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Farahani SJ, Li J, Minder B, Vielh P, Glisic M, Muka T. Impact of implementing the first edition of the Paris system for reporting: A systematic review and meta-analysis. Cytopathology 2024; 35:616-633. [PMID: 38934101 DOI: 10.1111/cyt.13407] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Revised: 05/09/2024] [Accepted: 05/21/2024] [Indexed: 06/28/2024]
Abstract
Urine cytology is a noninvasive, widely used diagnostic tool for screening and surveillance of genitourinary tract neoplasms. However, the absence of unified terminology and clear objective morphological criteria limits the clinical benefit of urine cytology. The Paris System for Reporting Urine Cytology (TPS) was developed with the goal of standardizing reporting and improving urine cytology performance in detecting high-grade malignancy (HGM). We aimed to evaluate potential effects of TPS on improving urine cytology diagnostic performance and clinical utility by conducting a systematic review and meta-analysis. We searched six electronic databases to identify cross-sectional and cohort studies written in English assessing the accuracy of urine cytology in detecting genitourinary tract malignancies of patients under surveillance or with clinical suspicion of malignancy from January 2004 to December 2022. We extracted relevant data from eligible studies to calculate relative distribution of cytology diagnostic categories; ratio of atypical to HGM cytology diagnosis; and risk of HGM (ROHGM) and HGM likelihood ratio (HGM-LR) associated with cytology diagnostic categories. We used a generalized linear mixed model with logit transformation to combine proportions and multilevel mixed-effect logistic regression to pool diagnostic accuracy measurements. We performed meta-regression to evaluate any significant difference between TPS and non-TPS cohorts. We included 64 studies for 99,796 combined total cytology samples, across 31 TPS and 49 non-TPS cohorts. Pooled relative distribution [95% confidence interval (CI)] of negative for high-grade urothelial carcinoma (NHGUC)/negative for malignancy (NM); atypical urothelial cells (AUC); suspicious for high-grade urothelial carcinoma (SHGUC)/suspicious for malignancy (SM); low-grade urothelial neoplasm (LGUN); and HGM categories among satisfactory cytology cases were 83.8% (80.3%-86.9%), 8.0% (6.0%-10.6%), 2.2% (1.4%-3.3%), 0.01% (0.0%-0.1%), and 4.2% (3.2%-5.5%) in TPS versus 80.8% (76.8-2.7%), 11.3% (8.6%-14.7%), 1.8% (1.2%-2.7%), 0.01% (0.0%-0.1%), and 3.3% (2.5%-4.3%) in non-TPS cohorts. Adopting TPS classification resulted in a significant increase in the frequency of NHGUC and a reduction in AUC cytology diagnoses, respectively. The AUC/HGM ratio in TPS cohort was 2.0, which showed a statistically significant difference from the atypical/HGM ratio of 4.1 in non-TPS cohort (p-value: 0.01). Moreover, the summary rate (95% CI) of LGUN called AUC on cytology significantly decreased to 20.8% (14.9%-28.3%) in the TPS compared with 34.1% (26.4%-42.8%) in non-TPS cohorts. The pooled ROHGM (95% CI) was 20.4% (6.2%-50.0%) in nondiagnostic (NDX), 15.5% (9.6%-24.2%) in NHGUC, 40.2% (30.9%-50.2%) in AUC, 80.8% (72.9%-86.8%) in SHGUC, 15.1% (5.7%-34.3%) in LGUN, and 91.4% (87.3%-94.3%) in HGM categories in TPS studies. NHGUC, AUC, SHGUC, and HGM categories were associated with HGM-LR (95% CI) of 0.2 (0.1-0.3), 0.9 (0.6-1.3), 6.9 (2.4-19.9), and 16.8 (8.3-33.8). Our results suggest that TPS 1.0 has reduced the relative frequency of AUC diagnosis, AUC/HGM ratio, and the frequency of LGUNs diagnosed as AUC on cytology. Adopting this classification has improved the clinical utility of SHGUC and HGM cytology diagnoses in ruling in high-grade lesions. However, an NHGUC diagnosis does not reliably rule out the presence of a high-grade lesion.
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Affiliation(s)
- Sahar J Farahani
- Department of Pathology and Laboratory Medicine, Memorial Sloan Kettering Cancer Caner, New York, New York, USA
| | - Joshua Li
- Department of Pathology, The University of Hong Kong, Pok Fu Lam, Hong Kong
| | - Beatrice Minder
- Public Health & Primary Care Library, University Library of Bern, University of Bern, Bern, Switzerland
| | - Philippe Vielh
- Department of Pathology, Medipath and American Hospital of Paris, Paris, France
| | - Marija Glisic
- Swiss Paraplegic Research, Nottwil, Switzerland
- Institute of Social and Preventive Medicine (ISPM), University of Bern, Bern, Switzerland
| | - Taulant Muka
- Institute of Social and Preventive Medicine (ISPM), University of Bern, Bern, Switzerland
- Epistudia, Bern, Switzerland
- Meta-Research Innovation Center at Stanford (METRICS), Stanford University, Stanford, California, USA
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Fu D, Shi X, Yi X, Wu D, He H, Zhou W, Cheng W. m6A reader IGF2BP2 promotes M2 macrophage polarization and malignant biological behavior of bladder cancer by stabilizing NRP1 mRNA expression. BMC Urol 2024; 24:147. [PMID: 39014364 PMCID: PMC11251312 DOI: 10.1186/s12894-024-01534-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Accepted: 07/02/2024] [Indexed: 07/18/2024] Open
Abstract
BACKGROUND Insulin-like growth factor 2 mRNA-binding protein 2 (IGF2BP2) has been confirmed to play oncogenic role in many cancers. However, the role and mechanism of IGF2BP2 in bladder cancer (BCa) still deserves to be further revealed. METHODS The mRNA and protein levels of IGF2BP2 and neuronilin-1 (NRP1) were detected by real-time quantitative PCR (RT-qPCR) and western blot. Cell proliferation, apoptosis, migration and invasion were determined using colony formation assay, EdU assay, CCK8 assay, flow cytometry and transwell assay. Xenograft tumor model was conducted to evaluate the role of IGF2BP2 in vivo. THP-1-M0 macrophages were co-cultured with the condition medium (CM) of BCa cells to induce polarization. M2 macrophage polarization was assessed by detecting the mRNA levels of M2 macrophage markers using RT-qPCR and measuring the proportion of M2 macrophage markers using flow cytometry. Moreover, MeRIP and RIP assay were performed to assess m6A level and the interaction between IGF2BP2 and NRP1. RESULTS IGF2BP2 and NRP1 were upregulated in BCa tissues and cells. IGF2BP2 knockdown suppressed BCa cell growth and metastasis, as well as inhibited BCa tumor growth. After THP-1-M0 macrophages were co-cultured with the CM of BCa cells, the levels of M2 macrophage markers were markedly enhanced, while this effect was abolished by IGF2BP2 knockdown. IGF2BP2 level was positively correlated with NRP1 level, and it could increase NRP1 mRNA stability. NRP1 overexpression reversed the suppressive effect of IGF2BP2 knockdown on M2 macrophage polarization and BCa cell progression. CONCLUSION m6A-reader IGF2BP2 enhanced M2 macrophage polarization and BCa cell progression by promoting NRP1 mRNA stability.
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Affiliation(s)
- Dian Fu
- Department of Urology, Jinling College of Clinical Medicine, Nanjing Medical University, No.305, Zhongshandong Road, Xuanwu District, Nanjing, Jiangsu, 210002, China
| | - Xiuquan Shi
- Department of Urology, Nanjing Jinling Hospital, Affiliated Hospital of Medical School, Nanjing University, No.305, Zhongshandong Road, Xuanwu District, Nanjing, Jiangsu, 210002, China
| | - Xiaoming Yi
- Department of Urology, Jinling College of Clinical Medicine, Nanjing Medical University, No.305, Zhongshandong Road, Xuanwu District, Nanjing, Jiangsu, 210002, China
| | - Ding Wu
- Department of Urology, Jinling College of Clinical Medicine, Nanjing Medical University, No.305, Zhongshandong Road, Xuanwu District, Nanjing, Jiangsu, 210002, China
| | - Haowei He
- Department of Urology, Jinling College of Clinical Medicine, Nanjing Medical University, No.305, Zhongshandong Road, Xuanwu District, Nanjing, Jiangsu, 210002, China
| | - Wenquan Zhou
- Department of Urology, Nanjing Jinling Hospital, Affiliated Hospital of Medical School, Nanjing University, No.305, Zhongshandong Road, Xuanwu District, Nanjing, Jiangsu, 210002, China.
| | - Wen Cheng
- Department of Urology, Jinling College of Clinical Medicine, Nanjing Medical University, No.305, Zhongshandong Road, Xuanwu District, Nanjing, Jiangsu, 210002, China.
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Asakawa K, Waratani M, Massey O, Holbrook T, Kondo M, Saito A, Nishiyama H. Real-world epidemiology and treatment patterns of patients with locally advanced or metastatic urothelial carcinoma: Retrospective analysis of Diagnosis Procedure Combination claims data in Japan. Int J Urol 2024; 31:730-738. [PMID: 38468564 DOI: 10.1111/iju.15450] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Accepted: 02/22/2024] [Indexed: 03/13/2024]
Abstract
OBJECTIVES Evaluate real-world epidemiologic trends and treatment patterns in newly diagnosed patients with locally advanced or metastatic urothelial carcinoma (la/mUC) in Japan. METHODS This retrospective analysis included adults with newly diagnosed la/mUC in Japan (January 2015-December 2019) from a nationwide-linked electronic medical record Diagnostic Procedure Combination claims dataset. Outcomes included epidemiologic trends (incidence and prevalence), baseline demographics, clinical characteristics, and treatment patterns in newly diagnosed patients with la/mUC before (2015-2017) and after (2018-2019) approval of pembrolizumab in Japan. RESULTS Of 975 patients included, 76.4% were men; 71.6% were aged 70 years or older. Most cases (70.5%) were of the bladder. Between 2015 and 2019, the annual age-adjusted incidence increased from 6.8 to 12.4 per 100 000; the annual age-adjusted period prevalence increased from 13.0 to 25.2 per 100 000; and 307 (31.5%) and 668 (68.5%) patients were diagnosed from 2015 to 2017 and 2018 to 2019, respectively. Overall, 731 (75%) patients received systemic anticancer therapy; all received 1 line and 50.2% received 2 lines of therapy; 78.3% of patients received gemcitabine plus platinum-based therapy and 2.2% received pembrolizumab as first-line treatment. First-line treatment rates increased from 69.4% to 77.5% after pembrolizumab approval. Of 367 patients who received second-line treatment, 22.3% received gemcitabine plus platinum-based therapy; 14.7% received pembrolizumab. CONCLUSIONS In the Japanese regions considered, incidence and prevalence of newly diagnosed la/mUC increased over time and first-line treatment with pembrolizumab increased after approval.
