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Reply to Laila Schneidewind, Fabian P. Stangl, Jennifer Kranz, and Gernot Bonkat's Letter to Editor re: Fredrik Liedberg, Evanguelos Xylinas, Paolo Gontero. Quinolone Prophylaxis in Conjunction with Bacillus Calmette-Guérin Instillations for Bladder Cancer: Time To Reconsider the Evidence and Open the Quinolone Box? Eur Urol Focus 2024;10:564-6. 回复Laila Schneidewind, Fabian P. Stangl, Jennifer Kranz和Gernot Bonkat给编辑的信:Fredrik Liedberg, Evanguelos Xylinas, Paolo Gontero。喹诺酮预防联合卡介苗-谷氨酰胺滴注治疗膀胱癌:是时候重新考虑证据并打开喹诺酮盒子了?[au:] [au:] [au:] [au:]
IF 4.8 2区 医学 Q1 UROLOGY & NEPHROLOGY Pub Date : 2024-12-17 DOI: 10.1016/j.euf.2024.12.001
Fredrik Liedberg, Evanguelos Xylinas, Paolo Gontero
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引用次数: 0
Re: Anirban Dey, Georgios Georgiadis, Justin Umezurike, et al. Mirabegron Versus Placebo and Other Therapeutic Modalities in the Treatment of Patients with Overactive Bladder Syndrome-A Systematic Review. Eur Urol Focus. In press. https://doi:10.1016/j.euf.2024.09.012. 回复:Anirban Dey, Georgios Georgiadis, Justin Umezurike等。Mirabegron与安慰剂及其他治疗方式治疗膀胱过度活动综合征的比较——系统评价。Eur url Focus。在出版社。https://doi: 10.1016 / j.euf.2024.09.012。
IF 4.8 2区 医学 Q1 UROLOGY & NEPHROLOGY Pub Date : 2024-12-16 DOI: 10.1016/j.euf.2024.11.013
Rong Dai, Changkai Deng
{"title":"Re: Anirban Dey, Georgios Georgiadis, Justin Umezurike, et al. Mirabegron Versus Placebo and Other Therapeutic Modalities in the Treatment of Patients with Overactive Bladder Syndrome-A Systematic Review. Eur Urol Focus. In press. https://doi:10.1016/j.euf.2024.09.012.","authors":"Rong Dai, Changkai Deng","doi":"10.1016/j.euf.2024.11.013","DOIUrl":"https://doi.org/10.1016/j.euf.2024.11.013","url":null,"abstract":"","PeriodicalId":12160,"journal":{"name":"European urology focus","volume":" ","pages":""},"PeriodicalIF":4.8,"publicationDate":"2024-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142846285","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Re: Fredrik Liedberg, Evanguelos Xylinas, Paolo Gontero. Quinolone Prophylaxis in Conjunction with Bacillus Calmette-Guérin Instillations for Bladder Cancer: Time To Reconsider the Evidence and Open the Quinolone Box? Eur Urol Focus. In press. https://doi.org/10.1016/j.euf.2023.11.007. Re:Fredrik Liedberg, Evanguelos Xylinas, Paolo Gontero.喹诺酮类药物预防膀胱癌与卡介苗-格林芽孢杆菌注射:是时候重新考虑证据并打开喹诺酮盒子了吗?欧洲泌尿聚焦》。https://doi.org/10.1016/j.euf.2023.11.007.
IF 4.8 2区 医学 Q1 UROLOGY & NEPHROLOGY Pub Date : 2024-12-13 DOI: 10.1016/j.euf.2024.10.012
Laila Schneidewind, Fabian P Stangl, Jennifer Kranz, Gernot Bonkat
{"title":"Re: Fredrik Liedberg, Evanguelos Xylinas, Paolo Gontero. Quinolone Prophylaxis in Conjunction with Bacillus Calmette-Guérin Instillations for Bladder Cancer: Time To Reconsider the Evidence and Open the Quinolone Box? Eur Urol Focus. In press. https://doi.org/10.1016/j.euf.2023.11.007.","authors":"Laila Schneidewind, Fabian P Stangl, Jennifer Kranz, Gernot Bonkat","doi":"10.1016/j.euf.2024.10.012","DOIUrl":"https://doi.org/10.1016/j.euf.2024.10.012","url":null,"abstract":"","PeriodicalId":12160,"journal":{"name":"European urology focus","volume":" ","pages":""},"PeriodicalIF":4.8,"publicationDate":"2024-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142824045","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Cytoreductive Nephrectomy in Metastatic Renal Cell Carcinoma Treated with Immune Checkpoint Inhibitors: A Systematic Review and Meta-analysis of Individual Patient Data. 免疫检查点抑制剂治疗转移性肾癌的细胞减少性肾切除术:个体患者数据的系统回顾和荟萃分析。
IF 4.8 2区 医学 Q1 UROLOGY & NEPHROLOGY Pub Date : 2024-12-11 DOI: 10.1016/j.euf.2024.11.007
Dimitrios Makrakis, Pavlos Msaouel, Jose A Karam, Stepan Μ Esagian

