Genitourinary Cancers

Image-guided radiofrequency ablation may be an effective alternative treatment for small renal cell carcinoma tumors, according to the results of a recent study.

Cisplatin-based chemotherapy has transformed the prognosis of testicular germ cell cancer (GCT). It has converted the chief mortal malignancy in younger men into a model for the curability of cancer.

Germ cell tumors (GCT) are an exemplar of the successful use of chemotherapy and of the successful interplay of phase II and phase III trials. The biggest contributor to cure in metastatic GCT is cisplatin-based chemotherapy, unchallenged after more than 30 years.

I have read multiple overviews of the current management of castration-resistant prostate cancer (CRPC). These articles have very adeptly summarized the key trials leading to a multitude of US Food and Drug Administration (FDA) approvals of new agents for men with CRPC.

With the emergence of several new agents for the treatment of advanced prostate cancer, new questions have arisen regarding the optimal sequence or combination of these agents. As we await the results of ongoing and planned clinical trials to answer some of these questions directly, the decision-making process will rely heavily on considerations of side effects and patient characteristics.

In this review we will outline an approach to sequencing new therapies for metastatic castration-resistant prostate cancer (CRPC), with particular attention paid to the biology of CRPC.

A recent study shows that men who were overweight or obese at the time of their prostate cancer diagnosis were more likely to die from their disease compared with their healthy weight counterparts.

Results of a recent study indicate that patient progression-free survival at 3 months and 6 months was predictive of the overall survival among metastatic RCC patients treated with interferon alpha and bevacizumab.

The facts presented about screening should be tailored to the patient’s exact situation, and the patient’s values should be used to guide the final decision. For younger, healthy men, PSA screening should continue to be strongly considered.

The Task Force’s recommendation against PSA screening for prostate cancer is based on the best available science and the knowledge that, while we all want to prevent suffering and death from prostate cancer, PSA screening simply does not get us there.

Once a patient has been appropriately educated by an informed healthcare provider about the possible benefits of PSA screening, then patient preference as part of shared decision making regarding PSA screening should be considered in all cases.

It may be appropriate to offer prostate cancer screening to carefully selected men with a previous history of colorectal cancer. However, the risks and benefits of establishing the diagnosis in this setting need to be considered and discussed with them.

Not all patients with colorectal cancer are candidates for such screening, however, as a remaining life expectancy of at least 10 years is generally required in order for PSA screening to yield a significant mortality benefit.

The mTOR inhibitor everolimus showed clinical efficacy for the initial treatment of advanced papillary renal cell carcinoma, according to the phase II results of the RAPTOR trial.

The anti-RANKL antibody denosumab is more effective for preventing bone metastasis in men with high-risk castration-resistant prostate cancer compared with low-risk disease, according to results of a new study.

Abiraterone acetate in combination with prednisone delays pain progression as well as health-related quality of life compared with prednisone alone in prostate cancer patients, a new study shows.

In a phase III trial, ipilimumab increased the overall survival of men with advanced castration-resistant prostate cancer when used with a single dose of radiotherapy by 1.2 months, but the results were not statistically significant.

The results of the study comparing Aveo’s tivozanib to sorafenib for the treatment of metastatic renal cell carcinoma showed no improvement in overall survival, the basis for the FDA’s rejection of the company’s new drug application earlier this year.

There will always be patients who are either not surgical candidates or who refuse radical cystectomy, but in all other cases radical extirpative surgery should be the preferred management for patients with HGT1 disease who fail to respond to intravesical bacillus Calmette-Guérin therapy.

Decades of experience now exist to support the use of chemoradiotherapy in the treatment of muscle-invasive bladder cancer. Chemoradiotherapy for T1 tumors that recur following bacillus Calmette-Guérin therapy is promising and provides an important curative alternative for those unable or unwilling to undergo radical cystectomy.

The patient is a 66-year-old male who presented to his primary care physician with a 3-week history of painless gross hematuria. He underwent a renal ultrasound that showed a left kidney mass.

A head-to-head comparison of pazopanib and sunitinib for the treatment of metastatic renal cell carcinoma showed that the two drugs resulted in similar progression-free survival, but also indicated that pazopanib may have a favorable safety profile.

Researchers have now identified a 3-gene signature that could indicate whether a particular early-stage prostate cancer is indolent. The test relies on a tissue sample, a PSA test, and a histology assessment.

Shift work is positively associated with higher levels of prostate-specific antigen (PSA) levels in men between the ages of 40 and 65, according to results of a new study.

Prostate tumors may not readily evolve from low to high grade, according to a new study. The results have important clinical implications for patients and clinicians when choosing active surveillance or treatment.

The long-term follow-up of the Prostate Cancer Prevention Trial confirms that finasteride reduces the risk of low-grade prostate cancer by one-third, but there were no significant survival differences between the two study arms.

A 22-year-old man presented to the emergency department with a 5-cm painful testicular mass that had increased in size over the previous month. Tumor markers were drawn and an inguinal orchiectomy was performed.

Surgeons saw advantages in robotic, over laparoscopic, ultrasound probes during robotic partial nephrectomy, and similar perioperative outcomes and margin rates.

At the 2013 ASCO meeting, investigators of a large Danish study have concluded that surveillance alone following surgery for stage I seminoma is sufficient, sparing patients in this setting from the unnecessary expense and associated toxicities of chemotherapy and radiation treatment.