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Affiliation(s)
- Keiko Asakawa
- Department of Global Medical Affairs Japan, Astellas Pharma, Inc., Tokyo, Japan
| | - Miina Waratani
- Department of Global Medical Affairs Japan, Astellas Pharma, Inc., Tokyo, Japan
| | - Olivia Massey
- Secondary Data Evidence Generation, Adelphi Real World, Bollington, UK
| | - Tim Holbrook
- Secondary Data Evidence Generation, Adelphi Real World, Bollington, UK
| | - Makoto Kondo
- Department of Global Medical Affairs Japan, Astellas Pharma, Inc., Tokyo, Japan
| | - Atsushi Saito
- Department of Global Medical Affairs Japan, Astellas Pharma, Inc., Tokyo, Japan
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Lee KS, Choi E, Cho SI, Park S, Ryu J, Puche AV, Ma M, Park J, Jung W, Ro J, Kim S, Park G, Song S, Ock CY, Choe G, Park JH. An artificial intelligence-powered PD-L1 combined positive score (CPS) analyser in urothelial carcinoma alleviating interobserver and intersite variability. Histopathology 2024; 85:81-91. [PMID: 38477366 DOI: 10.1111/his.15176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2023] [Revised: 02/20/2024] [Accepted: 02/29/2024] [Indexed: 03/14/2024]
Abstract
AIMS Immune checkpoint inhibitors targeting programmed death-ligand 1 (PD-L1) have shown promising clinical outcomes in urothelial carcinoma (UC). The combined positive score (CPS) quantifies PD-L1 22C3 expression in UC, but it can vary between pathologists due to the consideration of both immune and tumour cell positivity. METHODS AND RESULTS An artificial intelligence (AI)-powered PD-L1 CPS analyser was developed using 1,275,907 cells and 6175.42 mm2 of tissue annotated by pathologists, extracted from 400 PD-L1 22C3-stained whole slide images of UC. We validated the AI model on 543 UC PD-L1 22C3 cases collected from three institutions. There were 446 cases (82.1%) where the CPS results (CPS ≥10 or <10) were in complete agreement between three pathologists, and 486 cases (89.5%) where the AI-powered CPS results matched the consensus of two or more pathologists. In the pathologist's assessment of the CPS, statistically significant differences were noted depending on the source hospital (P = 0.003). Three pathologists reevaluated discrepancy cases with AI-powered CPS results. After using the AI as a guide and revising, the complete agreement increased to 93.9%. The AI model contributed to improving the concordance between pathologists across various factors including hospital, specimen type, pathologic T stage, histologic subtypes, and dominant PD-L1-positive cell type. In the revised results, the evaluation discordance among slides from different hospitals was mitigated. CONCLUSION This study suggests that AI models can help pathologists to reduce discrepancies between pathologists in quantifying immunohistochemistry including PD-L1 22C3 CPS, especially when evaluating data from different institutions, such as in a telepathology setting.
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Affiliation(s)
- Kyu Sang Lee
- Department of Pathology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam-si, Republic of Korea
| | - Euno Choi
- Department of Pathology, Ewha Womans University Mokdong Hospital, Ewha Womans University College of Medicine, Seoul, Republic of Korea
| | | | | | | | | | | | | | | | | | | | | | | | | | - Gheeyoung Choe
- Department of Pathology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam-si, Republic of Korea
| | - Jeong Hwan Park
- Department of Pathology, SMG-SNU Boramae Medical Center, Seoul National University College of Medicine, Seoul, Republic of Korea
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Huang J, Pang WS, Fung YC, Mak FY, Chan SC, Liu X, Zhang L, Lucero-Prisno DE, Xu W, Zheng ZJ, Moschini M, Pradere B, Soria F, Enikeev D, Roupret M, Shariat S, Ng ACF, Teoh JYC, Wong MCS. Global burden, risk factors, and temporal trends of ureteral cancer: a comprehensive analysis of cancer registries. BMC Med 2024; 22:264. [PMID: 38915094 PMCID: PMC11197334 DOI: 10.1186/s12916-024-03485-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Accepted: 06/13/2024] [Indexed: 06/26/2024] Open
Abstract
BACKGROUND Ureteral cancer is a rare cancer. This study aimed to provide an up-to-date and comprehensive analysis on the global trends of ureteral cancer incidence and its association with lifestyle and metabolic risk factors. METHODS The incidence of ureteral cancer was estimated from the Cancer Incidence in Five Continents Plus and Global Cancer Observatory databases. We analyzed the (1) global incidence of ureteral cancer by region, country, sex, and age group by age-standardized rates (ASR); (2) associated risk factors on a population level by univariable linear regression with logarithm transformation; and (3) incidence trend of ureteral cancer by sex and age group in different countries by Average Annual Percentage Change (AAPC). RESULTS The global age-standardized rate of ureteral cancer incidence in 2022 was 22.3 per 10,000,000 people. Regions with higher human development index (HDI), such as Europe, Northern America, and East Asia, were found to have a higher incidence of ureteral cancer. Higher HDI and gross domestic product (GDP) and a higher prevalence of smoking, alcohol drinking, physical inactivity, unhealthy dietary, obesity, hypertension, diabetes, and lipid disorder were associated with higher incidence of ureteral cancer. An overall increasing trend of ureteral cancer incidence was observed for the past decade, especially among the female population. CONCLUSIONS Although ureteral cancer was relatively rare, the number of cases reported was rising over the world. The rising trends among females were more evident compared with the other subgroups, especially in European countries. Further studies could be conducted to examine the reasons behind these epidemiological changes and confirm the relationship with the risk factors identified.
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Affiliation(s)
- Junjie Huang
- Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
- Centre for Health Education and Health Promotion, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Wing Sze Pang
- Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Yat Ching Fung
- Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Fung Yu Mak
- Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Sze Chai Chan
- Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Xianjing Liu
- Department of Radiology and Nuclear Medicine, Erasmus MC University Medical Center, Rotterdam, the Netherlands
| | - Lin Zhang
- Suzhou Industrial Park Monash Research Institute of Science and Technology, Suzhou, China
- The School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Don Eliseo Lucero-Prisno
- Department of Global Health and Development, London School of Hygiene and Tropical Medicine, London, UK
- Faculty of Public Health, Mahidol University, Bangkok, Thailand
| | - Wanghong Xu
- School of Public Health, Fudan University, Shanghai, China
| | - Zhi-Jie Zheng
- Department of Global Health, School of Public Health, Peking University, Beijing, China
| | - Marco Moschini
- Division of Oncology/Unit of Urology, Urological Research Institute, IRCCS Ospedale San Raffaele, Milan, Italy
- European Association of Urology - Young Academic Urologists (EAU-YAU), Arnhem, the Netherlands
| | - Benjamin Pradere
- European Association of Urology - Young Academic Urologists (EAU-YAU), Arnhem, the Netherlands
- Department of Urology, La Croix du Sud Hôpital, Quint Fonsegrives, France
| | - Francesco Soria
- European Association of Urology - Young Academic Urologists (EAU-YAU), Arnhem, the Netherlands
- Division of Urology, Department of Surgical Sciences, AOU Città Della Salute E Della Scienza Di Torino, Torino School of Medicine, Turin, Italy
| | - Dmitry Enikeev
- Department of Urology, Medical University of Vienna, Vienna, Austria
- Institute for Urology and Reproductive Health, Sechenov University, Moscow, Russia
| | - Morgan Roupret
- 16GRC 5 Predictive Onco-Uro, Sorbonne University, AP-HP, Urology, Pitie-Salpetriere Hospital, Paris, France
| | - Shahrokh Shariat
- Department of Urology, Medical University of Vienna, Vienna, Austria
- Departments of Urology, Weill Cornell Medical College, New York, NY, USA
- Department of Urology, University of Texas Southwestern, Dallas, TX, USA
- Department of Urology, Second Faculty of Medicine, Charles University, Prague, Czech Republic
- Division of Urology, Department of Special Surgery, Jordan University Hospital, The University of Jordan, Amman, Jordan
| | - Anthony Chi-Fai Ng
- Department of Surgery, S.H. Ho Urology Centre, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Jeremy Yuen-Chun Teoh
- European Association of Urology - Young Academic Urologists (EAU-YAU), Arnhem, the Netherlands.
- Department of Surgery, S.H. Ho Urology Centre, The Chinese University of Hong Kong, Hong Kong SAR, China.
| | - Martin C S Wong
- Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China.
- Centre for Health Education and Health Promotion, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China.
- School of Public Health, Fudan University, Shanghai, China.
- Department of Global Health, School of Public Health, Peking University, Beijing, China.
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Xin L, Xiao X, Xiao W, Peng R, Wang H, Pan F. Screening for urothelial carcinoma cells in urine based on digital holographic flow cytometry through machine learning and deep learning methods. LAB ON A CHIP 2024; 24:2736-2746. [PMID: 38660758 DOI: 10.1039/d3lc00854a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/26/2024]
Abstract
The incidence of urothelial carcinoma continues to rise annually, particularly among the elderly. Prompt diagnosis and treatment can significantly enhance patient survival and quality of life. Urine cytology remains a widely-used early screening method for urothelial carcinoma, but it still has limitations including sensitivity, labor-intensive procedures, and elevated cost. In recent developments, microfluidic chip technology offers an effective and efficient approach for clinical urine specimen analysis. Digital holographic microscopy, a form of quantitative phase imaging technology, captures extensive data on the refractive index and thickness of cells. The combination of microfluidic chips and digital holographic microscopy facilitates high-throughput imaging of live cells without staining. In this study, digital holographic flow cytometry was employed to rapidly capture images of diverse cell types present in urine and to reconstruct high-precision quantitative phase images for each cell type. Then, various machine learning algorithms and deep learning models were applied to categorize these cell images, and remarkable accuracy in cancer cell identification was achieved. This research suggests that the integration of digital holographic flow cytometry with artificial intelligence algorithms offers a promising, precise, and convenient approach for early screening of urothelial carcinoma.
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Affiliation(s)
- Lu Xin
- Key Laboratory of Precision Opto-mechatronics Technology, Beihang University, Beijing 100191, China.
| | - Xi Xiao
- Peking University Third Hospital, Department of Radiation Oncology, Beijing 100191, China.
| | - Wen Xiao
- Key Laboratory of Precision Opto-mechatronics Technology, Beihang University, Beijing 100191, China.
| | - Ran Peng
- Peking University Third Hospital, Department of Radiation Oncology, Beijing 100191, China.
| | - Hao Wang
- Peking University Third Hospital, Department of Radiation Oncology, Beijing 100191, China.
- Peking University Third Hospital, Cancer Center, Beijing 100191, China
| | - Feng Pan
- Key Laboratory of Precision Opto-mechatronics Technology, Beihang University, Beijing 100191, China.