Background and objective: The role of cytoreductive nephrectomy (CN) in metastatic renal cell carcinoma (mRCC) in the era of immune checkpoint inhibitors (ICIs) is controversial. We aimed to investigate the survival benefit of CN in patients with mRCC treated with ICIs.

Methods: We searched the EMBASE, MEDLINE, and Web of Science databases up to August 26, 2023 to identify studies comparing overall survival (OS) for patients with mRCC treated with ICIs with or without CN. We reconstructed individual patient data using published Kaplan-Meier curves and performed one- and two-stage meta-analyses using 6-mo and 12-mo landmarks to control for immortal time bias. We also performed subgroup analyses for patients treated with first-line ICI or upfront CN.

Key findings and limitations: We identified eight eligible studies involving a total of 2319 patients. There were statistically significant differences in baseline characteristics (age, clear cell histology, International mRCC Database Consortium scores) between the ICI + CN and ICI-alone groups. Combined CN + ICI therapy was associated with superior OS in the primary analysis (hazard ratio [HR] 0.45, 95% confidence interval [CI] 0.37-0.54) and secondary analyses, and in subgroup analyses for patients receiving first-line ICI therapy (HR 0.39, 95% CI 0.30-0.48) and upfront CN (HR 0.52, 95% CI 0.40-0.69).

Conclusions and clinical implications: CN combined with ICI therapy in mRCC may be associated with superior OS. Further studies are needed to confirm this finding and identify the patients most likely to benefit from CN in this setting.

Patient summary: We compared outcomes after immune checkpoint inhibitor (ICI) therapy, which boosts the immune system to fight cancer, with or without nephrectomy (surgical removal of the kidney) in patients with metastatic kidney cancer. We found that the combination of nephrectomy and ICI therapy was associated with better survival than just ICI therapy.

