with mccRCC, 956 (38.5%) had BM at diagnosis, and 210 (22.0%) received a BPA. First-line tyrosine kinase inhibitor (TKI) containing regimen use was higher in BM + patients (79.3% vs. 74.9%). First-line median TTF was similar (9.4 vs. 8.7 mos); however, median OS was longer in BM- vs. BM + patients: 54.2 vs. 35.0 mos (HR, 1.32; P < .0001), irrespective of first-line therapy. BPA omission in BM + only patients resulted in a non-statistically significant shorter TTF (8.3 vs. 10.4 mos; HR, 0.91) and OS (34.3 vs. 38.5 mos; HR, 1.00). Receipt of first-line IO/IO (HR, 0.69; 0.60-0.81) and IO + TKI (HR, 0.61; 0.54-0.74) compared to monotherapy TKI resulted in a significantly longer OS in all patients, though not in BM + only patients.</p><p><strong>Conclusions: </strong>BM remain a poor prognostic factor in mccRCC in this contemporary cohort. Despite more use in BM + patients, BPAs were not associated with improved TTF or OS, though their potential impact on skeletal-related events is not captured in the current study.</p>","PeriodicalId":93941,"journal":{"name":"Clinical genitourinary cancer","volume":" ","pages":"102539"},"PeriodicalIF":2.7,"publicationDate":"2026-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147824568","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Concomitant medications and survival outcomes in patients receiving avelumab maintenance for advanced urothelial carcinoma: sub analysis of Meet-URO 25 study.","authors":"Giandomenico Roviello, Martina Catalano, Elisabetta Gambale, Irene De Gennaro Aquino, Eleonora Lai, Carlo Messina, Ismaela Anna Vascotto, Virginia Rossi, Davide Bimbatti, Elisa Erbetta, Marco Messina, Alessia Mennitto, Sara Elena Rebuzzi, Cecilia Nasso, Chiara Mercinelli, Brigida Anna Maiorano, Martina Fanelli, Mariella Sorarù, Federico Scolari, Marinella Micol Mela, Luca Galli, Alessia Salfi, Mimma Rizzo, Silvia Puglisi, Valentina Orlando, Giuseppe Fornarini, Alessandro Rametta, Patrizia Giannatempo, Linda Cerbone, Sebastiano Buti, Laura Doni, Serena Pillozzi, Lorenzo Antonuzzo","doi":"10.1016/j.clgc.2026.102550","DOIUrl":"https://doi.org/10.1016/j.clgc.2026.102550","url":null,"abstract":"<p><strong>Background: </strong>Concomitant medications may impair immune checkpoint inhibitor (ICI) activity through modulation of the gut microbiome and systemic immunity. While a medication-based risk model (drug score) has been validated in pan-cancer cohorts, evidence in advanced urothelial carcinoma (aUC) remains limited. This study assessed the association between concomitant medications and survival in patients receiving avelumab maintenance in the Meet-URO 25 cohort.</p><p><strong>Methods: </strong>We retrospectively analyzed patients with aUC treated with avelumab maintenance in several Italian centers. The drug score assigned 1 point each for antibiotics and PPIs, and 2 points for corticosteroids ≥ 10 mg prednisone equivalent. Patients were classified as good (0), intermediate (1-2), or poor (3-4) risk. Progression-free survival (PFS) and overall survival (OS) were evaluated using Kaplan-Meier and Cox models.</p><p><strong>Results: </strong>Among 251 patients (median age 72; 82% male), use of interfering medications was low. Drug score distribution was 76.5% good, 21.9% intermediate, and 1.6% poor risk. Median PFS was 8.0, 3.9, and 2.9 months, respectively; median OS was 27.6, 14.0, and 3.4 months. Drug score, ECOG performance status, and bone metastases were independent prognostic factors.</p><p><strong>Conclusions: </strong>The drug score showed significant prognostic value in aUC patients receiving avelumab maintenance, supporting its integration into risk stratification for ICI-treated UC.</p>","PeriodicalId":93941,"journal":{"name":"Clinical genitourinary cancer","volume":" ","pages":"102550"},"PeriodicalIF":2.7,"publicationDate":"2026-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147824538","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Real-World Effectiveness and Treatment Persistence of Darolutamide, Apalutamide, and Enzalutamide in Non-Metastatic Castration-Resistant Prostate Cancer: A Multicenter Study.","authors":"Shuhei Hara, Keiichiro Mori, Masaki Hashimoto, Yuji Yata, Shiro Kurawaki, Yuya Iwamoto, Shota Kawano, Takashi Otsuka, Wataru Fukuokaya, Keiichiro Miyajima, Mimu Ishikawa, Gaku Kurokawa, Yu Imai, Minoru Nakazono, Mahito Atsuta, Fumihiko Urabe, Takafumi Yanagisawa, Shunsuke Tsuzuki, Tatsuya Shimomura, Hiroki Yamada, Takahiro Kimura","doi":"10.1016/j.clgc.2026.102546","DOIUrl":"https://doi.org/10.1016/j.clgc.2026.102546","url":null,"abstract":"<p><strong>Introduction: </strong>Three androgen receptor signaling inhibitors (ARSIs), darolutamide (DAR), apalutamide (APA), and enzalutamide (ENZ), are standard treatments for non-metastatic castration-resistant prostate cancer (nmCRPC); comparative real-world data on treatment persistence and safety remain limited.