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Meneceur S, De Vos CE, Petzsch P, Köhrer K, Niegisch G, Hoffmann MJ. New synergistic combination therapy approaches with HDAC inhibitor quisinostat, cisplatin or PARP inhibitor talazoparib for urothelial carcinoma. J Cell Mol Med 2024; 28:e18342. [PMID: 38693852 PMCID: PMC11063726 DOI: 10.1111/jcmm.18342] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Revised: 02/13/2024] [Accepted: 04/05/2024] [Indexed: 05/03/2024] Open
Abstract
Urothelial carcinoma (UC) urgently requires new therapeutic options. Histone deacetylases (HDAC) are frequently dysregulated in UC and constitute interesting targets for the development of alternative therapy options. Thus, we investigated the effect of the second generation HDAC inhibitor (HDACi) quisinostat in five UC cell lines (UCC) and two normal control cell lines in comparison to romidepsin, a well characterized HDACi which was previously shown to induce cell death and cell cycle arrest. In UCC, quisinostat led to cell cycle alterations, cell death induction and DNA damage, but was well tolerated by normal cells. Combinations of quisinostat with cisplatin or the PARP inhibitor talazoparib led to decrease in cell viability and significant synergistic effect in five UCCs and platinum-resistant sublines allowing dose reduction. Further analyses in UM-UC-3 and J82 at low dose ratio revealed that the mechanisms included cell cycle disturbance, apoptosis induction and DNA damage. These combinations appeared to be well tolerated in normal cells. In conclusion, our results suggest new promising combination regimes for treatment of UC, also in the cisplatin-resistant setting.
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Affiliation(s)
- Sarah Meneceur
- Department of Urology, Medical Faculty and University Hospital DüsseldorfHeinrich Heine University DüsseldorfDüsseldorfGermany
- Center for Integrated Oncology (CIO) DüsseldorfCIO Aachen Bonn Köln DüsseldorfDüsseldorfGermany
| | - Caroline E. De Vos
- Department of Urology, Medical Faculty and University Hospital DüsseldorfHeinrich Heine University DüsseldorfDüsseldorfGermany
- Center for Integrated Oncology (CIO) DüsseldorfCIO Aachen Bonn Köln DüsseldorfDüsseldorfGermany
| | - Patrick Petzsch
- Center for Integrated Oncology (CIO) DüsseldorfCIO Aachen Bonn Köln DüsseldorfDüsseldorfGermany
- Genomics and Transcriptomics Laboratory (GTL), Biological and Medical Research Center (BMFZ)Medical Faculty and University Hospital Düsseldorf, Heinrich Heine University DüsseldorfDüsseldorfGermany
| | - Karl Köhrer
- Center for Integrated Oncology (CIO) DüsseldorfCIO Aachen Bonn Köln DüsseldorfDüsseldorfGermany
- Genomics and Transcriptomics Laboratory (GTL), Biological and Medical Research Center (BMFZ)Medical Faculty and University Hospital Düsseldorf, Heinrich Heine University DüsseldorfDüsseldorfGermany
| | - Günter Niegisch
- Department of Urology, Medical Faculty and University Hospital DüsseldorfHeinrich Heine University DüsseldorfDüsseldorfGermany
- Center for Integrated Oncology (CIO) DüsseldorfCIO Aachen Bonn Köln DüsseldorfDüsseldorfGermany
| | - Michèle J. Hoffmann
- Department of Urology, Medical Faculty and University Hospital DüsseldorfHeinrich Heine University DüsseldorfDüsseldorfGermany
- Center for Integrated Oncology (CIO) DüsseldorfCIO Aachen Bonn Köln DüsseldorfDüsseldorfGermany
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Hu J, Gu H, Zhang D, Wen M, Yan Z, Song B, Xie C. Establishment and validation of a nomogram for predicting overall survival of upper-tract urothelial carcinoma with bone metastasis: a population-based study. BMC Urol 2024; 24:100. [PMID: 38689213 PMCID: PMC11059636 DOI: 10.1186/s12894-024-01488-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Accepted: 04/22/2024] [Indexed: 05/02/2024] Open
Abstract
BACKGROUND Bone metastasis (BM) carries a poor prognosis for patients with upper-tract urothelial carcinoma (UTUC). This study aims to identify survival predictors and develop a prognostic nomogram for overall survival (OS) in UTUC patients with BM. METHODS The Surveillance, Epidemiology, and End Results database was used to select patients with UTUC between 2010 and 2019. The chi-square test was used to assess the baseline differences between the groups. Kaplan-Meier analysis was employed to assess OS. Univariate and multivariate analyses were conducted to identify prognostic factors for nomogram establishment. An independent cohort was used for external validation of the nomogram. The discrimination and calibration of the nomogram were evaluated using concordance index (C-index), area under receiver operating characteristic curve (AUC), calibration curve, and decision curve analysis (DCA). All statistical analyses were performed using SPSS 23.0 and R software 4.2.2. RESULTS The mean OS for UTUC patients with BM was 10 months (95% CI: 8.17 to 11.84), with 6-month OS, 1-year OS, and 3-year OS rates of 41%, 21%, and 3%, respectively. Multi-organ metastases (HR = 2.21, 95% CI: 1.66 to 2.95, P < 0.001), surgery (HR = 0.72, 95% CI: 0.56 to 0.91, P = 0.007), and chemotherapy (HR = 0.37, 95% CI: 0.3 to 0.46, P < 0.001) were identified as independent prognostic factors. The C-index was 0.725 for the training cohort and 0.854 for the validation cohort, and all AUC values were > 0.679. The calibration curve and DCA curve showed the accuracy and practicality of the nomogram. CONCLUSIONS The OS of UTUC patients with BM was poor. Multi-organ metastases was a risk factor for OS, while surgery and chemotherapy were protective factors. Our nomogram was developed and validated to assist clinicians in evaluating the OS of UTUC patients with BM.
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Affiliation(s)
- Jiasheng Hu
- Department of Urology, The First Affiliated Hospital of Ningbo University, Ningbo, China
- Ningbo Clinical Research Center for Urological Disease, Ningbo, China
| | - Haowen Gu
- Department of Urology, The First Affiliated Hospital of Ningbo University, Ningbo, China
| | - Dongxu Zhang
- Department of Urology, The First Affiliated Hospital of Ningbo University, Ningbo, China
- Ningbo Clinical Research Center for Urological Disease, Ningbo, China
| | - Min Wen
- Department of Urology, The First Affiliated Hospital of Ningbo University, Ningbo, China
- Ningbo Clinical Research Center for Urological Disease, Ningbo, China
| | - Zejun Yan
- Department of Urology, The First Affiliated Hospital of Ningbo University, Ningbo, China
- Ningbo Clinical Research Center for Urological Disease, Ningbo, China
| | - Baiyang Song
- Department of Urology, The First Affiliated Hospital of Ningbo University, Ningbo, China.
| | - Chengxin Xie
- Shandong First Medical University, Jinan, 250021, China.
- Department of Orthopedics, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Linhai, China.
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9
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Tang M, Garg A, Bonate PL, Rosenberg JE, Matsangou M, Kadokura T, Yamada A, Choules M, Pavese J, Nagata M, Tenmizu D, Koibuchi A, Heo N, Wang L, Wojtkowski T, Hanley WD, Poondru S. Clinical Pharmacology of the Antibody-Drug Conjugate Enfortumab Vedotin in Advanced Urothelial Carcinoma and Other Malignant Solid Tumors. Clin Pharmacokinet 2024; 63:423-438. [PMID: 38609704 PMCID: PMC11052883 DOI: 10.1007/s40262-024-01369-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/12/2024] [Indexed: 04/14/2024]
Abstract
Enfortumab vedotin is an antibody-drug conjugate comprised of a human monoclonal antibody directed to Nectin-4 and monomethyl auristatin E (MMAE), a microtubule-disrupting agent. The objectives of this review are to summarize the clinical pharmacology of enfortumab vedotin monotherapy and demonstrate that the appropriate dose has been selected for clinical use. Pharmacokinetics (PK) of enfortumab vedotin (antibody-drug conjugate and total antibody) and free MMAE were evaluated in five clinical trials of patients with locally advanced or metastatic urothelial carcinoma (n = 748). Intravenous enfortumab vedotin 0.5-1.25 mg/kg on days 1, 8, and 15 of a 28-day cycle showed linear, dose-proportional PK. No significant differences in exposure or safety of enfortumab vedotin and free MMAE were observed in mild, moderate, or severe renal impairment versus normal renal function. Patients with mildly impaired versus normal hepatic function had a 37% increase in area under the concentration-time curve (0-28 days), a 31% increase in maximum concentration of free MMAE, and a similar adverse event profile. No clinically significant PK differences were observed based on race/ethnicity with weight-based dosing, and no clinically meaningful QT prolongation was observed. Concomitant use with dual P-glycoprotein and strong cytochrome P450 3A4 inhibitors may increase MMAE exposure and the risk of adverse events. Approximately 3% of patients developed antitherapeutic antibodies against enfortumab vedotin 1.25 mg/kg. These findings support enfortumab vedotin 1.25 mg/kg monotherapy on days 1, 8, and 15 of a 28-day cycle. No dose adjustments are required for patients with renal impairment or mild hepatic impairment, or by race/ethnicity.
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Affiliation(s)
- Mei Tang
- Clinical Pharmacology and Exploratory Development, Astellas Pharma Global Development Inc., 2375 Waterview Drive, Northbrook, IL, 60062-6111, USA
| | - Amit Garg
- Clinical Pharmacology Oncology, Pfizer Inc., 181 Oyster Point Boulevard, South San Francisco, CA, 94080, USA.
| | - Peter L Bonate
- Clinical Pharmacology and Exploratory Development, Astellas Pharma Global Development Inc., 2375 Waterview Drive, Northbrook, IL, 60062-6111, USA
| | - Jonathan E Rosenberg
- Genitourinary Oncology Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Maria Matsangou
- Therapeutic Area-Oncology, Astellas Pharma Global Development, Astellas Pharma, Inc., Northbrook, IL, USA
| | - Takeshi Kadokura
- Clinical Pharmacology and Exploratory Development, Astellas Pharma Inc., Tokyo, Japan
| | - Akihiro Yamada
- Clinical Pharmacology and Exploratory Development, Astellas Pharma Inc., Tokyo, Japan
| | - Mary Choules
- Clinical Pharmacology and Exploratory Development, Astellas Pharma Global Development Inc., 2375 Waterview Drive, Northbrook, IL, 60062-6111, USA
| | - Janet Pavese
- Clinical Pharmacology and Exploratory Development, Astellas Pharma Global Development Inc., 2375 Waterview Drive, Northbrook, IL, 60062-6111, USA
| | - Masanori Nagata
- Analysis and Pharmacokinetics Research Laboratories, Drug Discovery Research, Astellas Pharma, Inc, Tsukuba, Japan
| | - Daisuke Tenmizu
- Analysis and Pharmacokinetics Research Laboratories, Drug Discovery Research, Astellas Pharma, Inc, Tsukuba, Japan
| | - Akira Koibuchi
- Clinical Pharmacology and Exploratory Development, Astellas Pharma Inc., Tokyo, Japan
| | - Nakyo Heo
- Clinical Pharmacology and Exploratory Development, Astellas Pharma Global Development Inc., 2375 Waterview Drive, Northbrook, IL, 60062-6111, USA
| | - Lu Wang
- Statistical and Real-World Data Science, Astellas Pharma Global Development Inc, Northbrook, IL, USA
| | - Tomasz Wojtkowski
- Data Science Development, Astellas Pharma Global Development Inc., Northbrook, IL, USA
| | - William D Hanley
- Clinical Pharmacology Oncology, Pfizer Inc., 181 Oyster Point Boulevard, South San Francisco, CA, 94080, USA
| | - Srinivasu Poondru
- Clinical Pharmacology and Exploratory Development, Astellas Pharma Global Development Inc., 2375 Waterview Drive, Northbrook, IL, 60062-6111, USA.