背景与目的:在免疫检查点抑制剂(ICIs)时代,细胞减原性肾切除术(CN)在转移性肾细胞癌(mRCC)中的作用存在争议。我们的目的是研究在接受ICIs治疗的mRCC患者中CN的生存获益。方法:我们检索了截至2023年8月26日的EMBASE、MEDLINE和Web of Science数据库,以确定比较有或无CN的ICIs治疗mRCC患者总生存期(OS)的研究。我们使用已发表的Kaplan-Meier曲线重建了个体患者数据,并使用6个月和12个月的里程碑进行了一阶段和两阶段荟萃分析,以控制不朽的时间偏差。我们还对一线ICI或前期CN治疗的患者进行了亚组分析。主要发现和局限性:我们确定了8项符合条件的研究,共涉及2319名患者。在ICI + CN组和ICI单独组之间,基线特征(年龄、透明细胞组织学、国际mRCC数据库联盟评分)存在统计学上的显著差异。在主要分析(风险比[HR] 0.45, 95%可信区间[CI] 0.37-0.54)和次要分析中,以及在接受一线ICI治疗的患者(HR 0.39, 95% CI 0.30-0.48)和前期CN (HR 0.52, 95% CI 0.40-0.69)的亚组分析中,CN + ICI联合治疗与较好的OS相关。结论和临床意义:CN联合ICI治疗mRCC可能与较好的OS相关。需要进一步的研究来证实这一发现,并确定在这种情况下最有可能从CN获益的患者。患者总结:我们比较了转移性肾癌患者接受免疫检查点抑制剂(ICI)治疗后的结果,该疗法可增强免疫系统对抗癌症,并伴有或不伴有肾切除术(手术切除肾脏)。我们发现联合肾切除术和ICI治疗比单纯的ICI治疗有更好的生存率。
{"title":"Cytoreductive Nephrectomy in Metastatic Renal Cell Carcinoma Treated with Immune Checkpoint Inhibitors: A Systematic Review and Meta-analysis of Individual Patient Data.","authors":"Dimitrios Makrakis, Pavlos Msaouel, Jose A Karam, Stepan Μ Esagian","doi":"10.1016/j.euf.2024.11.007","DOIUrl":"https://doi.org/10.1016/j.euf.2024.11.007","url":null,"abstract":"<p><strong>Background and objective: </strong>The role of cytoreductive nephrectomy (CN) in metastatic renal cell carcinoma (mRCC) in the era of immune checkpoint inhibitors (ICIs) is controversial. We aimed to investigate the survival benefit of CN in patients with mRCC treated with ICIs.</p><p><strong>Methods: </strong>We searched the EMBASE, MEDLINE, and Web of Science databases up to August 26, 2023 to identify studies comparing overall survival (OS) for patients with mRCC treated with ICIs with or without CN. We reconstructed individual patient data using published Kaplan-Meier curves and performed one- and two-stage meta-analyses using 6-mo and 12-mo landmarks to control for immortal time bias. We also performed subgroup analyses for patients treated with first-line ICI or upfront CN.</p><p><strong>Key findings and limitations: </strong>We identified eight eligible studies involving a total of 2319 patients. There were statistically significant differences in baseline characteristics (age, clear cell histology, International mRCC Database Consortium scores) between the ICI + CN and ICI-alone groups. Combined CN + ICI therapy was associated with superior OS in the primary analysis (hazard ratio [HR] 0.45, 95% confidence interval [CI] 0.37-0.54) and secondary analyses, and in subgroup analyses for patients receiving first-line ICI therapy (HR 0.39, 95% CI 0.30-0.48) and upfront CN (HR 0.52, 95% CI 0.40-0.69).</p><p><strong>Conclusions and clinical implications: </strong>CN combined with ICI therapy in mRCC may be associated with superior OS. Further studies are needed to confirm this finding and identify the patients most likely to benefit from CN in this setting.</p><p><strong>Patient summary: </strong>We compared outcomes after immune checkpoint inhibitor (ICI) therapy, which boosts the immune system to fight cancer, with or without nephrectomy (surgical removal of the kidney) in patients with metastatic kidney cancer. We found that the combination of nephrectomy and ICI therapy was associated with better survival than just ICI therapy.</p>","PeriodicalId":12160,"journal":{"name":"European urology focus","volume":" ","pages":""},"PeriodicalIF":4.8,"publicationDate":"2024-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142817634","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Assessing the Molecular Heterogeneity of Prostate Cancer Biopsy Sampling: Insights from the MAST Trial. 评估前列腺癌活检样本的分子异质性:来自MAST试验的见解。
IF 4.8 2区 医学 Q1 UROLOGY & NEPHROLOGY Pub Date : 2024-12-10 DOI: 10.1016/j.euf.2024.11.012
Tarek Ajami, Hui Yu, Joao G Porto, Nachiketh Soodana Prakash, Adam Williams, Yuval Avda, Ankur Malpani, Dinno F Mendiola, Pedro F S Freitas, Archan Khandekar, Sanjaya Swain, Sandra Gaston, Brandon Mahal, Elena Cortizas, Zoe Szczotka, Timothy Gerard, Bruce Kava, Radka Stoyanova, Oleksandr N Kryvenko, Patricia Castillo, Chad R Ritch, Bruno Nahar, Mark L Gonzalgo, Alan Pollack, Dipen J Parekh, Sanoj Punnen

Background and objective: Prostate cancer (PC) heterogeneity can result in sampling discrepancies during biopsy, leading to inaccurate molecular classifications that affect treatment decisions. We evaluated transcriptomic profile variability between multiparametric magnetic resonance imaging (mpMRI)-targeted biopsy (TBx) and systematic biopsy (SBx) methods using the Decipher GRID platform.

Methods: The study included 205 men from the MAST trial. We analyzed 408 biopsy samples, of which 149 were TBx and 259 were SBx samples. Three prognostic signatures-the Decipher genomic classifier (DGC), cell cycle progression (CCP), and Genomic Prostate Score-were assessed in relation to grade group (GG) and MRI phenotype. Multivariable linear regression was conducted to adjust for the confounding effects of GG and tumor purity.

