Metastasectomy in patients with renal cell carcinoma: when and how?
Purpose of review
The role of metastasectomy in the management of metastatic renal cell carcinoma (mRCC) remains controversial. The aim of this review is to summarize and evaluate the recent findings about the surgical treatment of patients with mRCC focusing on the literature published in the last 2 years.
Recent findings
Despite the lack of randomized controlled trials, the benefit of metastasectomy in term of cancer-specific and overall survival have been demonstrated in large observational studies. Results of ongoing clinical trials evaluating the impact of combination of surgical and systemic therapies are eagerl...
Source: Current Opinion in Urology - May 28, 2020 Category: Urology & Nephrology Tags: SPECIAL COMMENTARIES Source Type: research
Novel therapies for advanced urologic cancers
Purpose of review
Systemic treatment of advanced urogenital malignancies has changed significantly in recent years and it will continue to change rapidly in upcoming years. It is the scope of this review article to providing the reader with the most recently approved treatment strategies to be used in daily routine for the individualized and most optimal treatment of our patients.
Recent findings
Immunooncological therapy (IOT) has emerged as the treatment of choice in metastatic renal cell carcinoma and we describe the most relevant clinical trials and we will give some differential therapeutic recommendation who mig...
Source: Current Opinion in Urology - May 28, 2020 Category: Urology & Nephrology Tags: NOVEL THERAPIES FOR ADVANCED UROLOGIC CANCERS: Edited by Shahrokh F. Shariat Source Type: research
Bladder-preserving strategies for Bacillus Calmette-Guérin unresponsive non-muscle invasive bladder cancer; where are we and what will be expected?
Purpose of review
Bacillus Calmette-Guérin (BCG) unresponsive non-muscle invasive bladder cancer (NMIBC) is a new definition including patients who failed intravesical BCG therapy and should not receive more BCG because of the very low efficacy and disproportionately poor prognosis. Radical cystectomy as the standard of care for these patients is associated with significant morbidity and altered quality of life. Therefore, the FDA has accepted phase II single-arm studies as a threshold to approve new agents in this setting.
Recent findings
Efforts to find an effective and safe bladder sparing strategy for BCG unrespo...
Source: Current Opinion in Urology - May 28, 2020 Category: Urology & Nephrology Tags: NOVEL THERAPIES FOR ADVANCED UROLOGIC CANCERS: Edited by Shahrokh F. Shariat Source Type: research
Systemic treatment options for metastatic hormone-sensitive prostate cancer: making sense of the data
Purpose of review
Systemic treatment options for metastatic hormone-sensitive prostate cancer (mHSPC) have recently shifted from the traditional androgen deprivation therapy (ADT) monotherapy to multidrug approaches incorporating drugs initially approved for castration-resistant state and ADT. However, clinicians have difficulties in choosing the adequate combination therapy for individualized patient care, because of the lack of consensus regarding disease risk factors, differences in study design of the major clinical trials and lack of direct comparisons between drugs. The aim of this review is to provide an update of...
Source: Current Opinion in Urology - May 28, 2020 Category: Urology & Nephrology Tags: NOVEL THERAPIES FOR ADVANCED UROLOGIC CANCERS: Edited by Shahrokh F. Shariat Source Type: research
Treatment of the primary in metastatic prostate cancer
This article emphasizes important aspects regarding a feasible management of mPCa, with possible impact on subsequent guidelines. The expected results from ongoing trials may provide another perspective in treatment of these cases. (Source: Current Opinion in Urology)
Source: Current Opinion in Urology - May 28, 2020 Category: Urology & Nephrology Tags: NOVEL THERAPIES FOR ADVANCED UROLOGIC CANCERS: Edited by Shahrokh F. Shariat Source Type: research
Fibroblast growth factor receptors across urothelial carcinoma landscape
Purpose of review
Fibroblast growth factor receptor (FGFR) signalling, especially induced by FGFR3, is a crucial factor in the pathogenesis of urothelial carcinoma and was therefore extensively studied over the last decades. In this review, we summarize the most relevant findings of the past two years.