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10
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Otis SU, Banna GL, Maniam A. The association between paraneoplastic neurological syndromes (PNS) and urothelial carcinoma - A review of the literature. Crit Rev Oncol Hematol 2024; 196:104314. [PMID: 38447785 DOI: 10.1016/j.critrevonc.2024.104314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2023] [Revised: 02/10/2024] [Accepted: 02/26/2024] [Indexed: 03/08/2024] Open
Abstract
Paraneoplastic neurological syndromes (PNS) are rare neurological disorders arising from malignancy-triggered autoimmunity, yet their association with urothelial carcinoma remains unclear. This systematic review intends to explore any connection, alongside patient/clinical features and management. A literature search identified 25 cases of bladder and upper tract carcinoma linked to PNS. Overall, while infrequent, a meaningful association between PNS and urothelial carcinoma was found in that 84% of cases met a 'possible'-or-'higher-likelihood' PNS diagnosis. Most cases presented with high-risk PNS phenotypes, predominantly cerebellar syndromes and encephalomyelitis/sensory neuronopathy, ∼17 months within cancer diagnosis/recurrence. Review findings suggest a female preponderance in suspected PNS despite higher male incidence of urothelial cancer. Main treatments consisted of surgery alongside chemotherapy or immunotherapeutics (IVIG and/or corticosteroids), which improved symptoms for a slight majority (60%). Ultimately, while common PNS-associated neoplasms should always first be excluded in suspected PNS, in the absence of alternative causes, urothelial carcinomas do merit clinical consideration.
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Affiliation(s)
- Sarafina Urenna Otis
- Medical Sciences Division, University of Oxford, John Radcliffe Hospital, Oxford, England OX3 9DU, UK
| | - Giuseppe Luigi Banna
- Portsmouth Hospitals University NHS Trust, Portsmouth, England PO6 3LY, UK; Faculty of Science and Health, School of Pharmacy and Biomedical Sciences, University of Portsmouth, Portsmouth, England PO1 2UP, UK
| | - Akash Maniam
- Portsmouth Hospitals University NHS Trust, Portsmouth, England PO6 3LY, UK; Caribbean Cancer Research Institute, Chanka Trace El Socorro South, Trinidad and Tobago.
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11
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Toribio-Vázquez C, Gómez Rivas J, Amigo F, Carrión DM, Yebes Á, Alonso-Bartolomé M, Ayllon H, Aguilera A, Martinez-Piñeiro L, Antón-Juanilla M, Crespo-Atín V, Otaola-Arca H, Herranz-Yague JA, Munoz Rivero MV, MacKenzie KR, Shah TT, Gao C, Zimmermann E, Jefferies M, Nambiar A, Gallagher KM, Khadhouri S, Kasivisvanathan V. Prevalence of urinary tract cancer in the Spanish cohort of the IDENTIFY study. Actas Urol Esp 2024; 48:228-237. [PMID: 37574012 DOI: 10.1016/j.acuroe.2023.08.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2023] [Revised: 06/12/2023] [Accepted: 06/14/2023] [Indexed: 08/15/2023]
Abstract
INTRODUCTION Malignant tumors of the urinary tract are associated with high morbidity and mortality, and their prevalence can vary worldwide. Recently, the IDENTIFY study has published results on the prevalence of urinary tract cancer at a global level. This study evaluates the prevalence of cancer within the Spanish cohort of the IDENTIFY study to determine whether the published results can be extrapolated to our population. PATIENTS AND METHODS An analysis of the data from the Spanish cohort of patients in the IDENTIFY study was performed. This is a prospective cohort of patients referred to secondary care with suspected cancer, predominantly due to hematuria. Patients were recruited between December 2017 and December 2018. RESULTS A total of 706 patients from 9 Spanish centers were analyzed. Of these, 277 (39.2%) were diagnosed with cancer: 259 (36.7%) bladder cancer, 10 (1.4%) upper tract urothelial carcinoma, 9 (1.2%) renal cancer and 5 (0.7%) prostate cancer. Increasing age (OR 1.05 (95% CI 1.03-1.06; P < 0.001)), visible hematuria (VH) OR 2.19 (95% CI 1.13-4.24; P = 0.02)) and smoking (ex-smokers: OR 2.11(95% CI 1.30-3.40; P = 0.002); smokers: OR 2.36 (95% CI 1.40-3.95; P = 0.001)) were associated with higher probability of bladder cancer. CONCLUSION This study highlights the risk of bladder cancer in patients with VH and smoking habits. Bladder cancer presented the highest prevalence; higher than the prevalence reported in previous series and presented in the IDENTIFY study. Future work should evaluate other associated factors that allow us to create cancer prediction models to improve the detection of cancer in our patients.
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Affiliation(s)
- C Toribio-Vázquez
- Servicio de Urología, Hospital Universitario La Paz, Madrid, Spain; Universidad Autónoma de Madrid, Madrid, Spain.
| | - J Gómez Rivas
- Servicio de Urología, Hospital Universitario Clínico San Carlos, Madrid, Spain
| | - F Amigo
- Institut Hospital del Mar d''Investigacions Mèdiques, Barcelona, Spain
| | - D M Carrión
- Servicio de Urología, Hospital Universitario La Paz, Madrid, Spain
| | - Á Yebes
- Servicio de Urología, Hospital Universitario La Paz, Madrid, Spain
| | | | - H Ayllon
- Servicio de Urología, Hospital Universitario La Paz, Madrid, Spain
| | - A Aguilera
- Servicio de Urología, Hospital Universitario La Paz, Madrid, Spain; Universidad Autónoma de Madrid, Madrid, Spain
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12
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Mori K, Hatakeyama S, Enokida H, Miyake H, Kikuchi E, Nishiyama H, Ichikawa T, Kamai T, Kaji Y, Kume H, Kondo T, Matsuyama H, Masumori N, Kawauchi A, Takenaka A, Uemura H, Eto M, Nonomura N, Fujii Y, Hinotsu S, Ohyama C. Summary of the Clinical Practice Guidelines for Upper Tract Urothelial Carcinoma 2023 by the Japanese Urological Association. Int J Urol 2024; 31:194-207. [PMID: 38113344 DOI: 10.1111/iju.15362] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Accepted: 11/26/2023] [Indexed: 12/21/2023]
Abstract
This article is an English translation of the Clinical Practice Guidelines for Upper Tract Urothelial Carcinoma (2nd edition) published in June 2023. The Japanese Urological Association's (JUA) Guidelines Committee on Upper Tract Urothelial Carcinoma (UTUC) created a 2023 update guideline to support clinicians' current evidence-based management of UTUC and to incorporate its recommendations into clinical practice. The new guideline adhered as closely as possible to the Minds Manual for Guideline Development 2020 ver. 3.0. Findings related to epidemiological, pathological, diagnosis, treatment, and follow-up were reviewed. In addition, seven clinical questions (CQs) were set to determine the grade of recommendation and level of evidence. Preconceptions and biases were removed from the preparation process, the overall evidence was evaluated appropriately, and recommendations were made after fully considering the balance between benefits and harms. Although the evidence is still insufficient to be taken up as a CQ, the latest important information is described in seven columns, and clinical issues that should be resolved in the future related to the CQ are described as recommendations for tomorrow. We hope that these guidelines will help medical professionals, patients, and their families involved in the treatment of UTUC in their decision-making, and hope that a critical review of these guidelines will lead to further refinements in the next edition.
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Affiliation(s)
- Kazuyuki Mori
- Department of Urology, Hirosaki University Graduate School of Medicine, Hirosaki, Aomori, Japan
| | - Shingo Hatakeyama
- Department of Urology, Hirosaki University Graduate School of Medicine, Hirosaki, Aomori, Japan
| | - Hideki Enokida
- Department of Urology, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Kagoshima, Japan
| | - Hideaki Miyake
- Department of Urology, Hamamatsu University School of Medicine, Hamamatsu, Shizuoka, Japan
| | - Eiji Kikuchi
- Department of Urology, St. Marianna University School of Medicine, Kawasaki, Kanagawa, Japan
| | - Hiroyuki Nishiyama
- Department of Urology, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan
| | - Tomohiko Ichikawa
- Department of Urology, Graduate School of Medicine, Chiba University, Chiba, Chiba, Japan
| | - Takao Kamai
- Department of Urology, Dokkyo Medical University, Mibu, Tochigi, Japan
| | - Yasushi Kaji
- Department of Radiology, Shimane University Faculty of Medicine, Izumo, Shimane, Japan
| | - Haruki Kume
- Department of Urology, Graduate School of Medicine, The University of Tokyo, Bunkyo, Tokyo, Japan
| | - Tsunenori Kondo
- Department of Urology, Tokyo Women's Medical University, Adachi Medical Center, Adachi, Tokyo, Japan
| | - Hideyasu Matsuyama
- Department of Urology, JA Yamaguchi Kouseiren Nagato General Hospital, Nagato, Yamaguchi, Japan
| | - Naoya Masumori
- Department of Urology, Sapporo Medical University, Sapporo, Hokkaido, Japan
| | | | - Atsushi Takenaka
- Division of Urology, Department of Surgery, Faculty of Medicine, Tottori University, Yonago, Tottori, Japan
| | - Hirotsugu Uemura
- Department of Urology, Kindai University Faculty of Medicine, Osakasayama, Osaka, Japan
| | - Masatoshi Eto
- Department of Urology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Fukuoka, Japan
| | - Norio Nonomura
- Department of Urology, Osaka University Graduate School of Medicine, Suita, Osaka, Japan
| | - Yasuhisa Fujii
- Department of Urology, Tokyo Medical and Dental University, Bunkyo, Tokyo, Japan
| | - Shiro Hinotsu
- Department of Biostatistics and Data Management, Sapporo Medical University, Sapporo, Hokkaido, Japan
| | - Chikara Ohyama
- Department of Urology, Hirosaki University Graduate School of Medicine, Hirosaki, Aomori, Japan
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13
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Dong Y, Wu X, Xu C, Hameed Y, Abdel-Maksoud MA, Almanaa TN, Kotob MH, Al-Qahtani WH, Mahmoud AM, Cho WC, Li C. Prognostic model development and molecular subtypes identification in bladder urothelial cancer by oxidative stress signatures. Aging (Albany NY) 2024; 16:2591-2616. [PMID: 38305808 PMCID: PMC10911378 DOI: 10.18632/aging.205499] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Accepted: 12/18/2023] [Indexed: 02/03/2024]
Abstract
BACKGROUND Mounting studies indicate that oxidative stress (OS) significantly contributes to tumor progression. Our study focused on bladder urothelial cancer (BLCA), an escalating malignancy worldwide that is growing rapidly. Our objective was to verify the predictive precision of genes associated with overall survival (OS) by constructing a model that forecasts outcomes for bladder cancer and evaluates the prognostic importance of these genetic markers. METHODS Transcriptomic data were obtained from TCGA-BLCA and GSE31684, which are components of the Cancer Genome Atlas (TCGA) and Gene Expression Omnibus (GEO), respectively. To delineate distinct molecular subtypes, we employed the non-negative matrix factorization (NMF)method. The significance of OS-associated genes in predicting outcomes was assessed using lasso regression, multivariate Cox analysis, and univariate Cox regression analysis. For external validation, we employed the GSE31684 dataset. CIBERSORT was utilized to examine the tumor immune microenvironment (TIME). A nomogram was created and verified using calibration and receiver operating characteristic (ROC) curves, which are based on risk signatures. We examined variations in clinical characteristics and tumor mutational burden (TMB) among groups classified as high-risk and low-risk. To evaluate the potential of immunotherapy, the immune phenomenon score (IPS) was computed based on the risk score. In the end, the pRRophetic algorithm was employed to forecast the IC50 values of chemotherapy medications. RESULTS In our research, we examined the expression of 275 genes associated with OS in 19 healthy and 414 cancerous tissues of the bladder obtained from the TCGA database. As a result, a new risk signature was created that includes 4 genes associated with OS (RBPMS, CRYAB, P4HB, and PDGFRA). We found two separate groups, C1 and C2, that showed notable variations in immune cells and stromal score. According to the Kaplan-Meier analysis, patients classified as high-risk experienced a considerably reduced overall survival in comparison to those categorized as low-risk (P<0.001). The predictive capability of the model was indicated by the area under the curve (AUC) of the receiver operating characteristic (ROC) curve surpassing 0.6. Our model showed consistent distribution of samples from both the GEO database and TCGA data. Both the univariate and multivariate Cox regression analyses validated the importance of the risk score in relation to overall survival (P < 0.001). According to our research, patients with a lower risk profile may experience greater advantages from using a CTLA4 inhibitor, whereas patients with a higher risk profile demonstrated a higher level of responsiveness to Paclitaxel and Cisplatin. In addition, methotrexate exhibited a more positive outcome in patients with low risk compared to those with high risk. CONCLUSIONS Our research introduces a novel model associated with OS gene signature in bladder cancer, which uncovers unique survival results. This model can assist in tailoring personalized treatment approaches and enhancing patient therapeutic effect in the management of bladder cancer.