Key findings and limitations: Unpaired analysis revealed that TBx samples had higher derived GPS and CCP scores than SBx samples (p < 0.05), but the difference was no longer significant after multiple-test adjustment. There was no significant difference in scores between SBx and TBx samples in the subgroup with GG 1 disease. For TBx cores, higher genomic scores were associated with higher Prostate Imaging-Reporting and Data System (PI-RADS) scores in the overall cohort, but not in the GG 1 subgroup. Multivariable analysis revealed significant associations between DGC and CCP scores and PI-RADS scores (p < 0.01). Higher DGC score concordance between TBx and SBx lesions was observed in the low-risk subgroup. A limitation of the study is the small sample size, so further validation is required.

Conclusions and clinical implications: TBx samples yield higher genomic scores than SBx samples, with grade influencing the association between PI-RADS score and genomic risk. For the GG 1 subgroup, there was no correlation between PI-RADS and genomic scores. These findings need further validation to assess the impact of TBx on genomic risk assessment in active surveillance.

Patient summary: We examined the effectiveness of two different biopsy methods in assessing the risk of prostate cancer (PC) progression. We found that while biopsy samples guided by MRI (magnetic resonance imaging) scans often showed higher genetic risk scores than biopsy samples without MRI guidance, the difference was not significant for men with lower-grade PC. Our findings suggest that MRI targeting for biopsy might not always provide additional information about cancer aggressiveness for patients with low-risk PC.

背景和目的:前列腺癌(PC)异质性可导致活检过程中采样差异,导致不准确的分子分类,影响治疗决策。我们使用Decipher GRID平台评估了多参数磁共振成像(mpMRI)靶向活检(TBx)和系统活检(SBx)方法之间的转录组谱差异。方法:该研究包括来自MAST试验的205名男性。我们分析了408例活检样本,其中149例为TBx, 259例为SBx。三个预后特征-破译基因组分类器(DGC),细胞周期进展(CCP)和前列腺基因组评分-与分级组(GG)和MRI表型相关进行评估。采用多变量线性回归来调整GG和肿瘤纯度的混杂效应。主要发现和局限性:非配对分析显示TBx样本的GPS和CCP评分高于SBx样本(p结论和临床意义:TBx样本的基因组评分高于SBx样本,其等级影响PI-RADS评分与基因组风险之间的关联。对于GG 1亚组,PI-RADS与基因组评分之间没有相关性。这些发现需要进一步验证,以评估TBx对主动监测中基因组风险评估的影响。患者总结:我们研究了两种不同活检方法在评估前列腺癌(PC)进展风险方面的有效性。我们发现,虽然MRI(磁共振成像)扫描引导下的活检样本通常比没有MRI指导的活检样本显示更高的遗传风险评分,但对于低级别PC的男性来说,差异并不显著。我们的研究结果表明,MRI靶向活检可能并不总是为低风险PC患者提供癌症侵袭性的额外信息。
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引用次数: 0
Efficacy of Treatments After Lenvatinib in Patients with Advanced Renal Cell Carcinoma. Lenvatinib治疗晚期肾癌的疗效观察。
IF 4.8 2区 医学 Q1 UROLOGY & NEPHROLOGY Pub Date : 2024-12-07 DOI: 10.1016/j.euf.2024.11.011
Justine Panian, Caiwei Zhong, Sharon H Choi, Kristine Ly, Roxanne Quinn, Evan Ferrier, Eddy Saad, Renee Maria Saliby, Carmel Malvar, Sumanta Pal, Hedyeh Ebrahimi, Ben Tran, Evon Jude, Aly-Khan Lalani, Cristina Suarez, Guillermo De Velasco, Ravindran Kanesvaran, Martin Zarba, Elizabeth Liow, Razane El Hajj Chehade, Toni K Choueiri, Daniel Y C Heng, Rana R McKay

Background and objective: Lenvatinib is a multitargeted tyrosine kinase inhibitor (TKI) used in the upfront and refractory settings for metastatic renal cell carcinoma (mRCC). However, there are limited data on the efficacy of subsequent TKI therapies after lenvatinib. We investigated the activity of TKI therapies after lenvatinib in patients with mRCC.

Methods: We conducted a retrospective analysis of data from the International Metastatic RCC Database Consortium (IMDC). Patients who received post-lenvatinib treatment were divided into two cohorts: a second-line cohort after first-line lenvatinib; and a third-line cohort after second-line lenvatinib. The primary endpoint was the objective response rate (ORR). Secondary endpoints included the time to treatment failure (TTF).

