Genitourinary Cancers

Dr. Bruce Roth, Professor of Oncology in the Division of Medicine at Siteman Cancer Center, Washington University at St. Louis, spoke at the 2013 ASCO meeting about topics in seminoma. Here he discusses the epidemiology of seminoma.

Dr. Bruce Roth discusses the large Danish study reported at ASCO (abstract 4502) that showed surveillance alone is sufficient after orchiectomy for stage I seminoma.

Dr. Bruce Roth discusses the large Danish study reported at ASCO (abstract 4502) that showed surveillance alone is sufficient after orchiectomy for stage I seminoma, focusing on its impact on post-surgery radiation therapy in this setting.

Both Internet and print-based decision aids equally helped men make important decisions related to prostate cancer screening, but did not affect actual screening rates.

Undergoing nephron-sparing surgery for small renal masses substantially reduced the risk of moderate renal dysfunction compared with radical nephrectomy, but not that of kidney failure among patients enrolled in the EORTC 30904 trial.

The ALSYMPCA phase III clinical trial, recently published, demonstrated that radium-223 dichloride was well-tolerated and resulted in an improvement in overall survival by 3.6 months compared with placebo.

Researchers have identified pathways that are important for prostate cancer growth after the tumor becomes resistant to androgen therapies.

A large and prospective study shows that a high concentration of omega-3 fatty acids is linked to a higher risk of aggressive prostate cancer.

General practitioners took longer to suspect a diagnosis of bladder or renal cancer in women compared with men, according to a recent study.

A high skeletal muscle density has been linked to a twofold prolonged survival in patients with metastatic renal cell carcinoma compared with patients with low muscle density, according to a new study.

We need to understand each patient’s cancer and its microenvironment well enough to develop targeted treatments that will kill the tumor the first time-for if we let it escape, 70 years of prostate cancer research teaches us that our job will only get harder.

Although high-level evidence is lacking, the existing literature indicates that select men with lymph node–positive prostate cancer benefit from local therapy.

There has never been a referendum on IL-2. True, in the era of paradigm-shifting therapies, IL-2 may be overlooked at times, but it must not be excluded from the conversation.

Unfortunately, although agents in the pipeline each extend life, none are curative. Therefore, physicians who investigate and treat mCRPC have two paths they can follow to further improve outcomes.

Ultimately, as agents in both VEGF-targeted and immunotherapy classes with lower toxicity rates are developed, questions of combination and sequence will inspire clinical investigations of strategies that, it is hoped, will maximize both the quantity and quality of life for patients with RCC. Melanoma therapy drug development continues to lead the way with regard to what is therapeutically possible with immunotherapy-and suggests that HD IL-2 continues to be relevant in today’s treatment landscape.

Node-positive prostate cancer without distant metastases (T any, N+, M0) currently is encountered rarely, primarily because of the shift to diagnosis at earlier stages, a result of widespread PSA testing.

In this review, we focus on the testosterone/androgen receptor pathway that is being targeted with potent new agents; we also discuss other important alternative biologic pathways that have given rise to new therapeutics that may attenuate prostate cancer growth, survival, and propagation.

The “experts” should maintain a stringent standard regarding what merits further development and reconsider carefully and critically the available data before committing to PARP inhibition, attacks on the PI3K pathway, and vasoactive agents in prostate cancer.

Current evidence for the management of lymph node–positive prostate cancer suggests both a disease-control and survival benefit to systemic ADT plus surgery and radiation.

In this review, we examine the currently approved options available for these disease processes, including the newer agents and selected combinatorial approaches under investigation, and we attempt to identify the role of high-dose IL-2 in the context of current clinical practice.

From 2004 to 2009, use of advanced treatment technologies increased among prostate cancer patients with low-risk disease and high risk of noncancer mortality.

Bone metastases result in poorer outcomes for those patients with advanced renal cell carcinoma (RCC), who were treated with a molecularly targeted therapy. The results were presented in two separate analyses at the annual ASCO meeting.

A new imaging approach, combining PET with magnetic resonance (MR), was shown to be more sensitive in detecting recurrent prostate cancer compared with PET/CT.

In a new study presented at the Endocrine Society’s annual meeting, researchers using animal models show that early BPA exposure increases prostate cancer risk.

The mTOR inhibitor everolimus failed to prove progression-free survival noninferiority compared with the VEGF-targeting tyrosine kinase inhibitor sunitinib when given as first-line treatment in patients with metastatic renal cell carcinoma.

Researchers observed durable responses in patients with renal cell carcinoma treated with the PD-L1 antibody MPDL3280A. The study, which was presented at the 2013 ASCO Annual Meeting, was one of the few immune therapy trials that allowed patients with non-clear cell histologies and some clinical activity was observed in these patients.

Recent studies suggest patients with bladder cancer are not receiving optimal care or the follow-up surveillance as recommended by the National Comprehensive Cancer Network (NCCN).

Surveillance of patients with stage I seminoma following orchiectomy can spare a majority of patients from adjuvant chemotherapy with a low risk of relapse, according to results presented at the 2013 ASCO meeting.

A new study shows that men diagnosed with prostate cancer may do better by substituting carbohydrates and saturated fats with plant-based fats such as those found in nuts and olive oil.

In my experience, being treated for low-volume Gleason 6 tumors is the norm, not the exception, for men in the United States. Surveillance may be discussed as an option, but it is not taken seriously.