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Affiliation(s)
- Ying Dong
- Department of Urology, The First Affiliated Hospital of Shenzhen University, Shenzhen Second People’s Hospital, Shenzhen, China
| | - Xiaoqing Wu
- Department of Oncology, Guang’anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Chaojie Xu
- Department of Urology, Peking University First Hospital, Peking University, Beijing, China
| | - Yasir Hameed
- Department of Biochemistry, Biotechnology, The Islamia University of Bahawalpur, Pakistan
| | - Mostafa A. Abdel-Maksoud
- Botany and Microbiology Department, College of Science, King Saud University, Riyadh, Saudi Arabia
| | - Taghreed N. Almanaa
- Botany and Microbiology Department, College of Science, King Saud University, Riyadh, Saudi Arabia
| | - Mohamed H. Kotob
- Department of Pharmaceutical Sciences, Division of Pharmacology and Toxicology, University of Vienna, Vienna, Austria
| | - Wahidah H. Al-Qahtani
- Department of Food Sciences and Nutrition, College of Food and Agricultural Sciences, King Saud University, Riyadh, Saudi Arabia
| | - Ayman M. Mahmoud
- Department of Life Sciences, Faculty of Science and Engineering, Manchester Metropolitan University, Manchester, United Kingdom
| | - William C. Cho
- Department of Clinical Oncology, Queen Elizabeth Hospital, Kowloon, Hong Kong, China
| | - Chen Li
- Department of Biology, Chemistry, Pharmacy, Free University of Berlin, Berlin, Germany
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14
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Zhang HP, Liang RX, Lin XY, Xue ES, Ye Q, Zhu YF. Application of contrast-enhanced ultrasound in diagnosis and grading of bladder urothelial carcinoma. BMC Med Imaging 2024; 24:26. [PMID: 38273224 PMCID: PMC10809509 DOI: 10.1186/s12880-024-01199-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2023] [Accepted: 01/11/2024] [Indexed: 01/27/2024] Open
Abstract
PURPOSE To explore the application of contrast-enhanced ultrasound (CEUS) for the diagnosis and grading of bladder urothelial carcinoma (BUC). METHODS The results of a two-dimensional ultrasound, color Doppler ultrasound and CEUS, were analyzed in 173 bladder lesion cases. The ultrasound and surgical pathology results were compared, and their diagnostic efficacy was analyzed. RESULTS There were statistically significant differences between BUC and benign lesions in terms of color blood flow distribution intensity and CEUS enhancement intensity (both P < 0.05). The area under the time-intensity curve (AUC), rising slope, and peak intensity of BUC were significantly higher than those of benign lesions (all P < 0.05). The H/T (height H / basal width T)value of 0.63 was the critical value for distinguishing high- and low-grade BUC, had a diagnostic sensitivity of 80.0% and a specificity of 60.0%. CONCLUSION The combination of CEUS and TIC can help improve the diagnostic accuracy of BUC. There is a statistically significant difference between high- and low-grade BUC in contrast enhancement intensity (P < 0.05); The decrease of H/T value indicates the possible increase of the BUC grade.
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Affiliation(s)
- Hui-Ping Zhang
- Department of Ultrasound, Fujian Medical University Union Hospital, Antai Street & Xin Quan Road 29, Fuzhou, Fujian Province, China
| | - Rong-Xi Liang
- Department of Ultrasound, Fujian Medical University Union Hospital, Antai Street & Xin Quan Road 29, Fuzhou, Fujian Province, China
| | - Xue-Ying Lin
- Department of Ultrasound, Fujian Medical University Union Hospital, Antai Street & Xin Quan Road 29, Fuzhou, Fujian Province, China
| | - En-Sheng Xue
- Department of Ultrasound, Fujian Medical University Union Hospital, Antai Street & Xin Quan Road 29, Fuzhou, Fujian Province, China
| | - Qin Ye
- Department of Ultrasound, Fujian Medical University Union Hospital, Antai Street & Xin Quan Road 29, Fuzhou, Fujian Province, China.
| | - Yi-Fan Zhu
- Department of Ultrasound, Fujian Medical University Union Hospital, Antai Street & Xin Quan Road 29, Fuzhou, Fujian Province, China
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15
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Zin Aung K, Hlaing STM, Damayanti P, Tabassum T, Tsukino H, Hinoura T, Kuroda Y. Transporter Associated With Antigen Processing (TAP) 1 Gene Polymorphisms and Risks of Urothelial Cell Carcinoma Among the Japanese Population. Cureus 2024; 16:e52310. [PMID: 38357083 PMCID: PMC10866181 DOI: 10.7759/cureus.52310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/15/2024] [Indexed: 02/16/2024] Open
Abstract
Urothelial cell carcinoma is one of the costliest types of cancer because of its recurrence, lengthy course of therapy, and tendency to lead to further complications. Gene polymorphisms are one of many factors that are thought to cause the carcinogenesis of urothelial cell carcinoma. Two single-nucleotide polymorphisms (SNPs) of the transporter associated with antigen processing (TAP) 1 gene and their relationship with the risks of urothelial cell carcinoma in the Japanese population were examined in this study by using polymerase chain reaction (PCR), restriction fragment length polymorphism (RFLP) for genotyping and statistical analysis. The adjusted odd ratios with 95% confidence interval (CI) of the mutant types (A/G+G/G) in females for the I333V and D637G polymorphisms are 2.28 (1.11-4.66) and 2.50 (1.21-5.17), respectively. The findings showed that females with the (A/G+G/G) genotype are more likely to develop urothelial cell carcinoma than those with the A/A genotype. Any correlation between smoking and gene polymorphism was absent. Results indicate that TAP1 gene polymorphisms and the risk of urothelial cell carcinoma are related in females.
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Affiliation(s)
- Khine Zin Aung
- Department of Biostatistics, University of Kentucky College of Medicine, Lexington, USA
- Department of Public Health, Faculty of Medicine, University of Miyazaki, Miyazaki, JPN
| | - Sa Tin Myo Hlaing
- Department of Public Health, Faculty of Medicine, University of Miyazaki, Miyazaki, JPN
| | - Putri Damayanti
- Department of Public Health, Faculty of Medicine, University of Miyazaki, Miyazaki, JPN
| | - Tamanna Tabassum
- Department of Public Health, Faculty of Medicine, University of Miyazaki, Miyazaki, JPN
| | - Hiromasa Tsukino
- Department of Urology, Junwakai Memorial Hospital, Miyazaki, JPN
| | - Takuji Hinoura
- Department of Public Health, Faculty of Medicine, University of Miyazaki, Miyazaki, JPN
| | - Yoshiki Kuroda
- Department of Public Health, Faculty of Medicine, University of Miyazaki, Miyazaki, JPN
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16
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Myoen S, Mochizuki M, Shibuya-Takahashi R, Fujimori H, Shindo N, Yamaguchi K, Yasuda J, Abe J, Imai T, Sato I, Adachi H, Kawamura S, Ito A, Tamai K. CD271 promotes proliferation and migration in bladder cancer. Genes Cells 2024; 29:73-85. [PMID: 38016691 DOI: 10.1111/gtc.13087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Revised: 11/08/2023] [Accepted: 11/15/2023] [Indexed: 11/30/2023]
Abstract
Bladder cancer is a urothelial cancer and effective therapeutic strategies for its advanced stages are limited. Here, we report that CD271, a neurotrophin receptor, promotes the proliferation and migration of bladder cancer cells. CD271 knockdown decreased proliferation in both adherent and spheroid cultures, and vice versa when CD271 was overexpressed in bladder cancer cell lines. CD271 depletion impaired tumorigenicity in vivo. Migration activity was reduced by CD271 knockdown and TAT-Pep5, a known CD271-Rho GDI-binding inhibitor. Apoptosis was induced by CD271 knockdown. Comprehensive gene expression analysis revealed alterations in E2F- and Myc-related pathways upon CD271 expression. In clinical cases, patients with high CD271 expression showed significantly shortened overall survival. In surgically resected specimens, pERK, a known player in proliferation signaling, colocalizes with CD271. These data indicate that CD271 is involved in bladder cancer malignancy by promoting cell proliferation and migration, resulting in poor prognosis.
