Clinical and biological markers for risk-stratification of T1 high-grade non-muscle invasive bladder cancer
Purpose of review
To summarize the prognostic and predictive role of current clinical and biological markers in patients with T1 high-grade (T1HG) nonmuscle invasive bladder cancer (NMIBC).
Recent findings
Classical clinico-pathologic markers such as age, tumor size, focality, and location as well as the presence of concomitant carcinoma in situ, lymphovascular invasion, and histological variants at the time of transurethral resection (TUR) should be used in the risk-stratification of T1HG to improve patients’ selection for early aggressive treatment. pathological T1 substaging has shown to predict disease pro...
Source: Current Opinion in Urology - August 3, 2022 Category: Urology & Nephrology Tags: CONTROVERSIES AND NEW DEVELOPMENTS IN UROTHELIAL CARCINOMA: Edited by Shahrokh F. Shariat and Benjamin Pradere Source Type: research
Brief update of the new WHO classification for urothelial carcinoma
Purpose of review
Six years after the release of the 4th edition of the WHO classification on male and genitourinary tumors in 2016, the upcoming 5th edition will be released in 2022. This review will discuss significant changes in the new WHO classification for urothelial carcinoma.
Recent findings
Substantial progress has been made during the last 6 years, especially in the molecular definition of bladder cancer, but also in treatment approaches. The authors have incorporated these and other changes relating to surgical pathology and made relevant changes to provide a more logical and consistent structure in s...
Source: Current Opinion in Urology - August 3, 2022 Category: Urology & Nephrology Tags: CONTROVERSIES AND NEW DEVELOPMENTS IN UROTHELIAL CARCINOMA: Edited by Shahrokh F. Shariat and Benjamin Pradere Source Type: research
Micropapillary bladder cancer: an evolving biology
Purpose of review
To summarize a comprehensive overview of more recent evidence on micropapillary bladder cancer (MPBC), focusing on actual incidence, clinical features, therapeutic strategies, and prognosis.
Recent findings
MPBC generally exhibits an aggressive behaviour compared with pure urothelial carcinoma (pUC) with advances in tumour stage and nodal and distant spread at diagnosis. Due to its rarity and presence of only small sample size and retrospective studies, no consensus currently exists regarding the most effective therapeutic strategy to be performed among nonmuscle-invasive (conservative treatmen...
Source: Current Opinion in Urology - August 3, 2022 Category: Urology & Nephrology Tags: CONTROVERSIES AND NEW DEVELOPMENTS IN UROTHELIAL CARCINOMA: Edited by Shahrokh F. Shariat and Benjamin Pradere Source Type: research
Progression-free survival is an adequate endpoint for clinical trials of locally advanced and metastatic urothelial carcinoma
Purpose of review
To evaluate intermediate clinical endpoints that have been proposed as potential surrogates for overall survival amongst patients with locally advanced and metastatic urothelial carcinoma.
Recent findings
Several endpoints have been proposed as potential surrogates for overall survival. They are: pathologic downstaging or complete response after neoadjuvant treatments and progression-free survival in the adjuvant setting and metastatic setting. Formal surrogacy, as per Prentice, has not been established among any of the aforementioned intermediate clinical endpoints and overall survival. Despit...
Source: Current Opinion in Urology - August 3, 2022 Category: Urology & Nephrology Tags: CONTROVERSIES AND NEW DEVELOPMENTS IN UROTHELIAL CARCINOMA: Edited by Shahrokh F. Shariat and Benjamin Pradere Source Type: research
The past, present, and future of pT0 in bladder cancer clinical trials
Purpose of review
Since the establishment of neoadjuvant chemotherapy as the standard of care for patients with muscle invasive bladder cancer, the pathologic absence of disease, denoted pT0, was found to be predictive of improved overall survival. Accordingly, it has been used in clinical trials as an optimal surrogate outcome measure, even in contemporary nonchemotherapeutic interventions. We review the role of pT0 as a catalyst for change in trial design and its suitability to facilitate more efficient and timely results. In addition, we explore the present and future of cT0, the clinical absence of disease, in defi...
Source: Current Opinion in Urology - August 3, 2022 Category: Urology & Nephrology Tags: CONTROVERSIES AND NEW DEVELOPMENTS IN UROTHELIAL CARCINOMA: Edited by Shahrokh F. Shariat and Benjamin Pradere Source Type: research
Major heritable renal cell carcinoma syndromes: novel treatment options and future perspectives
Purpose of review
To provide an overview of diagnosis, genetic abnormalities, clinical signs and treatment options for the major heritable renal cell carcinoma (RCC) syndromes.
Recent findings
RCC in major hereditary syndromes are disorders which are typically autosomal dominant. They predispose patients to early onset of RCC and may exhibit other extrarenal manifestations. Early recognition of these diseases allows correct screening at appropriate ages as well as early detection of RCC. Moreover, expedient identification may optimize the management of extra renal manifestations as well as allow for genetic test...
Source: Current Opinion in Urology - August 3, 2022 Category: Urology & Nephrology Tags: GENETICS IN UROLOGY: Edited by Melanie R. Hassler and Nathan Lawrentschuk Source Type: research
Genetics of testicular cancer: a review
Purpose of review
Testicular germ cell tumours (TGCTs) are the most common solid malignant cancer diagnosed in young males and the incidence is increasing. Understanding the genetic basis of this disease will help us to navigate the challenges of early detection, diagnosis, treatment, surveillance, and long-term outcomes for patients.
Recent findings
TGCTs are highly heritable. Current understanding of germline risk includes the identification of one moderate-penetrance predisposition gene, checkpoint kinase 2 (CHEK2), and 78 low-to-moderate-risk single nucleotide polymorphisms identified in genome-wide-associat...
