Urologic Oncology-seminars and Original Investigations最新文献

{"title":"Editorial comment on \"Comparison of 4 local anesthetic techniques for open radical cystectomy: A prospective, randomized controlled trial\".","authors":"Alireza Ghoreifi, Hooman Djaladat","doi":"10.1016/j.urolonc.2026.111001","DOIUrl":"https://doi.org/10.1016/j.urolonc.2026.111001","url":null,"abstract":"","PeriodicalId":23408,"journal":{"name":"Urologic Oncology-seminars and Original Investigations","volume":" ","pages":"111001"},"PeriodicalIF":2.3,"publicationDate":"2026-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146137864","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Adapting patient priorities care for older adults with non-muscle-invasive bladder cancer: A qualitative inquiry","authors":"Tullika Garg ,&nbsp;Steven Negron-Candelario ,&nbsp;Halle Miller ,&nbsp;Seyma Demirsoy ,&nbsp;Kirstin West ,&nbsp;William Calo ,&nbsp;Mary Tinetti ,&nbsp;Lauren J. Van Scoy","doi":"10.1016/j.urolonc.2026.110996","DOIUrl":"10.1016/j.urolonc.2026.110996","url":null,"abstract":"<div><h3>Introduction</h3><div>Shared decision-making involves understanding a person’s goals and healthcare preferences, especially for older adults with cancer. When making treatment decisions, older adults with non-muscle-invasive bladder cancer (NMIBC) face tradeoffs due to aging and multimorbidity. Our objective was to obtain initial feedback from older adults with NMIBC and their urologists to begin adapting an existing written goal-elicitation tool, Patient Priorities Care (PPC), for shared decision-making in NMIBC.</div></div><div><h3>Methods</h3><div>We recruited 5 dyads of older adults with NMIBC (age ≥65) paired with their urologists to use PPC and collected demographics. Patients also completed a frailty assessment. Qualitative interviews with participants were conducted to assess modifications needed (<em>n</em> = 10). We calculated descriptive statistics of quantitative data and used Braun and Clarke’s six-phase framework and Interpretative Phenomenological Analysis to analyze interview transcripts.</div></div><div><h3>Results</h3><div>Mean patient age was 76.4 years, and all were males and frail. Urologists had been in practice for an average of 14.8 years. Four themes emerged from the interviews: 1) PPC should be administered periprocedurally and at multiple time points, 2) PPC was appropriate but modifications were needed to the format and to make it specific to NMIBC, 3) PPC helped urologists learn about their patients, and 4) age, multimorbidity, and urinary symptoms contributed to NMIBC treatment decisions.</div></div><div><h3>Conclusions</h3><div>In this pilot qualitative study, participants found PPC easy to use with appropriate content, but it required modifications for format and specificity for NMIBC. Next steps include focus groups to further adapt PPC followed by feasibility testing in the clinic.</div></div>","PeriodicalId":23408,"journal":{"name":"Urologic Oncology-seminars and Original Investigations","volume":"44 4","pages":"Article 110996"},"PeriodicalIF":2.3,"publicationDate":"2026-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146137831","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Venous invasion in upper tract urothelial carcinoma: Diagnostic features and oncologic outcomes","authors":"Stephan Brönimann MD ,&nbsp;Zahra Moghimi MD ,&nbsp;Philipp Korn MD ,&nbsp;Ezra Baraban MD ,&nbsp;Farzad Sedaghat MD ,&nbsp;Nirmish Singla MD, MSCS","doi":"10.1016/j.urolonc.2026.110998","DOIUrl":"10.1016/j.urolonc.2026.110998","url":null,"abstract":"<div><h3>Objectives</h3><div>To characterize clinical, radiological and histopathological features of upper tract urothelial carcinoma (UTUC) with venous tumor thrombus (VTT) and assess associated oncological outcomes in patients who underwent radical nephroureterectomy (RNU).</div></div><div><h3>Material and methods</h3><div>We retrospectively identified consecutive patients with UTUC with VTT who underwent radical nephroureterectomy (RNU) at our institution. Cross-sectional imaging was reviewed by a dedicated genitourinary radiologist, and pathology was reviewed by a dedicated genitourinary pathologist. Clinical characteristics, radiographic features, pathologic features, and oncologic outcomes were analyzed.