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Affiliation(s)
- Shingo Myoen
- Division of Cancer Stem Cell, Miyagi Cancer Center Research Institute, Natori, Miyagi, Japan
- Division of Urology, Miyagi Cancer Center, Natori, Miyagi, Japan
- Department of Urology, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan
| | - Mai Mochizuki
- Division of Cancer Stem Cell, Miyagi Cancer Center Research Institute, Natori, Miyagi, Japan
| | - Rie Shibuya-Takahashi
- Division of Cancer Stem Cell, Miyagi Cancer Center Research Institute, Natori, Miyagi, Japan
| | - Haruna Fujimori
- Division of Cancer Stem Cell, Miyagi Cancer Center Research Institute, Natori, Miyagi, Japan
| | - Norihisa Shindo
- Division of Molecular and Cellular Oncology, Miyagi Cancer Center Research Institute, Natori, Miyagi, Japan
| | - Kazunori Yamaguchi
- Division of Molecular and Cellular Oncology, Miyagi Cancer Center Research Institute, Natori, Miyagi, Japan
| | - Jun Yasuda
- Division of Molecular and Cellular Oncology, Miyagi Cancer Center Research Institute, Natori, Miyagi, Japan
| | - Jiro Abe
- Division of Thoracic Surgery, Miyagi Cancer Center, Natori, Miyagi, Japan
| | - Takayuki Imai
- Division of Head and Neck Surgery, Miyagi Cancer Center, Natori, Miyagi, Japan
| | - Ikuro Sato
- Division of Pathology, Miyagi Cancer Center, Natori, Miyagi, Japan
| | - Hisanobu Adachi
- Division of Urology, Miyagi Cancer Center, Natori, Miyagi, Japan
| | | | - Akihiro Ito
- Department of Urology, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan
| | - Keiichi Tamai
- Division of Cancer Stem Cell, Miyagi Cancer Center Research Institute, Natori, Miyagi, Japan
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Masaoka H, Matsuo K, Oze I, Kimura T, Tamakoshi A, Sugawara Y, Tsuji I, Sawada N, Tsugane S, Ito H, Wada K, Nagata C, Kitamura T, Zha L, Sakata R, Ozasa K, Lin Y, Mizoue T, Tanaka K, Abe SK, Inoue M. Cigarette Smoking, Smoking Cessation, and Bladder Cancer Risk: A Pooled Analysis of 10 Cohort Studies in Japan. J Epidemiol 2023; 33:582-588. [PMID: 36310059 PMCID: PMC10518381 DOI: 10.2188/jea.je20220085] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Accepted: 10/11/2022] [Indexed: 09/29/2023] Open
Abstract
BACKGROUND Although cigarette smoking is an established risk factor for bladder cancer, assessment of smoking impact on bladder cancer in Asian populations has been hindered by few cohort studies conducted in Asian populations. Therefore, we investigated the risk of bladder cancer associated with smoking status, cumulative smoking intensity, and smoking cessation in Japan. METHODS We analyzed data for 157,295 men and 183,202 women in 10 population-based cohort studies in Japan. The risk associated with smoking behaviors was estimated using Cox regression models within each study, and pooled hazard ratios (HRs) and their 95% confidence intervals (CIs) for the incidence of bladder cancer were calculated. RESULTS During 4,729,073 person-years of follow-up, 936 men and 325 women developed bladder cancer. In men, former smokers (HR 1.47; 95% CI, 1.18-1.82) and current smokers (HR 1.96; 95% CI, 1.62-2.38) had higher risk than never smokers. In women, current smokers had higher risk than never smokers (HR 2.35; 95% CI, 1.67-3.32). HRs in men linearly increased with increasing pack-years. Risk decreased with increasing years of smoking cessation in men, with a significant dose-response trend. Former smokers with a duration of more than 10 years after smoking cessation had no significantly increased risk compared with never smokers (HR 1.26; 95% CI, 0.97-1.63). CONCLUSION Data from a pooled analysis of 10 population-based cohort studies in Japan clearly show an association between cigarette smoking and bladder cancer risk. The risk of smokers may approximate that of never smokers following cessation for many years.
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Affiliation(s)
- Hiroyuki Masaoka
- Division of Cancer Epidemiology and Prevention, Department of Preventive Medicine, Aichi Cancer Center Research Institute, Nagoya, Japan
- Department of Urology, Kyushu Central Hospital, Fukuoka, Japan
| | - Keitaro Matsuo
- Division of Cancer Epidemiology and Prevention, Department of Preventive Medicine, Aichi Cancer Center Research Institute, Nagoya, Japan
- Department of Epidemiology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Isao Oze
- Division of Cancer Epidemiology and Prevention, Department of Preventive Medicine, Aichi Cancer Center Research Institute, Nagoya, Japan
| | - Takashi Kimura
- Department of Public Health, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - Akiko Tamakoshi
- Department of Public Health, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - Yumi Sugawara
- Division of Epidemiology, Department of Health Informatics and Public Health, Tohoku University School of Public Health, Graduate School of Medicine, Sendai, Japan
| | - Ichiro Tsuji
- Division of Epidemiology, Department of Health Informatics and Public Health, Tohoku University School of Public Health, Graduate School of Medicine, Sendai, Japan
| | - Norie Sawada
- Division of Cohort Research, National Cancer Center Institute for Cancer Control, Tokyo, Japan
| | - Shoichiro Tsugane
- Division of Cohort Research, National Cancer Center Institute for Cancer Control, Tokyo, Japan
| | - Hidemi Ito
- Department of Epidemiology, Nagoya University Graduate School of Medicine, Nagoya, Japan
- Division of Cancer Information and Control, Department of Preventive Medicine, Aichi Cancer Center Research Institute, Nagoya, Japan
| | - Keiko Wada
- Department of Epidemiology and Preventive Medicine, Gifu University Graduate School of Medicine, Gifu, Japan
| | - Chisato Nagata
- Department of Epidemiology and Preventive Medicine, Gifu University Graduate School of Medicine, Gifu, Japan
| | - Tetsuhisa Kitamura
- Division of Environmental Medicine and Population Sciences, Department of Social and Environmental Medicine, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Ling Zha
- Division of Environmental Medicine and Population Sciences, Department of Social and Environmental Medicine, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Ritsu Sakata
- Department of Epidemiology, Radiation Effects Research Foundation, Hiroshima, Japan
| | - Kotaro Ozasa
- Department of Epidemiology, Radiation Effects Research Foundation, Hiroshima, Japan
| | - Yingsong Lin
- Department of Public Health, Aichi Medical University School of Medicine, Aichi, Japan
| | - Tetsuya Mizoue
- Department of Epidemiology and Prevention, Center for Clinical Sciences, National Center for Global Health and Medicine, Tokyo, Japan
| | - Keitaro Tanaka
- Department of Preventive Medicine, Faculty of Medicine, Saga University, Saga, Japan
| | - Sarah Krull Abe
- Division of Prevention, National Cancer Center Institute for Cancer Control, Tokyo, Japan
| | - Manami Inoue
- Division of Cohort Research, National Cancer Center Institute for Cancer Control, Tokyo, Japan
- Division of Prevention, National Cancer Center Institute for Cancer Control, Tokyo, Japan
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18
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Shuai H, Duan X, Zhou JJ, Liu Y, Wu T. Effect of the TERT mutation on the prognosis of patients with urothelial carcinoma: a systematic review and meta-analysis. BMC Urol 2023; 23:177. [PMID: 37915019 PMCID: PMC10621162 DOI: 10.1186/s12894-023-01349-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Accepted: 10/23/2023] [Indexed: 11/03/2023] Open
Abstract
BACKGROUND Telomerase reverse transcriptase (TERT) mutation represents the most prevalent genetic mutation found in urothelial carcinoma (UC) and holds potential as a prognostic indicator for tumor outcomes. However, the association between TERT mutation and prognosis in UC patients remains poorly elucidated due to conflicting findings in existing literature. Therefore, this study aimed to investigate the effect of the TERT mutation on the survival of UC patients. METHODS We systematically searched the PubMed, Embase, and Cochrane Library databases for studies that investigated the relationship between the TERT mutation and the prognosis of UC patients. Endpoints included the 2-year and 5-year recurrence-free survival (RFS) and overall survival (OS). The Newcastle-Ottawa Scale (NOS) tool was used to assess the risk of bias in the included studies. Review Manager 5.3 was used for the meta-analysis. RESULTS Nine studies with a total of 1,552 patients were included in the analysis. Two studies were prospective, and seven were retrospective. The TERT promoter mutation was associated with a lower 2-year OS (relative risk [RR] = 0.92, 95% confidence interval [CI] 0.86-0.98; P = 0.007) and a lower 5-year OS (RR = 0.80, 95% CI 0.68-0.94; P = 0.008) compared with the TERT wild type. However, no significantly differences were found between two groups in terms of HR for OS (hazard ratio [HR] = 1.29, 95% CI 0.80-2.08; P = 0.29). Furthermore, we investigated the differences in RFS and disease-specific survival (DSS) between the two groups. CONCLUSION The TERT mutation increases the risk of death and decreases the survival time of UC patients. TERT may be a valuable marker with individual prognostic value.
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Grants
- 20SXQT0305, 18SXHZ0321 the City of Nanchong Strategic Cooperation with the Local Universities Foundation of Technology
- 20SXQT0305, 18SXHZ0321 the City of Nanchong Strategic Cooperation with the Local Universities Foundation of Technology
- 20SXQT0305, 18SXHZ0321 the City of Nanchong Strategic Cooperation with the Local Universities Foundation of Technology
- 20SXQT0305, 18SXHZ0321 the City of Nanchong Strategic Cooperation with the Local Universities Foundation of Technology
- 20SXQT0305, 18SXHZ0321 the City of Nanchong Strategic Cooperation with the Local Universities Foundation of Technology
- 2020YJ0185, 2022NSFSC0804 the Application and Basic Research Program of the Sichuan Science and Technology Department
- 2020YJ0185, 2022NSFSC0804 the Application and Basic Research Program of the Sichuan Science and Technology Department
- 2020YJ0185, 2022NSFSC0804 the Application and Basic Research Program of the Sichuan Science and Technology Department
- 2020YJ0185, 2022NSFSC0804 the Application and Basic Research Program of the Sichuan Science and Technology Department
- 2020YJ0185, 2022NSFSC0804 the Application and Basic Research Program of the Sichuan Science and Technology Department
- SWFZ21-C-98 the Primary Health Development Research Center of Sichuan Province Program
- SWFZ21-C-98 the Primary Health Development Research Center of Sichuan Province Program
- SWFZ21-C-98 the Primary Health Development Research Center of Sichuan Province Program
- SWFZ21-C-98 the Primary Health Development Research Center of Sichuan Province Program
- SWFZ21-C-98 the Primary Health Development Research Center of Sichuan Province Program
- S21061 the Medical Research Project of the Sichuan Medical Association
- S21061 the Medical Research Project of the Sichuan Medical Association
- S21061 the Medical Research Project of the Sichuan Medical Association
- S21061 the Medical Research Project of the Sichuan Medical Association
- S21061 the Medical Research Project of the Sichuan Medical Association
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Affiliation(s)
- Hui Shuai
- Department of Urology, Affiliated Hospital of North Sichuan Medical College, Wenhua Road 57, Shunqing District, Nanchong, Sichuan, 637000, People's Republic of China
| | - Xi Duan
- Department of Dermatology, Affiliated Hospital of North Sichuan Medical College, No. 1 Maoyuan South Road, Shunqing, Nanchong, Sichuan, 637000, People's Republic of China
| | - Jun-Jie Zhou
- Department of Urology, Affiliated Hospital of North Sichuan Medical College, Wenhua Road 57, Shunqing District, Nanchong, Sichuan, 637000, People's Republic of China
| | - Yuan Liu
- Department of Urology, Affiliated Hospital of North Sichuan Medical College, Wenhua Road 57, Shunqing District, Nanchong, Sichuan, 637000, People's Republic of China
| | - Tao Wu
- Department of Urology, Affiliated Hospital of North Sichuan Medical College, Wenhua Road 57, Shunqing District, Nanchong, Sichuan, 637000, People's Republic of China.