Recent findings
Recent studies support the concept that FGFR3 mediates a pathway of urothelial carcinogenesis associated with low malignant potential. FGFR3 may represent a highly accurate biomarker for diagnosis and prediction of recurrence, progression or therapy response. The pan FGFR-inhibitor erdafitinib was recent...
Source: Current Opinion in Urology - May 28, 2020 Category: Urology & Nephrology Tags: NOVEL THERAPIES FOR ADVANCED UROLOGIC CANCERS: Edited by Shahrokh F. Shariat Source Type: research
Immune checkpoint inhibition in muscle-invasive and locally advanced bladder cancer
Purpose of review
Immune-checkpoint inhibitors (CPIs) have been implemented in the treatment algorithm of metastatic urothelial cancer as they have shown higher and more sustained responses compared with conventional second-line chemotherapy. Recently, several clinical trials have reported on CPIs in earlier disease stages such as muscle-invasive bladder cancer (MIBC). This review summarizes ongoing clinical trials and results from early phase clinical trials in muscle invasive and locally advanced bladder cancer.
Recent findings
In phase II clinical trials, neoadjuvant use of CPIs as mono and combination therapy, in ...
Source: Current Opinion in Urology - May 28, 2020 Category: Urology & Nephrology Tags: NOVEL THERAPIES FOR ADVANCED UROLOGIC CANCERS: Edited by Shahrokh F. Shariat Source Type: research
Bladder sparing landscape for bacillus Calmette-Guérin unresponsive bladder cancer
Purpose of review
The treatment of bacillus Calmette-Guérin (BCG) unresponsive disease remains a challenge for urooncologists. The search for effective conservative treatments is ongoing and several new agents have been recently tested for this purpose. The aim of this manuscript was to review the last developments in this interesting field.
Recent findings
The advent of systemic immunotherapy in the nonmuscle invasive setting promise to revolutionize the paradigm of treatment of BCG unresponsive disease. The preliminary results of the Keynote-057 trial (3 months complete response of 41% in carcinoma-in-situ patients...
Source: Current Opinion in Urology - May 28, 2020 Category: Urology & Nephrology Tags: NOVEL THERAPIES FOR ADVANCED UROLOGIC CANCERS: Edited by Shahrokh F. Shariat Source Type: research
PD1/PD-L1 therapy in metastatic renal cell carcinoma
Purpose of review
The aim of the article to summarize recent changes of treatment options in metastatic renal cell carcinoma (mRCC) with a special emphasis on immune checkpoint inhibition.
Recent findings
The introduction of checkpoint inhibitor (CPI) therapy has led to a paradigm change in advanced renal cell carcinoma (RCC). Dual immune checkpoint inhibition or the combination of CPI and tyrosine kinase inhibitors (TKIs) was shown to improve survival when compared with the former standard of care sunitinib. Moreover, these novel strategies were shown to enable unprecedented rates of complete and durable responses, p...
Source: Current Opinion in Urology - May 28, 2020 Category: Urology & Nephrology Tags: NOVEL THERAPIES FOR ADVANCED UROLOGIC CANCERS: Edited by Shahrokh F. Shariat Source Type: research
The role of taxane-based chemotherapy in the treatment of prostate cancer
Purpose of review
Indications for chemotherapy have increased in prostate cancer (PCA), many of which are shared with new hormonal agents (NHA). With no head to head comparison available, defining the optimal sequence and identifying biomarkers to predict response, has been a focus of intense research in PCA. We aim to summarize the best currently available evidence in all stages of disease to help guide therapy.
Recent findings
In metastatic castration-resistant prostate cancer, Cabazitaxel has shown improved radiographic progression-free survival over another NHA after Docetaxel and one NHA. For hormone sensitive PC...
