Genitourinary Cancers

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.

Dr. Bruce Roth, Siteman Cancer Center, spoke at the 2013 ASCO meeting about topics in seminoma. Here he discusses recurrence, relapse, and seminomatous vs nonseminomatous testicular cancer.

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.