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Santini D, Banna GL, Buti S, Isella L, Stellato M, Roberto M, Iacovelli R. Navigating the Rapidly Evolving Advanced Urothelial Carcinoma Treatment Landscape: Insights from Italian Experts. Curr Oncol Rep 2023; 25:1345-1362. [PMID: 37855848 PMCID: PMC10640402 DOI: 10.1007/s11912-023-01461-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/04/2023] [Indexed: 10/20/2023]
Abstract
PURPOSE OF REVIEW To discuss recent advances in the treatment of advanced urothelial carcinoma (UC) and how best to incorporate new therapies into clinical practice. RECENT FINDINGS There have been several recent practice-changing phase 2 and 3 trials of immune checkpoint inhibitors (ICIs), antibody-drug conjugates (ADCs), and targeted agents in advanced UC. Based on data from these trials, ICIs can be used as first-line maintenance therapy in patients who do not progress on platinum-based chemotherapy, second-line therapy for those with progression, and first-line therapy in cisplatin-ineligible patients with PD-L1 expression; ADCs and targeted agents provide later-line treatment options. Despite substantial progress in the treatment of advanced UC, there are still many uncertainties, including the optimal treatment sequence for novel agents, and reliable predictive biomarkers to aid in treatment selection. There is also an unmet need for effective treatment options in patients unfit for any platinum-based chemotherapy.
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Affiliation(s)
- Daniele Santini
- Medical Oncology A, University of Rome, Policlinico Umberto I, "La Sapienza, Rome, Italy
| | - Giuseppe Luigi Banna
- Portsmouth Hospitals University NHS Trust, Portsmouth, PO6 3LY, UK
- Faculty of Science and Health, School of Pharmacy and Biomedical Sciences, University of Portsmouth, Portsmouth, PO1 2UP, UK
| | - Sebastiano Buti
- Department of Medicine and Surgery, University of Parma, Viale A. Gramsci 14, 43126, Parma, Italy.
- Oncology Unit, University Hospital of Parma, Viale A. Gramsci 14, 43126, Parma, Italy.
| | - Luca Isella
- Department of Medicine and Surgery, University of Parma, Viale A. Gramsci 14, 43126, Parma, Italy
| | - Marco Stellato
- Medical Oncology Department, Fondazione IRCCS National Cancer Institute, Milan, Italy
| | - Michela Roberto
- UOC Oncology A, Department of Radiological, Oncological and Anatomo-Pathological Science, Policlinico Umberto I, "La Sapienza" University of Rome, Rome, Italy
| | - Roberto Iacovelli
- UOC Medical Oncology, Comprehensive Cancer Center, Fondazione Policlinico A. Gemelli IRCCS, Rome, Italy
- Department of Translational Medicine and Surgery, Università Cattolica del Sacro Cuore, Rome, Italy
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20
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Hlaing STM, Damayanti P, Zin Aung K, Tsukino H, Hinoura T, Kuroda Y. The Relationship Between PD-1(rs2227981) and PD-L1(rs2890658) Polymorphisms and Urothelial Cell Carcinoma. Cureus 2023; 15:e48120. [PMID: 38046711 PMCID: PMC10693471 DOI: 10.7759/cureus.48120] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/30/2023] [Indexed: 12/05/2023] Open
Abstract
Background Urothelial cell carcinoma, which is believed to develop from the urothelium (transitional epithelium), is the most common aggressive tumor and accounts for the ten most prevalent cancers in the world. The risk factors for urothelial cell carcinoma are aging, smoking, gender, and genetic alternations. Programmed cell death1 (PD-1) has been widely described as a negative regulator of T-cells by sending inhibitory signals to the T-cell. Through PD-1 binding with PD-L1 (ligand for PD-1), an inhibitory signal is propagated to the T cell. The polymorphisms of PD-1 and PD-L1 lead to an efficient T-cell response and affect an anti-tumor reaction. The polymorphisms of PD-1 and PD-L1 could also affect the carcinogenesis of human cancer, including urothelial cell carcinoma. Therefore, in this study, we evaluated the relation between PD-1(rs2227981) and PD-L1(rs2890658) polymorphisms and the carcinogenesis of urothelial cell carcinoma. Materials and methods This study was conducted using 211 healthy controls and 256 cases of urothelial cell carcinoma among the Japanese population. The DNA samples were extracted from the peripheral white blood cells of each subject. The genotype was detected by using the Polymerase Chain Reaction-Restriction Fragment Length Polymorphism (PCR-RFLP) method. Results C/T (Adjusted OR 1.55, 95% CI:1.02-2.35) and C/T+T/T (OR 1.46, 95% CI:1.01-2.12) genotypes of PD-1 rs2227981 were significant and risk factors for urothelial cancer. Male with A/A genotype in PD-L1 and CT genotype in PD-1 has a significant higher risk factor compared with other genotypes (Adjusted OR 1.83, 95% CI:1.05-3.21). Conclusions and discussion We found that C/T(PD-1) and "A/A (PD-L1) and C/T(PD-1)" were predominant in urothelial cell carcinoma cases. This indicates that C/T(PD-1) and "A/A (PD-L1) and C/T(PD-1)" genotypes could increase susceptibility to urothelial cell carcinoma. However, since our findings indicated that the effects of PD-1 and PD-L1 polymorphisms included discrepancies, additional research will be needed to evaluate the relationship between human cancer and PD-1 and PD-L1 polymorphisms. This is the first study that seeks to find the relation between PD-1(rs2227981) and PD-L1(rs2890658) polymorphisms concerning urothelial cell carcinoma among the Japanese population.
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Affiliation(s)
- Sa Tin Myo Hlaing
- Department of Public Health, Faculty of Medicine, University of Miyazaki, Miyazaki, JPN
| | - Putri Damayanti
- Department of Public Health, Faculty of Medicine, University of Miyazaki, Miyazaki, JPN
| | - Khine Zin Aung
- Department of Public Health, Faculty of Medicine, University of Miyazaki, Miyazaki, JPN
| | - Hiromasa Tsukino
- Department of Urology, Junwakai Memorial Hospital, Miyazaki, JPN
| | - Takuji Hinoura
- Department of Public Health, Faculty of Medicine, University of Miyazaki, Miyazaki, JPN
| | - Yoshiki Kuroda
- Department of Public Health, Faculty of Medicine, University of Miyazaki, Miyazaki, JPN
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21
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Damayanti P, Hlaing STM, Zin Aung K, Tsukino H, Hinoura T, Kuroda Y. The Relationship Between CTLA-4 (-318 C/T) Polymorphism and Urothelial Cancer Carcinogenesis in Japanese Patients. Cureus 2023; 15:e48068. [PMID: 38046481 PMCID: PMC10689122 DOI: 10.7759/cureus.48068] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/28/2023] [Indexed: 12/05/2023] Open
Abstract
Background Urothelial cancer is one of the most common types of urinary system cancer and there are several factors that can influence its growth. One of the most prominent factors among these is genetics. The Cytotoxic T-Lymphocyte Antigen-4 (CTLA-4) gene is suspected to be a susceptibility gene in urothelial carcinoma. The aim of this study is to investigate polymorphism in the CTLA-4 gene (CTLA-4 -318 C/T) and whether it is associated with urothelial cancer. Methods The study population consisted of 253 cases and 272 controls. In this case-control study, DNA was extracted from peripheral blood cells, and the CTLA-4 -318C/T genotypes were detected using polymerase chain reaction-restriction fragment length polymorphism. Results C/T (adjusted OR (aOR) 3.37; 95%CI: 1.98-5.74) genotype, C/T + T/T (aOR 3.25; 95%CI: 1.96-5.39) genotype, and T allele (aOR 2.94 95%CI: 1.87-4.62) all indicated they are significant risk factors for urothelial cancer, with the effects of polymorphism being higher in the nonsmoker group than in the smoker group. Furthermore, the association between polymorphism and urothelial cancer carcinogenesis was similar among men and women. Conclusions This is the first study examining the association between CTLA-4 -318C/T polymorphism and urothelial carcinoma in Japanese patients. A significant association between CTLA-4 -318C/T polymorphism and urothelial cancer among Japanese patients was detected in this study. This supports the development of research on polymorphisms in urothelial cancer and is an important root of immunoreactions in cancer. We believe this study will be beneficial to clarify the relationship between CTLA-4 polymorphism and urothelial cancer.
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Affiliation(s)
- Putri Damayanti
- Department of Public Health, Faculty of Medicine, University of Miyazaki, Miyazaki, JPN
| | - Sa Tin Myo Hlaing
- Department of Public Health, Faculty of Medicine, University of Miyazaki, Miyazaki, JPN
| | - Khine Zin Aung
- Department of Public Health, Faculty of Medicine, University of Miyazaki, Miyazaki, JPN
| | - Hiromasa Tsukino
- Department of Urology, Junwakai Memorial Hospital, Miyazaki, JPN
| | - Takuji Hinoura
- Department of Public Health, Faculty of Medicine, University of Miyazaki, Miyazaki, JPN
| | - Yoshiki Kuroda
- Department of Public Health, Faculty of Medicine, University of Miyazaki, Miyazaki, JPN
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Nishiyama H, Tsuzuki T, Ohyama C, Matsuyama H, Shinozaki K, Hayashi Y, Hayashi N, Koto R, Shin E, Ogawa O. Tumor immune microenvironment and clinical outcomes in stage IV urothelial cancer: YODO study. Int J Clin Oncol 2023; 28:1398-1410. [PMID: 37498492 PMCID: PMC10543076 DOI: 10.1007/s10147-023-02386-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Accepted: 07/02/2023] [Indexed: 07/28/2023]
Abstract
BACKGROUND Bladder cancer is the 10th most common cancer globally, with a growing incidence in Japan. Evaluation of molecular, genetic, and cellular biomarkers that predict treatment response and prognosis in patients with metastatic urothelial carcinoma (mUC) may help optimize sequential treatment strategies with chemotherapy and immune checkpoint inhibitors (ICIs). METHODS This multicenter, retrospective cohort study, evaluated programmed death-ligand 1 (PD-L1) expression, tumor mutational burden (TMB), and cancer-immune phenotype as predictive prognostic biomarkers following first-/second-line treatment in Japanese adult patients with mUC. The primary endpoint was prevalence of PD-L1 expression. Secondary endpoints were TMB, overall survival (OS), and progression-free survival (PFS) from initiation of first-line treatment, and exploratory endpoints were cancer-immune phenotype, OS, PFS, and treatment response according to potential biomarker status. RESULTS Of the 143 patients included (mean age 71.7 years), PD-L1 expression was high in 29.4% of patients. Non-synonymous TMB was high in 33.6% and low in 66.4%. Cancer-immune phenotype was immune-desert in 62.9%, immune-excluded in 30.8%, and inflamed in 6.3%. Median OS and PFS following first-line treatment were 18.2 and 7.4 months, respectively. Overall response to second-line treatment was slightly better with high versus low/negative PD-L1 expression. PD-L1 expression and TMB were non-significant predictors of OS or PFS, whereas immune-excluded phenotype was associated with better OS in comparison with immune-desert phenotype. CONCLUSION PD-L1 expression and TMB were non-significant predictors of prognosis after first-line treatment in Japanese patients with mUC, but cancer-immune phenotype may be an important prognostic factor in chemotherapy-ICI sequential treatment strategies. Clinical trial registration number UMIN000037727.
