Pub Date : 2025-11-10DOI: 10.1038/s41585-025-01104-9
Marc Carceles-Cordon, Veronica Rodriguez-Bravo, Daniel P. Petrylak, Josep Domingo-Domenech
{"title":"20 years of taxane therapy in prostate cancer — the past, present and future","authors":"Marc Carceles-Cordon, Veronica Rodriguez-Bravo, Daniel P. Petrylak, Josep Domingo-Domenech","doi":"10.1038/s41585-025-01104-9","DOIUrl":"https://doi.org/10.1038/s41585-025-01104-9","url":null,"abstract":"","PeriodicalId":19088,"journal":{"name":"Nature Reviews Urology","volume":"70 1","pages":""},"PeriodicalIF":15.3,"publicationDate":"2025-11-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145484858","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-11-07DOI: 10.1038/s41585-025-01108-5
Michael George, Susan Wong, Raj Mathur, Nikolaos Tsampras, Alexander Lewis, Ian Pearce, Theodora Stasinou, Vaibhav Modgil
{"title":"Persistent Müllerian duct syndrome — a rare but important cause of male factor infertility","authors":"Michael George, Susan Wong, Raj Mathur, Nikolaos Tsampras, Alexander Lewis, Ian Pearce, Theodora Stasinou, Vaibhav Modgil","doi":"10.1038/s41585-025-01108-5","DOIUrl":"https://doi.org/10.1038/s41585-025-01108-5","url":null,"abstract":"","PeriodicalId":19088,"journal":{"name":"Nature Reviews Urology","volume":"1 1","pages":""},"PeriodicalIF":15.3,"publicationDate":"2025-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145461317","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-11-07DOI: 10.1038/s41585-025-01106-7
Rui M Bernardino,João Lobo,Jihad Kaouk,Theodorus van der Kwast,Susan Prendeville,Fabio Zanotti,Lorenzo Bianchi,Alberto Martini,Pawel Rajwa,Veeru Kasivisvanathan,Giancarlo Marra,Neil Fleshner,
Atypical intraductal proliferation (AIP) is considered a borderline lesion, characterized by architectural complexity and cytological atypia greater than that seen in high-grade prostatic intraepithelial neoplasia, but insufficient to fulfil the diagnostic criteria for intraductal carcinoma (IDC). Consequently, AIP remains diagnostically challenging, and the clinical significance of this lesion is still uncertain. Emerging evidence suggests that AIP in prostate biopsy specimens is a strong predictor of unsampled IDC and other adverse pathological features, warranting reconsideration of the AIP role in prostate cancer risk stratification. Results from prospective and molecular studies indicate that AIP frequently coexists with intermediate-risk prostate cancer and shares molecular alterations with IDC, such as PTEN loss and ERG overexpression, reinforcing AIP potential as a marker of occult aggressive disease. Considering the growing emphasis on precision diagnostics and active surveillance in prostate cancer management, understanding the implications of AIP is particularly relevant.