</p><p><strong>Patients and methods: </strong>We retrospectively analyzed 343 Japanese patients with nmCRPC treated with DAR (n = 92), APA (n = 64), or ENZ (n = 187) across 16 institutions. Oncological outcomes, including PSA progression-free survival (PSA-PFS) and PFS, were compared using multivariable Cox regression to adjust for baseline imbalances. Treatment persistence was evaluated by time to treatment discontinuation (TTD) and reasons for discontinuation.</p><p><strong>Results: </strong>The ENZ group had significantly worse baseline characteristics than the other groups. After multivariable adjustment, DAR showed consistently favorable hazard ratios for PSA progression (HR, 0.55, P = .038) and disease progression (HR, 0.59, P = .047) compared with ENZ; however, these differences were attenuated and no longer statistically significant after PSM (PSA-PFS HR, 0.62, P = .119), suggesting broadly comparable oncological outcomes across agents. Median TTD was significantly shorter in the APA group (11.0 months) compared with the DAR (27.0 months) and ENZ (25.0 months) groups (P = .019). Discontinuation due to adverse events was significantly more frequent in APA (51.6%) than DAR (19.6%) or ENZ (18.8%), primarily due to skin rash. Among discontinuers, AEs were the primary reason in 82.5% of APA, 42.9% of DAR, and 41.7% of ENZ.</p><p><strong>Conclusion: </strong>In this real-world cohort, all 3 ARSIs demonstrated broadly comparable oncological outcomes, consistent with PSM. The principal differentiator was treatment persistence: APA was limited by markedly shorter TTD (median 11.0 months), primarily driven by skin rash; this difference was numerically preserved after PSM, though it did not reach statistical significance in the smaller matched sample. The high frequency of APA-related rash (46.9%) is consistent with prior Japanese/East Asian reports, including the integrated SPARTAN/TITAN Japanese analysis, and should be prioritized in treatment selection and patient counseling.</p>","PeriodicalId":93941,"journal":{"name":"Clinical genitourinary cancer","volume":" ","pages":"102546"},"PeriodicalIF":2.7,"publicationDate":"2026-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147694244","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prognostic Significance of Circulating Tumor DNA in Metastatic Prostate Cancer: A Systematic Review and Meta-Analysis.","authors":"Duming Ye, Yimin Zhao, Liying Yang, Xingyao Sun, Tianchong Cao, Meicheng Yuan, Tianyue Qiao, Ligang Xing, Xiaorong Sun","doi":"10.1016/j.clgc.2026.102545","DOIUrl":"https://doi.org/10.1016/j.clgc.2026.102545","url":null,"abstract":"<p><p>Circulating tumor DNA (ctDNA) is a minimally invasive biomarker that enables molecular profiling and prognostic stratification in cancer. This meta-analysis evaluated the prognostic significance of ctDNA in metastatic prostate cancer (mPC). PubMed, Web of Science and Scopus were searched from inception to September 15, 2025 for studies assessing ctDNA and survival in prostate cancer. Hazard ratios (HRs) for progression-free survival (PFS) and overall survival (OS) were extracted; when unavailable, HRs were reconstructed from published survival curves. Meta-analyses were performed according to ctDNA detectability, ctDNA levels and ctDNA-detected gene mutations. About 13 studies including 18,575 patients were eligible. Across 9 studies, detectable ctDNA was associated with significantly worse PFS (HR = 1.65, 95% CI: 1.22-2.22) and OS (HR = 2.20, 95% CI: 1.92-2.51) versus undetectable ctDNA. In patients receiving androgen receptor pathway inhibitors and in mCRPC, ctDNA negativity consistently correlated with longer PFS and OS. Gene-level analyses showed that AR, CDK6/12, MYC, PIK3CA, and BRCA1/2 mutations in ctDNA were linked to inferior PFS, whereas BRCA1/2 mutations did not significantly worsen OS. About 5 studies examined ctDNA levels: higher ctDNA levels predicted poorer survival (PFS: HR = 1.68, 95% CI: 1.18-2.38; OS: HR = 2.43, 95% CI: 1.50-3.93), and lower levels were associated with better outcomes in ARPI-treated and mCRPC patients. In mPC, ctDNA detectability and elevated ctDNA levels are strongly associated with adverse survival. Quantitative ctDNA profiling, including assessment of key gene mutations, offers a clinically relevant tool to refine risk stratification and to support molecularly informed treatment selection and monitoring where clinically validated.</p>","PeriodicalId":93941,"journal":{"name":"Clinical genitourinary cancer","volume":" ","pages":"102545"},"PeriodicalIF":2.7,"publicationDate":"2026-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147679539","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Renal Melanotic Xp11 Translocation PEComa (XTTP): A Retrospective Case Series Analysis.","authors":"Zilin Wang, Feng Che, Xu Hu, Xinyuan Wei, Hao Zeng","doi":"10.1016/j.clgc.2026.102549","DOIUrl":"https://doi.org/10.1016/j.clgc.2026.102549","url":null,"abstract":"","PeriodicalId":93941,"journal":{"name":"Clinical genitourinary cancer","volume":" ","pages":"102549"},"PeriodicalIF":2.7,"publicationDate":"2026-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147719207","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}