Genitourinary Cancers

This article discusses the current status and potential future developments in immunotherapy for genitourinary malignancies with insights from urologic oncology specialists Hyung L. Kim, MD, and Daniel P. Petrylak, MD.

The role of protein- and cell-based urinary biomarkers for bladder cancer detection and surveillance is controversial, and in 2017 these assays have yet to come into widespread use among urologists. Their uptake is expected to increase, however, considering that the AUA/Society of Urologic Oncology “Guideline on Diagnosis and Treatment of Non-Muscle Invasive Bladder Cancer” that was released in 2016 identifies situations for using urinary biomarkers, according to Badrinath R. Konety, MD.

This article highlights the key points of two urologic cancer guidelines (which provide evidence-based guidance) and two consensus statements (which provide consensus recommendations by a multidisciplinary panel of experts) that have been published in the past year.

Targeted treatment with a small molecule RNA inhibitor demonstrates promising activity for promoting apoptosis of prostate cancer cells in culture, report investigators from Scripps Florida.

“The data from our study show that combination therapy [for metastatic renal cell carcinoma] may offer a much higher response rate with manageable side effects,” says study author Jianjun Gao, MD, PhD.

A recent study found that compared to white light cystoscopy, fluorescent cystoscopy was linked to a 41% decreased risk of bladder cancer recurrence at less than 3 months.

Other pipeline developments include efficacy results for a bladder and prostate cancer drug, an infertility tool to predict sperm quality, the initiation of an immunotherapy combination for mUC, and more.

The noninvasive molecular test for detecting recurrent urothelial carcinoma also demonstrates high negative predictive value in a prospective study.

Since passage of the Affordable Care Act, the number of testicular cancer patients with insurance has dwindled, while rates of advanced testis cancer have climbed, according to a recent study.

New research suggests that post-surgery symptoms may last for at least 3 months in cystectomy patients and worsen over time in some cases, posing unique management challenges for urologists.

The purpose of this article is to discuss important principles of radical cystectomy, whether performed using the open, laparoscopic, or robotic approach.

Nearly one-third of men with testicular cancer undergo diagnostic or therapeutic interventions that are at odds with guidelines from the National Comprehensive Cancer Network (NCCN), according a study published in the Journal of Urology (2017; 197:684-9).

Persistent clinical benefit was seen among a small group of patients with metastatic renal cell carcinoma who had to discontinue therapy with the PD-1 inhibitor nivolumab (Opdivo) because of immune-related adverse events, according to a study presented at the Genitourinary Cancers Symposium in Orlando, FL.

Administration of broad-spectrum antibiotics in patients with metastatic renal cell carcinoma (RCC) undergoing treatment with immune checkpoint inhibitors may have a negative effect on the efficacy of the immunotherapy drugs, according to the results of a recent retrospective analysis.

Urology-related FDA approvals from 2016 encompassed drugs and devices for prostate cancer, renal cell carcinoma, bladder cancer, stone disease, and more.

Other products discussed include an updated prostate tissue ablation device, a contrast agent for voiding ultrasonography, a bladder cancer test and more.

Other pipeline developments discussed include an implantable device for OAB treatment, a subcutaneous hypogonadism treatment, efficacy results for an HPV drug, and the status of a device-based BPH treatment.

Administering sipuleucel-T (Provenge) before rather than after androgen deprivation therapy in men with biochemically recurrent prostate cancer appears to result in a more robust immunologic response, according to a recent study.

Statement authors recommend using immunotherapy prior to an androgen receptor-targeted agent in men with metastatic castration-resistant prostate cancer.

Sanofi Pasteur recently announced that it is discontinuing its BCG products TheraCys and ImmuCyst, prompting fears of a shortage of BCG for bladder cancer patients. In this interview, Dr. Benjamin J. Davies, associate professor of urology at the University of Pittsburgh School of Medicine, discusses the implications of the announcement and what’s next for patients and clinicians.

“We need to identify those patients with high-grade T1 bladder cancer that are likely to recur or progress… and find additional options to prevent recurrence and progression in these patients,” said Joaquim Bellmunt, MD, PhD, in a presentation at the SUO annual meeting.

Read highlights from a presentation by Toni K. Choueiri, MD, at the Society of Urologic Oncology annual meeting.

Other products discussed include a stent system for treating ureteral obstructions, a male infertility test, and more.

Other pipeline developments discussed include a bladder cancer test, a male infertility assay, and the first oral dosage treatment for hypogonadism.

Other new products discussed in this article include a surgical training model, devices designed to improve prostate biopsy accuracy, an updated label and more.