{"title":"Atypical intraductal proliferation in prostate biopsy - a diagnostic grey zone with clinical implications.","authors":"Rui M Bernardino,João Lobo,Jihad Kaouk,Theodorus van der Kwast,Susan Prendeville,Fabio Zanotti,Lorenzo Bianchi,Alberto Martini,Pawel Rajwa,Veeru Kasivisvanathan,Giancarlo Marra,Neil Fleshner, ","doi":"10.1038/s41585-025-01106-7","DOIUrl":"https://doi.org/10.1038/s41585-025-01106-7","url":null,"abstract":"Atypical intraductal proliferation (AIP) is considered a borderline lesion, characterized by architectural complexity and cytological atypia greater than that seen in high-grade prostatic intraepithelial neoplasia, but insufficient to fulfil the diagnostic criteria for intraductal carcinoma (IDC). Consequently, AIP remains diagnostically challenging, and the clinical significance of this lesion is still uncertain. Emerging evidence suggests that AIP in prostate biopsy specimens is a strong predictor of unsampled IDC and other adverse pathological features, warranting reconsideration of the AIP role in prostate cancer risk stratification. Results from prospective and molecular studies indicate that AIP frequently coexists with intermediate-risk prostate cancer and shares molecular alterations with IDC, such as PTEN loss and ERG overexpression, reinforcing AIP potential as a marker of occult aggressive disease. Considering the growing emphasis on precision diagnostics and active surveillance in prostate cancer management, understanding the implications of AIP is particularly relevant.","PeriodicalId":19088,"journal":{"name":"Nature Reviews Urology","volume":"103 1","pages":""},"PeriodicalIF":15.3,"publicationDate":"2025-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145462022","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-10-30DOI: 10.1038/s41585-025-01098-4
Martin Egger, Vincent D. D’Andrea, Clara Steiner, Nnamdi O. Onochie, Timothy N. Clinton, Chong-Xian Pan, Adam S. Kibel, Cheryl T. Lee, Kent W. Mouw, Matthew Mossanen
{"title":"Optimizing local control in the surgical management of bladder cancer","authors":"Martin Egger, Vincent D. D’Andrea, Clara Steiner, Nnamdi O. Onochie, Timothy N. Clinton, Chong-Xian Pan, Adam S. Kibel, Cheryl T. Lee, Kent W. Mouw, Matthew Mossanen","doi":"10.1038/s41585-025-01098-4","DOIUrl":"https://doi.org/10.1038/s41585-025-01098-4","url":null,"abstract":"","PeriodicalId":19088,"journal":{"name":"Nature Reviews Urology","volume":"3 1","pages":""},"PeriodicalIF":15.3,"publicationDate":"2025-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145396910","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-10-13DOI: 10.1038/s41585-025-01095-7
Dmitry Ratner,Jason L Vassy
Interest in using polygenic scores (PGS) to improve the risk stratification for and early detection of prostate cancer is considerable. Despite the absence of clinical guidelines for the use of prostate cancer PGS in patient care, existing and emerging standards for the clinical translation and reporting of genetic testing generally and PGS specifically provide a relevant framework to help guide these efforts. This framework is intended to harmonize advances in the development of PGS clinical assays and standardization of PGS reporting in the context of prostate cancer PGS specifically. The analytical and clinical validity of prostate cancer PGS have been progressively refined, but evidence firmly establishing clinical utility beyond modelling studies is still lacking. Standardized approaches for designing, explaining and reporting prostate cancer PGS are key to accelerating clinical implementation in a manner that would increase access to the benefits of precision prostate cancer screening to patients across ancestry backgrounds.
{"title":"Clinical translation of polygenic scores for prostate cancer screening.","authors":"Dmitry Ratner,Jason L Vassy","doi":"10.1038/s41585-025-01095-7","DOIUrl":"https://doi.org/10.1038/s41585-025-01095-7","url":null,"abstract":"Interest in using polygenic scores (PGS) to improve the risk stratification for and early detection of prostate cancer is considerable. Despite the absence of clinical guidelines for the use of prostate cancer PGS in patient care, existing and emerging standards for the clinical translation and reporting of genetic testing generally and PGS specifically provide a relevant framework to help guide these efforts. This framework is intended to harmonize advances in the development of PGS clinical assays and standardization of PGS reporting in the context of prostate cancer PGS specifically. The analytical and clinical validity of prostate cancer PGS have been progressively refined, but evidence firmly establishing clinical utility beyond modelling studies is still lacking. Standardized approaches for designing, explaining and reporting prostate cancer PGS are key to accelerating clinical implementation in a manner that would increase access to the benefits of precision prostate cancer screening to patients across ancestry backgrounds.","PeriodicalId":19088,"journal":{"name":"Nature Reviews Urology","volume":"120 1","pages":""},"PeriodicalIF":15.3,"publicationDate":"2025-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145283445","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-10-13DOI: 10.1038/s41585-025-01099-3
