Quality indicators for the management of high-risk upper tract urothelial carcinoma requiring radical nephroureterectomy
Purpose of review
The purpose of this article was to identify quality indicators for an optimized management of high-risk upper tract urothelial carcinoma (UTUC) requiring radical nephroureterectomy (RNU).
Recent findings
RNU with bladder cuff resection is the standard treatment of high-risk UTUC. For the bladder cuff resection, two main approaches are accepted: transvesical and extravesical. Lymph node dissection following a dedicated template should be performed in all high-risk patients undergoing RNU as it improves tumour staging and possibly survival. Postoperative bladder instillation of single-dose chemot...
Source: Current Opinion in Urology - June 3, 2021 Category: Urology & Nephrology Tags: HEALTH CARE FACTORS IN UROLOGY: Edited by Shahrokh F. Shariat and Mohammed Abufaraj Source Type: research
Rising significance of antibiotic stewardship in urology and urinary tract infections – a rapid review
Purpose of review
To give an overview of the significance as well as recent developments in antibiotic stewardship (ABS) in urology and for the treatment of urinary tract infections (UTI). This rapid review is focused on recent publications during the past 18 months.
Recent findings
Despite the evidence to support the use of ABS interventions in the treatment of UTIs, there remains considerable inappropriate use of antibiotics, up to 68%, especially concerning the treatment of asymptomatic bacteriuria and the overuse of fluoroquinolones. Emerging evidence indicate that ABS programs can improve patient outcome ...
Source: Current Opinion in Urology - June 3, 2021 Category: Urology & Nephrology Tags: HEALTH CARE FACTORS IN UROLOGY: Edited by Shahrokh F. Shariat and Mohammed Abufaraj Source Type: research
Editorial introductions
No abstract available (Source: Current Opinion in Urology)
Source: Current Opinion in Urology - June 3, 2021 Category: Urology & Nephrology Tags: EDITORIAL INTRODUCTIONS Source Type: research
What is next in second- and later-line treatment of metastatic renal cell carcinoma? review of the recent literature
Purpose of review
The current treatment landscape of metastatic renal cell carcinoma has changed dramatically from the dominance of single-agent tyrosine kinase inhibitor (TKI) therapy to immune-checkpoint inhibitor (ICI)-based combinations in recent years. However, the optimal subsequent therapy remains ill-defined owing to the novelty of this approach.
Recent findings
Treatment with TKIs after failure of single or dual ICI therapies may result in robust clinical efficacy. Nonetheless, there is a trend toward lower efficacy of TKIs after previous ICI–TKI combination therapy. Currently, tivozanib is the only d...
Source: Current Opinion in Urology - April 6, 2021 Category: Urology & Nephrology Tags: KIDNEY CANCER: Edited by Jens Bedke, Axel Bex and Manuela Schmidinger Source Type: research
Dual immune check point blockade or immune check point-tyrosine kinase inhibitor combination: as a first-line treatment in metastatic renal cell carcinoma?
Purpose of review
To discuss treatment decisions in the first-line setting of metastatic renal cell carcinoma (mRCC).
Recent findings
Immune check point inhibitor (ICI) combinations have replaced sunitinib as the standard of care in the first-line treatment of mRCC. Dual ICI treatment with nivolumab and ipilimumab was shown to significantly improve overall survival and objective response rates. Similarly, the ICI–tyrosine kinase inhibitor combinations pembrolizumab and axitinib and nivolumab and cabozantinib have demonstrated superiority in terms of overall survival, objective response rates and progression-fr...
Source: Current Opinion in Urology - April 6, 2021 Category: Urology & Nephrology Tags: KIDNEY CANCER: Edited by Jens Bedke, Axel Bex and Manuela Schmidinger Source Type: research
Perioperative therapy in renal cancer in the era of immune checkpoint inhibitor therapy
Purpose of review
Immune checkpoint inhibitor (ICI) combination therapy has revolutionized therapy of metastatic renal cancer. The success of immunotherapy has renewed an interest to study these agents in adjuvant and neoadjuvant settings and prior to cytoreductive nephrectomy. This narrative review will give an overview of ongoing trials and early translational research outcomes.
Recent findings
In nonmetastatic renal cell carcinoma (RCC), five phase 3 adjuvant and neoadjuvant trials with ICI monotherapy or combinations are ongoing with atezolizumab (IMmotion 010; NCT03024996), pembrolizumab (KEYNOTE-564; NCT03...
Source: Current Opinion in Urology - April 6, 2021 Category: Urology & Nephrology Tags: KIDNEY CANCER: Edited by Jens Bedke, Axel Bex and Manuela Schmidinger Source Type: research
How to improve outcome in nephron-sparing surgery: the impact of new techniques
Purpose of review
Nephron-sparing partial nephrectomy is the state of the art for localized small renal mass and it is gaining attention also for more advanced cases. In the present narrative review, we discuss the new developments that have occurred in the advancement of this approach over the past few years.
Recent findings
Off-clamp, selective/superselective clamp and early-unclamping techniques are safe and feasible approaches, with potentially superior functional outcomes, and noninferior complications rate and oncological outcomes, when compared with main artery clamping. Renorrhaphy must preserve the phys...
Source: Current Opinion in Urology - April 6, 2021 Category: Urology & Nephrology Tags: KIDNEY CANCER: Edited by Jens Bedke, Axel Bex and Manuela Schmidinger Source Type: research
Targeted PET/CT imaging for clear cell renal cell carcinoma with radiolabeled antibodies: recent developments using girentuximab
Purpose of review
Conventional imaging is unable to differentiate clear cell renal cell carcinoma (ccRCC) from other more indolent and benign renal tumors. Positron emission tomography/computed tomography (PET/CT) using radiolabeled antibodies may aid in detecting both localized and metastatic ccRCC. The purpose of this review is to summarize recent literature regarding the use of radiolabeled antibodies for imaging of ccRCC.