Key findings and limitations: Of the 168 patients included, 122 (73%) had clear-cell histology. In the second-line cohort (n = 20), all patients received first-line pembrolizumab + lenvatinib. The ORR was 50% and median TTF was 19.7 mo for first-line treatment. Median follow-up from initiation of second-line treatment was 4.9 mo. The ORR to second-line treatment was 5% (95% confidence interval [CI] 0.2-25%) and median TTF was 5.8 mo (95% CI 1.9-14.9). In the third-line cohort (n = 34), most patients received second-line everolimus + lenvatinib (97%). The ORR was 31% and median TTF was 9.2 mo for second-line therapy. Median follow-up from initiation of third-line treatment was 14.9 mo. The ORR to third-line treatment was 12% (95% CI 3.3-27%) and median TTF was 2.8 mo (95% CI 1.9-7.4).

Conclusions and clinical implications: Our data demonstrate modest activity of TKI-based therapy after exposure to lenvatinib. The results highlight the need for better treatment options for patients who experience progression on lenvatinib-based therapies.

Patient summary: Lenvatinib is a type of drug called a tyrosine kinase inhibitor (TKI). It is used to treat metastatic kidney cancer either when first diagnosed or after progression on a previous treatment. There is limited information on how patients respond to a different TKI after receiving lenvatinib. Our results show that other TKIs have modest clinical activity after patients have received lenvatinib.

背景和目的:来伐替尼是一种多靶点酪氨酸激酶抑制剂(TKI),用于转移性肾细胞癌(mRCC)的前期和难治性治疗。然而,有关来伐替尼之后的后续TKI疗法疗效的数据十分有限。我们研究了来伐替尼治疗mRCC患者后TKI疗法的活性:我们对国际转移性RCC数据库联盟(IMDC)的数据进行了回顾性分析。接受来伐替尼治疗后的患者被分为两个队列:一线来伐替尼治疗后的二线队列;二线来伐替尼治疗后的三线队列。主要终点是客观反应率(ORR)。次要终点包括治疗失败时间(TTF):在纳入的168例患者中,122例(73%)为透明细胞组织学。在二线队列(n = 20)中,所有患者均接受了一线pembrolizumab+来伐替尼治疗。一线治疗的ORR为50%,中位TTF为19.7个月。二线治疗的ORR为5%(95%置信区间[CI] 0.2-25%),中位TTF为5.8个月(95%置信区间[CI] 1.9-14.9)。在三线队列(n = 34)中,大多数患者接受了依维莫司+来伐替尼(97%)的二线治疗。二线治疗的ORR为31%,中位TTF为9.2个月。三线治疗的ORR为12%(95% CI 3.3-27%),中位TTF为2.8个月(95% CI 1.9-7.4):我们的数据表明,在接受来伐替尼治疗后,以TKI为基础的治疗具有一定的活性。患者总结:来伐替尼是一种被称为酪氨酸激酶抑制剂(TKI)的药物。它可用于治疗首次确诊的转移性肾癌或之前治疗进展后的转移性肾癌。关于患者在接受来伐替尼治疗后对不同TKI反应如何的信息很有限。我们的研究结果表明,其他TKIs在患者接受来伐替尼治疗后具有适度的临床活性。
{"title":"Efficacy of Treatments After Lenvatinib in Patients with Advanced Renal Cell Carcinoma.","authors":"Justine Panian, Caiwei Zhong, Sharon H Choi, Kristine Ly, Roxanne Quinn, Evan Ferrier, Eddy Saad, Renee Maria Saliby, Carmel Malvar, Sumanta Pal, Hedyeh Ebrahimi, Ben Tran, Evon Jude, Aly-Khan Lalani, Cristina Suarez, Guillermo De Velasco, Ravindran Kanesvaran, Martin Zarba, Elizabeth Liow, Razane El Hajj Chehade, Toni K Choueiri, Daniel Y C Heng, Rana R McKay","doi":"10.1016/j.euf.2024.11.011","DOIUrl":"https://doi.org/10.1016/j.euf.2024.11.011","url":null,"abstract":"<p><strong>Background and objective: </strong>Lenvatinib is a multitargeted tyrosine kinase inhibitor (TKI) used in the upfront and refractory settings for metastatic renal cell carcinoma (mRCC). However, there are limited data on the efficacy of subsequent TKI therapies after lenvatinib. We investigated the activity of TKI therapies after lenvatinib in patients with mRCC.</p><p><strong>Methods: </strong>We conducted a retrospective analysis of data from the International Metastatic RCC Database Consortium (IMDC). Patients who received post-lenvatinib treatment were divided into two cohorts: a second-line cohort after first-line lenvatinib; and a third-line cohort after second-line lenvatinib. The primary endpoint was the objective response rate (ORR). Secondary endpoints included the time to treatment failure (TTF).</p><p><strong>Key findings and limitations: </strong>Of the 168 patients included, 122 (73%) had clear-cell histology. In the second-line cohort (n = 20), all patients received first-line pembrolizumab + lenvatinib. The ORR was 50% and median TTF was 19.7 mo for first-line treatment. Median follow-up from initiation of second-line treatment was 4.9 mo. The ORR to second-line treatment was 5% (95% confidence interval [CI] 0.2-25%) and median TTF was 5.8 mo (95% CI 1.9-14.9). In the third-line cohort (n = 34), most patients received second-line everolimus + lenvatinib (97%). The ORR was 31% and median TTF was 9.2 mo for second-line therapy. Median follow-up from initiation of third-line treatment was 14.9 mo. The ORR to third-line treatment was 12% (95% CI 3.3-27%) and median TTF was 2.8 mo (95% CI 1.9-7.4).</p><p><strong>Conclusions and clinical implications: </strong>Our data demonstrate modest activity of TKI-based therapy after exposure to lenvatinib. The results highlight the need for better treatment options for patients who experience progression on lenvatinib-based therapies.</p><p><strong>Patient summary: </strong>Lenvatinib is a type of drug called a tyrosine kinase inhibitor (TKI). It is used to treat metastatic kidney cancer either when first diagnosed or after progression on a previous treatment. There is limited information on how patients respond to a different TKI after receiving lenvatinib. Our results show that other TKIs have modest clinical activity after patients have received lenvatinib.</p>","PeriodicalId":12160,"journal":{"name":"European urology focus","volume":" ","pages":""},"PeriodicalIF":4.8,"publicationDate":"2024-12-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142794620","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Triplet or Doublet Therapy in Metastatic Hormone-sensitive Prostate Cancer Patients: An Updated Network Meta-analysis Including ARANOTE Data. 转移性激素敏感前列腺癌患者的三重或双重治疗:包括ARANOTE数据的最新网络荟萃分析
IF 4.8 2区 医学 Q1 UROLOGY & NEPHROLOGY Pub Date : 2024-12-05 DOI: 10.1016/j.euf.2024.11.004
Benedikt Hoeh, Mike Wenzel, Zhe Tian, Pierre I Karakiewicz, Fred Saad, Thomas Steuber, Markus Graefen, Derya Tilki, Roman Herout, Christian Thomas, Felix K-H Chun, Philipp Mandel

