Genitourinary Cancers

Even those renal cell carcinomas (RCCs) that are smaller than 4 cm may put patients at risk for aggressive cancer, according to a new study presented at the 28th Annual European Association of Urology Congress in Milan, Italy.

Researchers have identified the enzyme PKCζ, which acts as a tumor suppressor in prostate cancer and is part of a pathway that partly controls cell growth and metastasis.

The concept of multiparametric MRI comes at an important time in the history of prostate cancer screening. It is a method that provides anatomic information about the location, number, size, and risk of prostate cancers. It permits more accurate targeted biopsies that will improve the quality of tissue obtained, thereby reducing the rate of upstaging associated with random biopsies.

Multiparametric MRI is a promising tool for identifying cancer within the prostate. It has the potential to drastically change the way prostate cancer is staged and treated. However, work remains to make this technique reproducible and accessible to the community-based radiologist and urologist.

Only the possibility of increasing survival with better tumor localization and staging is probable with multiparametric MRI-and improved survival with MR imaging in prostate cancer has not been shown in a clinical trial or meta-analysis to date.

Our aims in this article are to describe the various imaging sequences that comprise the multiparametric MRI exam, as well as to review current literature on the strengths/weaknesses of these sequences; to delineate strategies for standardizing interpretation and reporting of MRI results; and to expound on the role of prostate MRI in clinical practice.

Targeting prostate cancer stem cells may be a method of treating prostate cancer while avoiding the development of resistance to androgen deprivation therapy, according to preclinical results presented at the annual meeting of the American Association for Cancer Research.

Researchers have identified a mechanism by which prostate cancer resists hormonal therapy to develop into castration-resistant prostate cancer (CRPC). The protein SIAH2 keeps a fraction of androgen receptors constitutively active in prostate cancer cells.

Imaging is important for both the diagnosis and management of prostate cancer. Standard techniques used in everyday clinical practice depend on the stage of the disease. Several new experimental modalities are currently in development to better identify and diagnose patients with progressive disease.

Radiolabeled small molecules targeting prostate-specific membrane antigen are well-tolerated tools for detection of metastatic prostate cancer, according to results of a phase I clinical trial.

This review focuses on targeted therapies related to these pathways of interest for the treatment of advanced urothelial carcinoma, describing the evidence to support further investigation of these approaches.

Current efforts utilizing genomic strategies to unravel the biology of urothelial carcinoma will undoubtedly lead to rational targets, new therapies, and a renewed enthusiasm among researchers and clinicians working in this field-which ultimately will improve the lives of patients with this devastating disease.

Acetaminophen and nonaspirin nonsteroidal anti-inflammatory drugs were associated with a 28% increased risk of developing kidney cancer, according to the results of a recently published meta-analysis.

Substitution of estrogen patches for luteinizing hormone-releasing hormone agonist therapy in men with castration-resistant prostate cancer has similar testosterone-depleting effects while improving metabolic side effects, according to results from the PATCH trial.

High levels of physical activity were linked with a 22% decreased risk for renal cancer, according to a meta-analysis that looked at results from 19 studies that quantified the relationship with physical activity and renal cancer.

Men being treated for their prostate cancer with a gonadotropin-releasing hormone had a significantly increased risk for biliary disease compared with men who underwent no treatment, according to the results of a large, population-based study.

One way of framing the ethical question in this case might be: “What are my ethical obligations to provide an anticancer therapy when I think it is unlikely to benefit the patient?” The broader clinical questions involved in this case are fundamentally the same in most patients.

In a trial of 64 patients, neoadjuvant chemotherapy with methotrexate, doxorubicin, vinblastine, and cisplatin (MVAC) had promising results in the treatment of muscle-invasive bladder cancer.

A trial comparing axitinib to sorafenib as first-line therapy for metastatic renal cell carcinoma showed a statistically significant improvement in progression-free survival for the drug; however, the difference failed to meet the phase III trial’s prespecified significance level of 0.025.

The use of presurgical characteristics to assign the clinical stage of a patient with bladder cancer was found to be highly inaccurate with a clinical/pathological stage discrepancy rate of 47.8% found in a large sample of patients taken from the National Cancer Data Base between 1998 and 2009.

Results from a retrospective analysis indicate that the use of the antiangiogenic, VEGF inhibitor sorafenib for the treatment of advanced renal cell carcinoma was well tolerated in patients aged 65 years or older.

The use of adjuvant radiotherapy in patients with pT3 prostate cancer subsequent to radical prostatectomy is safe, according to 10-year follow-up results presented at the 2013 Genitourinary Cancers Symposium.

In two phase III studies-READY and VENICE-targeted agents combined with standard first-line chemotherapy failed to increase overall survival for men with metastatic castration-resistant prostate cancer.

Physicians treating men with high-risk prostate cancer can safely reduce the duration of androgen blockade given in combination with pelvic radiation from 36 months to 18 months without compromising outcomes, including survival.

New data suggest that surveillance of patients with small kidney tumors may be a safe alternative to surgery, especially in older patients or those with comorbid conditions.