Source: Current Opinion in Urology - August 3, 2022 Category: Urology & Nephrology Tags: GENETICS IN UROLOGY: Edited by Melanie R. Hassler and Nathan Lawrentschuk Source Type: research
New approaches to targeting epigenetic regulation in prostate cancer
Purpose of review
Many clinical trials are currently underway to target the epigenome of castration-resistant prostate cancer. In this review, we summarize the major epigenetic alterations that occur during prostate cancer progression, describe their biological consequences, and highlight potential of therapies that target epigenetic regulators for use in patients.
Recent findings
Epigenetic alterations frequently occur in tumour suppressor genes, DNA repair genes, and genes that regulate cell proliferation and differentiation. Unlike genetic alterations, epigenetic changes are reversible, making them promising ...
Source: Current Opinion in Urology - August 3, 2022 Category: Urology & Nephrology Tags: GENETICS IN UROLOGY: Edited by Melanie R. Hassler and Nathan Lawrentschuk Source Type: research
Polygenic risk score in prostate cancer
This study was conducted in order to review the outcomes regarding polygenic risk score (PRS) in prediction of prostate cancer (PCa). With the increasing proficiency of genetic analysis, assessment of PRS for prediction of PCa has been performed in numerous studies. Genetic risk prediction models for PCa that include hundreds to thousands of independent risk-associated variants are under development. For estimation of additive effect of multiple variants, the number of risk alleles carried by an individual is summed, and each variant is weighted according to its estimated effect size for generation of a PRS.
Recent find...
Source: Current Opinion in Urology - August 3, 2022 Category: Urology & Nephrology Tags: GENETICS IN UROLOGY: Edited by Melanie R. Hassler and Nathan Lawrentschuk Source Type: research
Genetics of neuroendocrine prostate cancer: recent progress in genetic understanding is translating into therapeutic opportunities
Purpose of review
Neuroendocrine prostate cancer (NEPC) is a rare histologic subtype of prostate cancer with extremely aggressive clinical behaviour and very limited data regarding treatment options. This review is intended to relay new research advances in the understanding of the genetic and epigenetic aberrations underlying NEPC development and to review new targeted therapeutic options developed based on NEPC genetics.
Recent findings
Multiple genomic alterations and epigenetic regulators have been identified in NEPC development. Among these are amplifications of oncogenic transcriptional factors, changes in...
Source: Current Opinion in Urology - August 3, 2022 Category: Urology & Nephrology Tags: GENETICS IN UROLOGY: Edited by Melanie R. Hassler and Nathan Lawrentschuk Source Type: research
Novel germline mutations for active surveillance and imaging strategies in prostate cancer
We describe the benefits of GLM integration into prostate cancer screening, diagnosis and management. Imaging techniques enhancing prostate cancer detection are advancing concurrently, facilitating strategic active surveillance protocols for appropriately selected patients. We aim to improve clinician awareness of the role of GLM in current and future practice.
Recent findings
We explore recent literature advancing the role of GLM in prostate cancer detection and management, particularly as this coexists with the development of imaging technology. Our current understanding of germline mutations implicated in familia...
Source: Current Opinion in Urology - August 3, 2022 Category: Urology & Nephrology Tags: GENETICS IN UROLOGY: Edited by Melanie R. Hassler and Nathan Lawrentschuk Source Type: research
Molecular uropathology and cancer genetics for the urologist: key findings for classification and diagnosis
Purpose of review
To highlight the latest changes in prostate cancer (PCa), urothelial carcinoma, upper tract urothelial carcinoma (UTUC) and renal cell carcinoma (RCC) diagnosis and the impact of genetics in this field.
Recent findings
Breast cancer1/2 mutations start to play a major role in PCa treatment with regard to personalized medicine. In urothelial carcinoma an overlap between histological pathological and molecular findings exists, fibroblast growth factor receptor alteration are starting to play a major role, programmed death-ligand 1 although problematic is still important in the treatment setting. U...
Source: Current Opinion in Urology - August 3, 2022 Category: Urology & Nephrology Tags: GENETICS IN UROLOGY: Edited by Melanie R. Hassler and Nathan Lawrentschuk Source Type: research
The role of prophylactic prostatectomy as a primary prevention strategy in high-risk germline mutation carriers
Purpose of review
Men with high-risk germline mutations are at significantly higher risk of developing and dying from prostate cancer. Current screening and treatment paradigms may lead to missed opportunities for cure. Herein we review the current literature on prevention, screening and treatment of these carriers and explore the potential role of prophylactic prostatectomy in primary prevention of prostate cancer mortality.
Recent findings
Prostate-specific antigen (PSA)-based screening has demonstrated marginal benefits in prostate cancer (PCa) survival and uncertainty remains on its true benefit among high-r...
Source: Current Opinion in Urology - August 3, 2022 Category: Urology & Nephrology Tags: GENETICS IN UROLOGY: Edited by Melanie R. Hassler and Nathan Lawrentschuk Source Type: research
Editorial: genetics in urology
No abstract available (Source: Current Opinion in Urology)
Source: Current Opinion in Urology - August 3, 2022 Category: Urology & Nephrology Tags: GENETICS IN UROLOGY: Edited by Melanie R. Hassler and Nathan Lawrentschuk Source Type: research
Editorial introductions
No abstract available (Source: Current Opinion in Urology)
Source: Current Opinion in Urology - August 3, 2022 Category: Urology & Nephrology Tags: EDITORIAL INTRODUCTIONS Source Type: research