The treatment landscape for metastatic hormone-sensitive prostate cancer (mHSPC) has been extended by another phase 3 randomized control trial (ARANOTE) demonstrating favorable outcomes of a doublet therapy combining the androgen receptor pathway inhibitor (ARPI) darolutamide with androgen deprivation therapy (ADT) over ADT monotherapy. Owing to differences in trial designs, patient enrollment, and most notably different control treatment regimens, we hereby present an updated network meta-analysis (NMA) embedding the doublet therapy with darolutamide within the current treatment regimens. In NMA-derived ranking, darolutamide and ADT showed similar oncological efficacy to the already known doublet therapies for progression-free survival (p = 0.49). These findings were consistent when solely doublet treatments, including apalutamide, enzalutamide, or darolutamide, were stratified according to disease volume. Overall survival (OS) data in ARANOTE are very immature, with up to date no significant differences in OS between the doublet regimen and the control group (hazard ratio: 0.81; 95% confidence interval: 0.59-1.12). The combination of darolutamide and ADT is likely-with the requirement of additional follow-up-to become another standard of care regimen for mHSPC following approval in the future. PATIENT SUMMARY: The phase 3 ARANOTE trial has shown the combination of darolutamide and androgen deprivation therapy (ADT) to have favorable outcomes for metastatic hormone-sensitive prostate cancer (mHSPC) over ADT monotherapy. This combination therapy was as effective as the already known doublet therapies for progression free-survival, and had a very favorable safety and toxicity profile. Following approval, the combination of darolutamide and ADT may become another standard of care regimen for mHSPC.