Source: Current Opinion in Urology - May 28, 2020 Category: Urology & Nephrology Tags: NOVEL THERAPIES FOR ADVANCED UROLOGIC CANCERS: Edited by Shahrokh F. Shariat Source Type: research
Poly(ADP-ribose) polymerase inhibitors in prostate and urothelial cancer
Purpose of review
The aim of this article is to give an overview of poly(ADP-ribose) polymerase inhibitors (PARPis) trials in prostate cancer and to discuss emerging approaches with potential future clinical implementation in both prostate and urothelial cancer.
Recent findings
PARPis are a class of drugs that can be applied for the treatment of homologous recombination repair (HRR)-deficient tumors. Tumors are potentially sensitive to PARPi harbor mutations in genes relevant for DNA damage repair, such as BRCA1/2 or ATM, which are present to a significant degree in metastatic prostate and urothelial cancer patients. ...
Source: Current Opinion in Urology - May 28, 2020 Category: Urology & Nephrology Tags: NOVEL THERAPIES FOR ADVANCED UROLOGIC CANCERS: Edited by Shahrokh F. Shariat Source Type: research
Tibial nerve stimulation in the treatment of overactive bladder syndrome: technical features of latest applications
We describe the technical aspects of recent developed implants and techniques of tibial nerve stimulation in a transcutaneous, percutaneous, and minimal invasive way. All different treatment options have advantages and disadvantages based on type of surgery, energy transfer, impedance, treatment setting options, risk of migration, and patient usability, which are described in this review. Only devices with data that are publicly available were included.
Summary
New technologies are on their way in the field of tibial nerve stimulation for the treatment of OAB. Technical aspects are important to demonstrate safety and ef...
Source: Current Opinion in Urology - May 28, 2020 Category: Urology & Nephrology Tags: NEUROUROLOGY AND INCONTINENCE: Edited by John Heesakkers and Frank Martens Source Type: research
Neurostimulation in neurogenic patients
Purpose of review
To provide an overview of available electrical stimulation devices in neurogenic patients with lower urinary tract disease.
Recent findings
It is advocated to do more studies in neurogenic patients as results seem promising and useful but most studies did not include neurogenic patients or neurogenic patients were not analyzed or reported separately. Most studies included a small heterogenous neurogenic group with multiple pathophysiologic origin focusing on effect of a treatment instead of results of a treatment in a specific neurogenic group. Neuromodulation or stimulation has the advantage that it...
Source: Current Opinion in Urology - May 28, 2020 Category: Urology & Nephrology Tags: NEUROUROLOGY AND INCONTINENCE: Edited by John Heesakkers and Frank Martens Source Type: research
Urological malignancies in neurogenic patients
Purpose of review
To review recent literature related to urologic malignancies in patients with neurogenic lower urinary tract dysfunction (NLUTD). We performed a literature search of electronic databases (PubMed, ScienceDirect, Scopus, and CIANHL), with a focus on articles published between January 2015 and December 2019.
Recent findings
Recent reports demonstrate a lower incidence of bladder cancer in the NLUTD population than previously found, although still significantly higher than the general population. Bladder cancer in patients with NLUTD is usually diagnosed at a younger age, and is associated with higher ra...
Source: Current Opinion in Urology - May 28, 2020 Category: Urology & Nephrology Tags: NEUROUROLOGY AND INCONTINENCE: Edited by John Heesakkers and Frank Martens Source Type: research
Female neurogenic stress urinary incontinence
Purpose of review
The aim of this article is to look into recent updates on the management of neurogenic stress urinary incontinence (NSUI) in adult females.
Recent findings
Recently, a small number of studies have investigated different surgical modalities in treatment of NSUI in adult females including artificial urinary sphincter (AUS), suburethral tapes (SUT) and adjustable slings and urethral bulking agents. Up to 70% of neurogenic patients who received AUS implants are continent and have not required surgical revision over a 20-year follow-up period. However, the risk for explantation of AUS may be twice as high...
Source: Current Opinion in Urology - May 28, 2020 Category: Urology & Nephrology Tags: NEUROUROLOGY AND INCONTINENCE: Edited by John Heesakkers and Frank Martens Source Type: research