</div></div><div><h3>Results</h3><div>Eight patients (median age: 74 years, range: 56–91) with UTUC and macroscopic VTT were identified. Imaging consistently revealed collecting system filling defects, irregular mural thickening, and an infiltrative, noncircumscribed growth pattern. Venous involvement was confined to the renal vein in 63% and extended into the inferior vena cava in 37%. Seventy-five percent of patients had pT4 disease, and 63% had pathologic nodal involvement (pN+). Sarcomatoid differentiation was present in 88% of tumors and was disproportionately enriched within the thrombus component, while absent in nodal metastases. One patient experienced a major complication (Clavien–Dindo ≥ III) from surgery. Over a median follow-up of 13.3 months (IQR: 7.7–41.4), 71% of patients developed metastatic disease, and overall mortality was 62.5%. Two patients received adjuvant chemotherapy following surgery. Notably, one achieved a complete response to pembrolizumab, confirmed radiologically and by circulating tumor DNA (ctDNA) clearance.</div></div><div><h3>Conclusions</h3><div>UTUC with VTT represents a rare but distinctly aggressive phenotype characterized by advanced local stage, frequent nodal involvement, and a striking prevalence of sarcomatoid differentiation. The consistent enrichment of sarcomatoid elements within thrombi suggests a unique biologic behavior potentially driven by epithelial-mesenchymal transition that may underlie vascular invasion and influence treatment response. Recognizing key imaging features may facilitate accurate diagnosis, avoid misclassification as RCC, and prompt timely multimodal treatment.</div></div>","PeriodicalId":23408,"journal":{"name":"Urologic Oncology-seminars and Original Investigations","volume":"44 4","pages":"Article 110998"},"PeriodicalIF":2.3,"publicationDate":"2026-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146137834","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Statin use and outcomes in advanced prostate cancer:Secondary analysis of the SPARTAN trial.","authors":"Ahmad Mousa, Julian Chavarriaga, Katherine Lajkosz, Linda Z Penn, Najia Khurram, Robert J Hamilton","doi":"10.1016/j.urolonc.2026.110992","DOIUrl":"https://doi.org/10.1016/j.urolonc.2026.110992","url":null,"abstract":"<p><strong>Objectives: </strong>To assess the impact of statin use on survival outcomes in the phase III SPARTAN trial of apalutamide for nonmetastatic castration-resistant prostate cancer.</p><p><strong>Subjects and methods: </strong>We analyzed data from all 1,207 SPARTAN participants, identifying baseline statin users and matching them 1:1 to nonusers using propensity scores. The primary endpoint was metastasis-free survival (MFS), compared between groups using Kaplan-Meier analysis. A multivariable Cox proportional hazards model, adjusted for key covariates, was applied to the matched cohort to assess associations between statin use and survival outcomes.</p><p><strong>Results: </strong>Of the 1,207 SPARTAN participants, 463 (38%) were baseline statin users; 456 users were propensity matched to 456 nonusers with balanced characteristics. Statin and nonstatin users were similarly distributed across treatment arms. While statin use was not associated with differences in metastasis-free survival (MFS) overall (P = 0.64), we observed a significant interaction by treatment arm (P = 0.018), with statin use linked to worse MFS in the placebo group (Hazard Ratio [HR] 1.40, 95% Confidence Interval [95% CI] 1.04-1.88). Statin use was also not associated with secondary endpoints overall, but again showed interaction for anticancer therapy-free survival, with harm in the placebo group (HR 1.32) and benefit in the apalutamide group (HR 0.79).</p><p><strong>Conclusion: </strong>In this secondary analysis of the SPARTAN trial, statin use was not associated with improved survival outcomes overall. However, a significant interaction was observed, with statin use linked to worse metastasis-free survival in the placebo arm. These findings suggest a hypothesized interplay between statins and androgen receptor inhibition that warrants further prospective investigation.