Henry H Woo
{"title":"A urologist as a urological patient.","authors":"Henry H Woo","doi":"10.1038/s41585-025-01099-3","DOIUrl":"https://doi.org/10.1038/s41585-025-01099-3","url":null,"abstract":"","PeriodicalId":19088,"journal":{"name":"Nature Reviews Urology","volume":"19 1","pages":""},"PeriodicalIF":15.3,"publicationDate":"2025-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145283444","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Immune-checkpoint inhibitors (ICIs) targeting programmed cell death 1 (PD1) and programmed cell death 1 ligand 1 (PDL1) have improved survival for patients with different types of solid tumour. However, clinical response in patients with muscle-invasive bladder cancer (MIBC) is limited, with only 20-30% demonstrating a sustained response. An improved understanding of ICI mechanisms and robust biomarkers will increase efficacy and enable patient stratification in MIBC. Hypoxia (low oxygen tension) and neutrophil infiltration are prevalent in MIBC and are associated with immunotherapy resistance. Hypoxia-associated extracellular matrix (ECM) remodelling can induce pro-tumour or anti-tumour neutrophil polarization through biomechanical and biochemical signalling. Hypoxia-associated ECM mechanisms alter neutrophil recruitment, polarization, activation and affect T cell-centric immunotherapies. However, the specific mechanisms by which hypoxia, ECM and neutrophils confer immunotherapy resistance in MIBC are not yet fully understood. ICI resistance could be overcome by targeting specific ECM remodelling-related and neutrophil-related pathways to elicit durable and efficacious responses in 70-80% of patients with MIBC who are currently non-responsive to ICIs.
{"title":"The hypoxic ECM and neutrophils in MIBC immunotherapy resistance.","authors":"Fraser Child,Sapna Lunj,Julie Gough,Martin J Humphries,Luisa Vanesa Biolatti,Peter J Hoskin,Ananya Choudhury,Conrado Guerrero Quiles","doi":"10.1038/s41585-025-01092-w","DOIUrl":"https://doi.org/10.1038/s41585-025-01092-w","url":null,"abstract":"Immune-checkpoint inhibitors (ICIs) targeting programmed cell death 1 (PD1) and programmed cell death 1 ligand 1 (PDL1) have improved survival for patients with different types of solid tumour. However, clinical response in patients with muscle-invasive bladder cancer (MIBC) is limited, with only 20-30% demonstrating a sustained response. An improved understanding of ICI mechanisms and robust biomarkers will increase efficacy and enable patient stratification in MIBC. Hypoxia (low oxygen tension) and neutrophil infiltration are prevalent in MIBC and are associated with immunotherapy resistance. Hypoxia-associated extracellular matrix (ECM) remodelling can induce pro-tumour or anti-tumour neutrophil polarization through biomechanical and biochemical signalling. Hypoxia-associated ECM mechanisms alter neutrophil recruitment, polarization, activation and affect T cell-centric immunotherapies. However, the specific mechanisms by which hypoxia, ECM and neutrophils confer immunotherapy resistance in MIBC are not yet fully understood. ICI resistance could be overcome by targeting specific ECM remodelling-related and neutrophil-related pathways to elicit durable and efficacious responses in 70-80% of patients with MIBC who are currently non-responsive to ICIs.","PeriodicalId":19088,"journal":{"name":"Nature Reviews Urology","volume":"7 1","pages":""},"PeriodicalIF":15.3,"publicationDate":"2025-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145283443","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-10-13DOI: 10.1038/s41585-025-01100-z
Melissa L Abel,Adam Sharp,Edwin M Posadas,Fatima Karzai,Frank I Lin,Peter L Choyke,Ravi A Madan
{"title":"Therapeutic targeting of prostate-specific membrane antigen could limit its potential as benchmark imaging.","authors":"Melissa L Abel,Adam Sharp,Edwin M Posadas,Fatima Karzai,Frank I Lin,Peter L Choyke,Ravi A Madan","doi":"10.1038/s41585-025-01100-z","DOIUrl":"https://doi.org/10.1038/s41585-025-01100-z","url":null,"abstract":"","PeriodicalId":19088,"journal":{"name":"Nature Reviews Urology","volume":"19 1","pages":""},"PeriodicalIF":15.3,"publicationDate":"2025-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145283694","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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