转移性激素敏感性前列腺癌(mHSPC)的治疗前景被另一项3期随机对照试验(ARANOTE)所扩展,该试验表明,雄激素受体途径抑制剂(ARPI) darolutamide联合雄激素剥夺疗法(ADT)的双重治疗效果优于ADT单药治疗。由于试验设计、患者入组和最明显的对照治疗方案的差异,我们在此提出一项更新的网络荟萃分析(NMA),将darolutamide的双重治疗纳入当前的治疗方案中。在nma衍生的排名中,darolutamide和ADT在无进展生存方面显示出与已知双重疗法相似的肿瘤疗效(p = 0.49)。当单独的双重治疗,包括阿帕鲁胺、恩杂鲁胺或达罗卢胺,根据疾病体积分层时,这些结果是一致的。ARANOTE的总生存期(OS)数据非常不成熟,到目前为止,双药组和对照组的总生存期(OS)没有显著差异(风险比:0.81;95%置信区间:0.59-1.12)。darolutamide和ADT的联合治疗(需要额外的随访)可能在未来获得批准后成为mHSPC的另一种标准治疗方案。患者总结:ARANOTE 3期临床试验显示,darolutamide联合雄激素剥夺疗法(ADT)治疗转移性激素敏感性前列腺癌(mHSPC)的疗效优于ADT单药治疗。这种联合治疗在无进展生存方面与已知的双重治疗一样有效,并且具有非常有利的安全性和毒性。批准后,darolutamide和ADT联合可能成为mHSPC的另一种标准护理方案。
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引用次数: 0
Artificial INtelligence to Support Informed DEcision-making (INSIDE) for Improved Literature Analysis in Oncology. 人工智能支持知情决策(INSIDE)改进肿瘤学文献分析。
IF 4.8 2区 医学 Q1 UROLOGY & NEPHROLOGY Pub Date : 2024-12-01 Epub Date: 2024-06-13 DOI: 10.1016/j.euf.2024.05.022
Arnulf Stenzl, Andrew J Armstrong, Andrea Sboner, Jenny Ghith, Lucile Serfass, Christopher S Bland, Bob J A Schijvenaars, Cora N Sternberg

Background: Defining optimal therapeutic sequencing strategies in prostate cancer (PC) is challenging and may be assisted by artificial intelligence (AI)-based tools for an analysis of the medical literature.

Objective: To demonstrate that INSIDE PC can help clinicians query the literature on therapeutic sequencing in PC and to develop previously unestablished practices for evaluating the outputs of AI-based support platforms.

Design, setting, and participants: INSIDE PC was developed by customizing PubMed Bidirectional Encoder Representations from Transformers. Publications were ranked and aggregated for relevance using data visualization and analytics. Publications returned by INSIDE PC and PubMed were given normalized discounted cumulative gain (nDCG) scores by PC experts reflecting ranking and relevance.

Intervention: INSIDE PC for AI-based semantic literature analysis.

Outcome measurements and statistical analysis: INSIDE PC was evaluated for relevance and accuracy for three test questions on the efficacy of therapeutic sequencing of systemic therapies in PC.

Results and limitations: In this initial evaluation, INSIDE PC outperformed PubMed for question 1 (novel hormonal therapy [NHT] followed by NHT) for the top five, ten, and 20 publications (nDCG score, +43, +33, and +30 percentage points [pps], respectively). For question 2 (NHT followed by poly [adenosine diphosphate ribose] polymerase inhibitors [PARPi]), INSIDE PC and PubMed performed similarly. For question 3 (NHT or PARPi followed by 177Lu-prostate-specific membrane antigen-617), INSIDE PC outperformed PubMed for the top five, ten, and 20 publications (+16, +4, and +5 pps, respectively).

Conclusions: We applied INSIDE PC to develop standards for evaluating the performance of AI-based tools for literature extraction. INSIDE PC performed competitively with PubMed and can assist clinicians with therapeutic sequencing in PC.

Patient summary: The medical literature is often very difficult for doctors and patients to search. In this report, we describe INSIDE PC-an artificial intelligence (AI) system created to help search articles published in medical journals and determine the best order of treatments for advanced prostate cancer in a much better time frame. We found that INSIDE PC works as well as another search tool, PubMed, a widely used resource for searching and retrieving articles published in medical journals. Our work with INSIDE PC shows new ways in which AI can be used to search published articles in medical journals and how these systems might be evaluated to support shared decision-making.