</p>","PeriodicalId":23408,"journal":{"name":"Urologic Oncology-seminars and Original Investigations","volume":" ","pages":"110992"},"PeriodicalIF":2.3,"publicationDate":"2026-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146137828","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Featured SUO fellow: Serkan Karakus, MD.","authors":"","doi":"10.1016/j.urolonc.2026.111022","DOIUrl":"https://doi.org/10.1016/j.urolonc.2026.111022","url":null,"abstract":"","PeriodicalId":23408,"journal":{"name":"Urologic Oncology-seminars and Original Investigations","volume":" ","pages":"111022"},"PeriodicalIF":2.3,"publicationDate":"2026-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146100497","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The predictive value of lesion density in enhancing multiparametric MRI for detecting clinically significant prostate cancer","authors":"Ali Khatib M.D., M.Sc. ,&nbsp;Zizo Al-Daqqaq M.D. ,&nbsp;Anna J. Black M.D. ,&nbsp;Silvia Chang M.D. ,&nbsp;Martin E Gleave M.D. ,&nbsp;Miles P. Mannas M.D., M.Sc.","doi":"10.1016/j.urolonc.2025.12.017","DOIUrl":"10.1016/j.urolonc.2025.12.017","url":null,"abstract":"<div><h3>Purpose</h3><div>The aim of this study was to evaluate the predictive value of lesion density on mpMRI for detecting clinically significant prostate cancer (csPCa) in men undergoing targeted prostate biopsy.</div></div><div><h3>Methods</h3><div>We retrospectively analyzed patients who underwent MRI-targeted transperineal or transrectal biopsy between 2019 and 2023. Lesion density was calculated as longest lesion diameter divided by prostate volume, with weighted averages used for multiple lesions. Multivariable logistic regression and receiver operating characteristic (ROC) analysis assessed predictors of csPCa. Threshold analysis evaluated trade-offs between missed csPCa and avoided biopsies.</div></div><div><h3>Results</h3><div>csPCa was diagnosed in 241/460 patients (52.4%). Median lesion density was higher in csPCa vs. non-csPCa cases (0.34 mm/cc, IQR 0.22–0.52 vs. 0.22 mm/cc, IQR 0.14–0.33; <em>P</em> &lt; 0.001). Lesion density was independently predictive in models with (OR 6.2, 95% CI 1.4–27.9) and without PI-RADS (OR 13.7, 95% CI 3.2–59.0). It achieved the highest AUC (0.71) compared with PSA density (0.69) and age (0.63). At a lesion density threshold of 0.15 mm/cc, 29.2% of biopsies would have been avoided with &lt;10% missed csPCa.</div></div><div><h3>Conclusion</h3><div>Lesion density was an independent predictor of csPCa on targeted biopsy. It may complement PI-RADS and PSA density and provide a pragmatic threshold-based tool to guide biopsy decision-making.</div></div>","PeriodicalId":23408,"journal":{"name":"Urologic Oncology-seminars and Original Investigations","volume":"44 4","pages":"Article 110981"},"PeriodicalIF":2.3,"publicationDate":"2026-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146079592","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Molecular pathology of rare histologic variants and treatment-resistant lineages of prostate cancer","authors":"Ryuta Watanabe M.D., Ph.D. ,&nbsp;Noriyoshi Miura M.D., Ph.D. ,&nbsp;Tadahiko Kikugawa M.D., Ph.D. ,&nbsp;Takashi Saika M.D., Ph.D. ,&nbsp;Michael C. Haffner M.D., Ph.D. ,&nbsp;Peter S. Nelson M.D.","doi":"10.1016/j.urolonc.2025.110987","DOIUrl":"10.1016/j.urolonc.2025.110987","url":null,"abstract":"<div><div>Rare histological variants of prostate cancer—including ductal adenocarcinoma, intraductal carcinoma of the prostate (IDC-P), neuroendocrine carcinoma, basal cell/adenoid cystic carcinoma, squamous cell carcinoma, sarcomatoid carcinoma, and stromal tumors—exhibit highly diverse biological behaviors and distinct molecular features. Accurate pathological recognition is essential, as these entities frequently diverge from conventional acinar adenocarcinoma in morphology, genomic alterations, therapeutic responsiveness, and clinical outcomes. Intraductal carcinoma of the prostate (IDC-P) and ductal adenocarcinoma often display genomic instability and aggressive clinical behavior, including enrichment for homologous recombination repair (HRR) defects and hypoxia-related pathways. Neuroendocrine subtypes, including <em>de novo</em> and treatment-related NEPC as well as double-negative prostate cancer (DNPC), are characterized by androgen receptor (AR) independence, <em>RB1/TP53</em> loss, low prostate-specific antigen (PSA) production, and poor prognosis, reflecting lineage plasticity under therapeutic pressure. Other rare tumors—such as basal cell carcinoma/adenoid cystic carcinoma, squamous cell carcinoma, and stromal tumors (STUMP and prostatic stromal sarcoma)—demonstrate unique pathological patterns and limited responsiveness to standard systemic therapies, underscoring the importance of tailored diagnostic and management strategies. This review integrates the histopathological, molecular, and emerging spatial transcriptomic insights across this spectrum of rare and treatment-resistant prostate cancer subtypes. By highlighting shared mechanisms such as genomic instability, androgen receptor (AR) pathway bypass, and microenvironmental remodeling, we outline key diagnostic considerations and evolving therapeutic implications relevant to precision oncology.