Genitourinary Cancers

Both the efficacy and safety of abiraterone acetate (ZYTIGA) treatment for metastatic castrate-resistant prostate cancer (mCRPC) appear to differ depending on race, according to results of Abi Race, a prospective, multicenter trial presented at the American Society of Clinical Oncology annual meeting in Chicago.

Median overall survival for African-American men with advanced prostate cancer who are treated with docetaxel (Taxotere) is similar to that of Caucasian men, according to an analysis of pooled data from nine randomized phase III clinical trials.

"Two provocative studies reported at the 2018 ASCO annual meeting provide additional insight into prostate cancer racial disparities in a different group of patients, namely men with advanced prostate cancer who participated in a variety of clinical trials," writes Leonard G. Gomella, MD.

In this interview, John W. Davis, MD, discusses the advantages and limitations of focal therapy, the ideal candidate, and what current guidelines say about its use.

Treatment with apalutamide (Erleada) resulted in a rapid and substantial decline in PSA, and greater magnitude of PSA decline correlated with improvement in several oncologic endpoints, results from the phase III SPARTAN study showed.

A study investigating associations between statin use and prostate cancer outcomes provides further evidence that the medication may have race-related benefit, providing protective effects among Caucasian men but not in African-Americans.

Studies show moderate alcohol intake has surprising links to prostate disease.

Findings of a multi-institutional cohort study provide further evidence that favorable outcomes can be achieved by carefully selected patients with muscle-invasive bladder cancer who forgo radical cystectomy after achieving a clinical complete response to neoadjuvant chemotherapy.

Other pipeline products discussed in this round-up include agents for metastatic urothelial cancer, clear cell renal cell carcinoma, and stress urinary incontinence.

Other topics covered in this year's take-home messages for basic science (benign) include interstitial cystitis/bladder pain syndrome and bladder cancer.

Radical prostatectomy can provide superior survival compared with radiation therapy, especially in young and healthy men.

Personally tailored intervention generates patient interest, QoL improvements.

Benefit evident regardless of metastasis site, phase III analysis shows.

An 18-year-old previously healthy collegiate athlete presented to the emergency room with a rapid weight gain of 20 pounds during the previous 2 months. She complained of significant fatigue and irregular menstrual periods.

Studies finding that fatty acid binding protein 5 is preferentially overexpressed in high-risk prostate cancer and that a ketogenic diet significantly inhibited tumor growth in a mouse model of clear cell RCC were among other AUA 2018 take-home messages in basic science (malignant).

Other take-home messages on transplantation from AUA 2018 included the finding that kidney paired donations have more than doubled since their inception in 2009 as well as early robotic kidney transplantation studies.

Length of stay is shorter with the robotic procedure, but operative time is longer.

Noteworthy minimally invasive surgery research from AUA 2018 also included topics such as robot-assisted versus open radical cystectomy as well as minimally invasive retroperitoneal lymph node dissection in men with testis cancer.

"Despite the potential benefits (fewer biopsies, less cost), the proposed approach to cancer detection and biopsy-that can miss 16%-40% of existing csPCa-may be difficult to justify for all patients," writes Badar M. Mian, MD.

The AUA 2018 take-home messages in outcomes also covered topics such as environmental exposures and bladder cancer and onabotulinumtoxinA (Botox) treatment for patients with overactive bladder.

Contrast-enhanced ultrasound for detecting renal cell carcinoma recurrence following ablation and new protocols for low-dose computed tomography in stone patients were among the other research highlights in imaging at the AUA annual meeting.

Other penile/urethral cancer highlights from AUA 2018 included analyses of fludeoxyglucose positron emission tomography-computed tomography and the Pl3K-AKT-mTOR pathway.

Active surveillance in selected patients with localized renal masses 4 cm to 7 cm and a patient-derived xenograft system for predicting response to targeted and immune therapies in patients with metastatic RCC were among other noteworthy kidney cancer studies presented at AUA 2018.

Other bladder cancer take-home messages covered topics such as artificial intelligence and deep learning for staging of T1 disease as well as a wearable fitness tracker for collecting data on physical activity after radical cystectomy.

Three new clinical guidelines, potentially practice-changing advances in robotics and artificial intelligence, and research on hot-button public health issues such as opioid abuse were among many highlights of the AUA annual meeting in San Francisco.

Other key prostate cancer studies from AUA 2018 included updated survival data from the European Randomized Study of Screening for Prostate Cancer and a multicenter trial of MRI-targeted biopsy.

Despite improved patient awareness and established guidelines, compliance remains low.

Findings from a retrospective analysis of data collected at the National Institutes of Health provide insight on how multiparametric MRI/transrectal ultrasound-fusion biopsy (“fusion biopsy”) may be affecting management patterns and outcomes for men with prostate cancer.

Adding abiraterone acetate (ZYTIGA) to androgen deprivation therapy for the management of patients with metastatic castration-naïve prostate cancer does not increase medical resource utilization.

The treatment method may delay need for systemic therapy in men with oligometastatic prostate cancer.