Recent findings
Two recent studies evaluated the use of radiolabeled anticarbonic anhydrase IX antibody girentuximab for the imaging of ccRCC. PET/CT with 89zirconium-labeled girentuximab (...
Source: Current Opinion in Urology - April 6, 2021 Category: Urology & Nephrology Tags: KIDNEY CANCER: Edited by Jens Bedke, Axel Bex and Manuela Schmidinger Source Type: research
Metastatic nonclear renal cell carcinoma current review in evolving treatment strategies
Purpose of review
Renal cell carcinoma (RCC) is the 6th most often diagnosed cancer in men and the 10th in women. Nearly 75% of the renal cancer cases are clear cell histologic subtype, whereas nonclear cell histologies represent the remaining 25%. Treatment options for clear renal type are well established. However, as nonclear RCC represents a heterogenous and less frequent group. Current treatment options for these tumors are limited and mostly based on evidence derived from small phase II clinical trials. The present review aims to provide an update of the available treatment options for nonclear RCC.
Recent fin...
Source: Current Opinion in Urology - April 6, 2021 Category: Urology & Nephrology Tags: KIDNEY CANCER: Edited by Jens Bedke, Axel Bex and Manuela Schmidinger Source Type: research
Individualizing renal cell carcinoma treatment through biomarkers discovery in the era of immune checkpoint inhibitors: where do we stand?
Purpose of review
The treatment landscape of metastatic renal cell carcinoma has greatly evolved over the past fifteen years, leading to a significant improvement in the outcome of our patients. However, there is still an urgent need for predictive biomarkers that could guide our treatment selection, especially in the present era of immune-based treatments.
Recent findings
A number of putative biomarkers of immunotherapy activity have been proposed over the past few years, including PD-L1 immunohistochemical expression, tumor mutational burden, neoantigens load, insertions and deletions, complex gene signatures,...
Source: Current Opinion in Urology - April 6, 2021 Category: Urology & Nephrology Tags: KIDNEY CANCER: Edited by Jens Bedke, Axel Bex and Manuela Schmidinger Source Type: research
Renal cell carcinoma pathology in 2021: ‘new need for renal cancer immune profiling’
Purpose of review
The aim of this review is to outline characteristics of the renal cell carcinoma (RCC) tumor immune microenvironment (TIME), the potential impact of tumor intrinsic alterations on the TIME and the value of metastatic tissue assessment in this context.
Recent findings
According to the latest European Association of Urology, European Society for Medical Oncology and National Comprehensive Cancer Network guidelines immune checkpoint inhibition represents a new core treatment strategy in advanced clear cell RCC (ccRCC). Despite its success, the prognosis of many RCC patients remains unsatisfactory ...
Source: Current Opinion in Urology - April 6, 2021 Category: Urology & Nephrology Tags: KIDNEY CANCER: Edited by Jens Bedke, Axel Bex and Manuela Schmidinger Source Type: research
Editorial: Standard and future in the treatment of renal cell carcinoma
No abstract available (Source: Current Opinion in Urology)
Source: Current Opinion in Urology - April 6, 2021 Category: Urology & Nephrology Tags: KIDNEY CANCER: Edited by Jens Bedke, Axel Bex and Manuela Schmidinger Source Type: research
Surgical intervention in patients with urothelial carcinoma of the bladder and lymph node metastasis
Purpose of review
To systematically review the most recent evidence on the role of surgery in patients with urothelial carcinoma of bladder and lymph node metastasis.
Recent findings
Patients with urothelial carcinoma of bladder and lymph node metastasis have a poor prognosis. The mainstay treatment for these patients is systemic chemotherapy. However, slowly growing body of literature suggests that multimodal therapy comprised of radical cystectomy, lymph node dissection, and perioperative chemotherapy is more effective than either chemotherapy or surgery alone. The timing of chemotherapy, whether preoperative ...
Source: Current Opinion in Urology - April 6, 2021 Category: Urology & Nephrology Tags: SALVAGE THERAPY IN UROLOGY ONCOLOGY: Edited by R. Jeffrey Karnes and Axel Heidenreich Source Type: research
Salvage therapy for localized recurrences of penile cancer
Purpose of review
To review the current literature and guidelines regarding salvage therapy for local and regional recurrence of primary penile cancer.
Recent findings
While invasive surgical management has not significantly changed, penile sparing treatments (PSTs) may have a promising role in the management of local recurrence. Penile sparing surgeries do appear to have higher rates of recurrence. However, the overall survival rate is comparable to that of partial and total penectomies. Additionally, a combination of therapies may have a more profound effect on management of penile cancer.
Summary
Clini...
Source: Current Opinion in Urology - April 6, 2021 Category: Urology & Nephrology Tags: SALVAGE THERAPY IN UROLOGY ONCOLOGY: Edited by R. Jeffrey Karnes and Axel Heidenreich Source Type: research
Salvage management of patients with relapsing testicular germ cell tumors
Purpose of review
This review aims to summarize the latest evidence of medical and surgical treatment options for patients with relapsing testicular germ cell tumors.
Recent findings
Depending on International Germ Cell Cancer Classification Group risk classification 10–50% of patients with metastatic TGCT develop relapse which needs further multimodality treatment. With regard to therapy, early relapses are stratified according to their prognostic risk profile which results in a 3-year overall survival between 6% in the very high to 77% in the very low risk group. Prognostic risk score dictates systemic thera...
Source: Current Opinion in Urology - April 6, 2021 Category: Urology & Nephrology Tags: SALVAGE THERAPY IN UROLOGY ONCOLOGY: Edited by R. Jeffrey Karnes and Axel Heidenreich Source Type: research