背景:确定前列腺癌(PC)的最佳治疗排序策略具有挑战性,基于人工智能(AI)的医学文献分析工具可为其提供帮助:目的:证明 INSIDE PC 可以帮助临床医生查询有关 PC 治疗排序的文献,并为评估基于人工智能的支持平台的输出结果制定之前尚未确立的做法:INSIDE PC 是通过定制来自 Transformers 的 PubMed 双向编码器表征而开发的。利用数据可视化和分析技术对出版物进行相关性排序和汇总。INSIDE PC和PubMed返回的出版物由PC专家给出归一化折现累积增益(nDCG)分数,以反映排名和相关性:INSIDE PC用于基于人工智能的语义文献分析:对 INSIDE PC 的相关性和准确性进行了评估,涉及 PC 系统疗法疗效排序的三个测试问题:在这一初步评估中,INSIDE PC在问题1(新型激素疗法[NHT],然后是NHT)的前五名、前十名和前二十名出版物中的表现优于PubMed(nDCG得分分别为+43、+33和+30个百分点[pps])。对于问题 2(NHT,其次是聚[腺苷二磷酸核糖]聚合酶抑制剂[PARPi]),INSIDE PC 和 PubMed 的表现类似。对于问题 3(NHT 或 PARPi 后加 177Lu-前列腺特异性膜抗原-617),INSIDE PC 在前 5 篇、10 篇和 20 篇出版物中的表现优于 PubMed(分别为 +16、+4 和 +5pps):我们应用 INSIDE PC 制定了评估基于人工智能的文献提取工具性能的标准。INSIDE PC的性能与PubMed不相上下,可以帮助临床医生对PC进行治疗排序。患者总结:对于医生和患者来说,医学文献的检索通常非常困难。在本报告中,我们介绍了 INSIDE PC--一种人工智能(AI)系统,该系统可帮助搜索医学期刊上发表的文章,并在更短的时间内确定晚期前列腺癌的最佳治疗顺序。我们发现,INSIDE PC 与另一种搜索工具 PubMed(一种广泛用于搜索和检索医学期刊上发表的文章的资源)一样有效。我们在 INSIDE PC 上的工作展示了使用人工智能搜索医学期刊发表文章的新方法,以及如何评估这些系统以支持共同决策。
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引用次数: 0
Microbiome-based Therapeutics: Cutting-edge Innovation. 基于微生物组的治疗:前沿创新。
IF 4.8 2区 医学 Q1 UROLOGY & NEPHROLOGY Pub Date : 2024-12-01 Epub Date: 2024-11-28 DOI: 10.1016/j.euf.2024.10.011
Mitsuru Komeya, Scott D Lundy

From bacillus Calmette-Guérin to cutting-edge research, the microbiome has played an integral role in urology treatments and will continue to do so for many generations to come.

从卡介苗芽孢杆菌到前沿研究,微生物组在泌尿外科治疗中发挥了不可或缺的作用,并将在未来的许多代中继续发挥作用。
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引用次数: 0
Microbiome-based Therapeutics: Cutting-edge Innovation or Perpetual Promise? 基于微生物组的治疗:前沿创新还是永恒的希望?
IF 4.8 2区 医学 Q1 UROLOGY & NEPHROLOGY Pub Date : 2024-12-01 Epub Date: 2024-12-07 DOI: 10.1016/j.euf.2024.11.008
David J McConkey, Jennifer J Barb, Armine K Smith, Cynthia L Sears

Recent preclinical and clinical research has established that the microbiome affects response to immunotherapy, and other work has shown that our diet has strong and rapid effects on the microbiome. Together, these findings have generated strong enthusiasm for the development of therapeutic approaches to exploit these effects. However, inconsistencies in sample collection and data analyses have made it challenging to evaluate the true impact of these interventions. We suggest that the research community needs to develop technical best practices before the true potential of therapeutic microbiome modulation can be realized.

最近的临床前和临床研究证实,微生物组会影响对免疫疗法的反应,而其他研究则表明,我们的饮食会对微生物组产生强烈而迅速的影响。这些发现共同激发了人们开发治疗方法以利用这些影响的强烈热情。然而,由于样本收集和数据分析的不一致,评估这些干预措施的真正影响变得十分困难。我们建议,研究界需要开发技术上的最佳实践,然后才能实现微生物组调节疗法的真正潜力。
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引用次数: 0
期刊
European urology focus
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