</div></div>","PeriodicalId":23408,"journal":{"name":"Urologic Oncology-seminars and Original Investigations","volume":"44 4","pages":"Article 110987"},"PeriodicalIF":2.3,"publicationDate":"2026-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146079505","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy and safety of tislelizumab plus intravesical chemotherapy in recurrent high-risk non-muscle-invasive bladder cancer: A retrospective single-center real-world study","authors":"Qing Chen PhD ,&nbsp;Rongpan Wu PhD ,&nbsp;Chen Zhang PhD ,&nbsp;Jiaxin Xie PhD ,&nbsp;Yi Wang PhD ,&nbsp;Xufeng Yu PhD ,&nbsp;Wei He PhD ,&nbsp;Maoyu Wang PhD ,&nbsp;Junjie Zhao PhD ,&nbsp;Zhensheng Zhang PhD ,&nbsp;Shuxiong Zeng PhD ,&nbsp;Chuanliang Xu PhD","doi":"10.1016/j.urolonc.2025.110988","DOIUrl":"10.1016/j.urolonc.2025.110988","url":null,"abstract":"<div><h3>Background</h3><div>Recurrent high-risk non-muscle-invasive bladder cancer (HR-NMIBC) poses significant therapeutic challenges due to frequent recurrences. <em>Bacillus</em> Calmette-Guérin (BCG) therapy limitations including global shortages, resistance and adverse effect. Patients often decline cystectomy due to significant impact on quality of life and complications, underscoring the need for effective bladder-preserving strategies.</div></div><div><h3>Methods</h3><div>In a retrospective single-center analysis, 43 recurrent HR-NMIBC patients received intravenous tislelizumab every 3 weeks for up to 17 cycles alongside intravesical chemotherapy. Intravesical instillation agents included gemcitabine, epirubicin or mitomycin C administered per protocol. The primary endpoint was 3-month complete response rate, defined as absence of tumor confirmed by biopsy, cystoscopy, cytology and imaging. Secondary endpoints encompassed duration of response, survival metrics, and adverse events graded per CTCAE v5.0.</div></div><div><h3>Results</h3><div>Among 43 recurrent HR-NMIBC patients with median age 67 years, 88.4% achieved 3-month complete response. Responders maintained a 24-month sustained response rate of 71.1% during median 28.4-month follow-up. The entire cohort demonstrated 36-month progression-free survival, overall survival, and cancer-specific survival rates of 82.8%, 85.0%, and 95.0% respectively. Subgroups with variant histology, BCG-unresponsive/intolerant disease, or multiple prior recurrences showed reduced responses. Treatment-related adverse events occurred in 90.7% of patients, with urinary frequency and hematuria being most common, which might stem from intravesical chemotherapy exposure. Grade 3 events affected 18.6% of patients, while immune-related adverse events led to discontinuation in 4.7%. No grade 4 or 5 toxicities were observed.</div></div><div><h3>Conclusion</h3><div>Tislelizumab plus intravesical chemotherapy achieves high response rates and durable survival benefits with manageable toxicity in recurrent HR-NMIBC, representing a promising non-BCG-dependent bladder-preserving strategy for surgically ineligible patients.</div></div>","PeriodicalId":23408,"journal":{"name":"Urologic Oncology-seminars and Original Investigations","volume":"44 4","pages":"Article 110988"},"PeriodicalIF":2.3,"publicationDate":"2026-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146025456","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Circulating tumor DNA in urothelial cancer as an intermediate disease state between localized and advanced stages: Moving from risk factors to micrometastatic disease in the perioperative setting","authors":"Sergio Bracarda M.D.,&nbsp;Giulia Mammone M.D.,&nbsp;Claudia Mosillo M.D.,&nbsp;Grazia Sirgiovanni M.D.,&nbsp;Annalisa Guida M.D.","doi":"10.1016/j.urolonc.2025.110986","DOIUrl":"10.1016/j.urolonc.2025.110986","url":null,"abstract":"<div><div>Urothelial carcinoma, especially muscle-invasive bladder cancer, presents a high risk of recurrence despite curative-intent surgery and perioperative therapies. A major clinical challenge remains the early identification of micrometastatic disease, undetectable with conventional imaging. Circulating tumor DNA (ctDNA), a minimally invasive biomarker, is emerging as a transformative tool for detecting minimal residual disease, allowing for earlier intervention and more tailored and efficacious treatment strategies. This review explores the evolving role of ctDNA in urothelial carcinoma, particularly in the perioperative setting. The negative adjuvant IMvigor010 trial established ctDNA as a prognostic and potentially predictive marker, demonstrating that ctDNA-positive patients postcystectomy were at higher risk of relapse but could benefit from adjuvant immunotherapy. Building on this, IMvigor011 prospectively validated a ctDNA-guided immunotherapy approach, showing that ctDNA clearance correlates with improved disease-free survival. We discuss ctDNA potential to redefine disease staging, introducing an “intermediate” category (M0, ctDNA-positive) between localized and overtly metastatic disease. ctDNA also offers value in surveillance, treatment de-escalation, and monitoring therapeutic response. Advances in tumor-informed assays have enhanced the sensitivity of ctDNA detection, though standardization and accessibility remain key challenges. In summary, ctDNA represents a paradigm shift in urothelial carcinoma management, enabling precision oncology through real-time disease monitoring and personalized treatments. Its integration into clinical practice may improve outcomes by addressing micrometastatic disease before clinical relapse or progression, transforming the way we stratify and treat patients across the urothelial carcinoma continuum.</div></div>","PeriodicalId":23408,"journal":{"name":"Urologic Oncology-seminars and Original Investigations","volume":"44 4","pages":"Article 110986"},"PeriodicalIF":2.3,"publicationDate":"2026-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146025454","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Distinct pathways of disease progression with dual checkpoint blockade versus immunotargeted therapy in metastatic renal cell carcinoma","authors":"Ilya Tsimafeyeu ,&nbsp;Fuad Guliyev ,&nbsp;Bakytzhan Ongarbayev ,&nbsp;Gunel Musaeva ,&nbsp;Ramil Abdrakhmanov ,&nbsp;Vyacheslav Chubenko ,&nbsp;Olga Baklanova ,&nbsp;Ruslan Zukov ,&nbsp;Vladislav Petkau ,&nbsp;Dilyara Kaidarova","doi":"10.1016/j.urolonc.2025.110989","DOIUrl":"10.1016/j.urolonc.2025.110989","url":null,"abstract":"<div><h3>Background</h3><div>Patterns of progression under immuno-oncology regimens in metastatic renal cell carcinoma (mRCC) remain poorly described. This study characterizes site-specific disease progression in patients receiving first-line dual immunotherapy or immunotargeted therapy.</div></div><div><h3>Methods</h3><div>This retrospective, observational cohort study included patients with clear-cell metastatic renal cell carcinoma treated between 2018 and 2024 with standard-dose regimens of nivolumab-ipilimumab (IO-IO) or pembrolizumab-axitinib and avelumab-axitinib combinations (IO-axitinib). The primary endpoint was the occurrence of new metastatic lesions at progression. Secondary endpoints included progression by &gt;20% increase in target lesion size.</div></div><div><h3>Results</h3><div>Of 334 patients identified, 233 were evaluable for analysis. Radiographic progression occurred in 86.3% of IO-IO and 60% of IO-axitinib. Development of new metastatic lesions was more frequent with Nivo-Ipi (39.3% vs. 22.2%), most commonly involving the lungs and bones. In contrast, IO-axitinib combinations showed a greater propensity for progression through enlargement of pre-existing lesions (77.8% vs. 60.7%), accompanied by the emergence of new adrenal gland metastases. Across both treatment groups, lymph nodes emerged as the most frequent new site of disease progression.</div></div><div><h3>Conclusions</h3><div>Nivo-Ipi was associated with more frequent development of new metastatic lesions, particularly in the lungs, bones, and lymph nodes, while axitinib-based combinations more often resulted in regrowth of existing disease with higher rates of adrenal involvement.</div></div>","PeriodicalId":23408,"journal":{"name":"Urologic Oncology-seminars and Original Investigations","volume":"44 4","pages":"Article 110989"},"PeriodicalIF":2.3,"publicationDate":"2026-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146025455","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}