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Affiliation(s)
- Hiroyuki Nishiyama
- Department of Urology, University of Tsukuba, 2-1-1 Amakubo, Tsukuba, Ibaraki 305-8576 Japan
| | - Toyonori Tsuzuki
- Department of Surgical Pathology, Aichi Medical University, 1-1 Yazakokarimata, Nagakute, Aichi 480-1195 Japan
| | - Chikara Ohyama
- Department of Urology, Hirosaki University, 5 Zaifu-Cho, Hirosaki, Aomori 036-8562 Japan
| | - Hideyasu Matsuyama
- Department of Urology, Graduate School of Medicine, Yamaguchi University, 1-1-1 Minamikogushi, Ube, Yamaguchi 755-8505 Japan
| | - Kenta Shinozaki
- AstraZeneca K.K, 3-1 Ofukacho, Kita-Ku, Osaka, 530-0011 Japan
| | - Yuko Hayashi
- AstraZeneca K.K, 3-1 Ofukacho, Kita-Ku, Osaka, 530-0011 Japan
| | - Nobuya Hayashi
- AstraZeneca K.K, 3-1 Ofukacho, Kita-Ku, Osaka, 530-0011 Japan
| | - Ryo Koto
- AstraZeneca K.K, 3-1 Ofukacho, Kita-Ku, Osaka, 530-0011 Japan
| | - Eisei Shin
- AstraZeneca K.K, 3-1 Ofukacho, Kita-Ku, Osaka, 530-0011 Japan
| | - Osamu Ogawa
- Department of Urology, Japanese Red Cross Otsu Hospital, 1-1-35 Nagara, Otsu, Shiga 520-8511 Japan
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Izzo P, Izzo L, Lai S, D’Onghia G, Giancontieri P, Gabriele R, Polistena A, Sibio S, Costanzo ML, De Intinis C, Izzo S. Nodular cutaneous metastasis of the leg in advanced urothelial bladder carcinoma: a case report and systematic literature review. Front Oncol 2023; 13:1216725. [PMID: 37675233 PMCID: PMC10477776 DOI: 10.3389/fonc.2023.1216725] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Accepted: 08/02/2023] [Indexed: 09/08/2023] Open
Abstract
Cutaneous metastases from urothelial carcinoma (UC) are very rare and indicate advanced disease with a poor prognosis. A 63-year-old female patient with a history of urothelial bladder carcinoma, treated 2 months prior with radical cystectomy and adjuvant gemcitabine and cisplatin (GC) therapy, presented a skin lesion localized in the lower third of the right leg. Punch biopsy revealed carcinomatous metastasis whose urothelial origin was confirmed by immunohistochemical analysis. 18-FDG PET-CT showed the spread of metastases to the lung and left ischium. Our review focuses on the time between surgery and skin metastasis, localization, and prognosis after metastasis diagnosis. In many cases, skin metastases occur within one year of initial UC surgery and in most cases occur on the abdominal wall. Local wide excision of metastasis should be considered in selected cases; however, chemotherapy remains the main treatment.
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Affiliation(s)
- Paolo Izzo
- “Pietro Valdoni” Department of Surgery, Policlinico “Umberto I”, “Sapienza” University of Rome, Rome, Italy
| | - Luciano Izzo
- “Pietro Valdoni” Department of Surgery, Policlinico “Umberto I”, “Sapienza” University of Rome, Rome, Italy
| | - Silvia Lai
- Department of Translational and Precision Medicine, Nephrology Unit, Sapienza University of Rome, Rome, Italy
| | - Giuliano D’Onghia
- “Pietro Valdoni” Department of Surgery, Policlinico “Umberto I”, “Sapienza” University of Rome, Rome, Italy
| | - Paola Giancontieri
- Department of Radiological, Oncological and Anatomo-Pathological Sciences, Policlinico “Umberto I”, “Sapienza” University of Rome, Rome, Italy
| | - Raimondo Gabriele
- “Pietro Valdoni” Department of Surgery, Policlinico “Umberto I”, “Sapienza” University of Rome, Rome, Italy
| | - Andrea Polistena
- “Pietro Valdoni” Department of Surgery, Policlinico “Umberto I”, “Sapienza” University of Rome, Rome, Italy
| | - Simone Sibio
- “Pietro Valdoni” Department of Surgery, Policlinico “Umberto I”, “Sapienza” University of Rome, Rome, Italy
| | - Maria Ludovica Costanzo
- “Pietro Valdoni” Department of Surgery, Policlinico “Umberto I”, “Sapienza” University of Rome, Rome, Italy
| | - Claudia De Intinis
- “Pietro Valdoni” Department of Surgery, Policlinico “Umberto I”, “Sapienza” University of Rome, Rome, Italy
| | - Sara Izzo
- Multidisciplinary Department of Medical-Surgical and Dental Specialties, Plastic Surgery Unit, Università degli Studi della Campania “Luigi Vanvitelli”, Piazza Luigi Miraglia, Naples, Italy
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24
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Shafique MA, Haseeb A, Siddiq MA, Mussarat A, Rangwala HS, Mustafa MS. Current and Emerging Treatments for Urothelial Carcinoma: A Focus on Enfortumab Vedotin. Cancer Manag Res 2023; 15:699-706. [PMID: 37485038 PMCID: PMC10362867 DOI: 10.2147/cmar.s418009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Accepted: 07/17/2023] [Indexed: 07/25/2023] Open
Abstract
Urothelial carcinoma is a common malignancy that affects the urinary system, with bladder cancer being the most prevalent form. Although the management of early-stage disease has seen significant improvements, the treatment of locally advanced and metastatic urothelial carcinoma remains challenging. Over the past decade, there has been an explosion in the number of therapies available for the treatment of advanced disease, with immune checkpoint inhibitors and antibody-drug conjugates leading the way. Enfortumab vedotin is an antibody-drug conjugate that targets Nectin-4, a protein that is overexpressed in urothelial carcinoma cells. In clinical trials, it has shown promising outcomes for the treatment of advanced urothelial carcinoma that has progressed after chemotherapy or immunotherapy. The US Food and Drug Administration has granted expedited approval for enfortumab vedotin in the treatment of advanced urothelial carcinoma. This review provides an overview of the current and emerging treatments for urothelial carcinoma, with a particular focus on enfortumab vedotin. We discuss the mechanisms of action, clinical efficacy, safety, and ongoing research of enfortumab vedotin, along with the current landscape of other approved therapies and promising agents in development. The aim of this review is to provide a comprehensive and up-to-date summary of the available treatment options for urothelial carcinoma, including their limitations and future prospects.
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Affiliation(s)
| | - Abdul Haseeb
- Department of Medicine, Jinnah Sindh Medical University, Karachi, Pakistan
| | | | - Abdullah Mussarat
- Department of Medicine, Jinnah Sindh Medical University, Karachi, Pakistan
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Lucchesi CA, Vasilatis DM, Mantrala S, Chandrasekar T, Mudryj M, Ghosh PM. Pesticides and Bladder Cancer: Mechanisms Leading to Anti-Cancer Drug Chemoresistance and New Chemosensitization Strategies. Int J Mol Sci 2023; 24:11395. [PMID: 37511154 PMCID: PMC10380322 DOI: 10.3390/ijms241411395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Revised: 07/05/2023] [Accepted: 07/06/2023] [Indexed: 07/30/2023] Open
Abstract
Multiple risk factors have been associated with bladder cancer. This review focuses on pesticide exposure, as it is not currently known whether agricultural products have a direct or indirect effect on bladder cancer, despite recent reports demonstrating a strong correlation. While it is known that pesticide exposure is associated with an increased risk of bladder cancer in humans and dogs, the mechanism(s) by which specific pesticides cause bladder cancer initiation or progression is unknown. In this narrative review, we discuss what is currently known about pesticide exposure and the link to bladder cancer. This review highlights multiple pathways modulated by pesticide exposure with direct links to bladder cancer oncogenesis/metastasis (MMP-2, TGF-β, STAT3) and chemoresistance (drug efflux, DNA repair, and apoptosis resistance) and potential therapeutic tactics to counter these pesticide-induced affects.
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Affiliation(s)
- Christopher A. Lucchesi
- VA Northern California Health Care System, Mather, CA 95655, USA; (D.M.V.); (M.M.)
- Department of Surgical & Radiological Sciences, School of Veterinary Medicine, University of California Davis, Davis, CA 95616, USA
| | - Demitria M. Vasilatis
- VA Northern California Health Care System, Mather, CA 95655, USA; (D.M.V.); (M.M.)
- Department of Urological Surgery, School of Medicine, University of California Davis, Sacramento, CA 95817, USA
| | - Saisamkalpa Mantrala
- VA Northern California Health Care System, Mather, CA 95655, USA; (D.M.V.); (M.M.)
| | - Thenappan Chandrasekar
- Department of Urological Surgery, School of Medicine, University of California Davis, Sacramento, CA 95817, USA
| | - Maria Mudryj
- VA Northern California Health Care System, Mather, CA 95655, USA; (D.M.V.); (M.M.)
- Department of Medical Microbiology and Immunology, School of Medicine, University of California Davis, Davis, CA 95616, USA
| | - Paramita M. Ghosh
- VA Northern California Health Care System, Mather, CA 95655, USA; (D.M.V.); (M.M.)
- Department of Urological Surgery, School of Medicine, University of California Davis, Sacramento, CA 95817, USA
- Department of Biochemistry and Molecular Medicine, School of Medicine, University of California Davis, Sacramento, CA 95817, USA
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Chang Y, Hsu W, Lee Y, Chiang C, Yang Y, You S, Chen Y, Lai T. Trends and sex-specific incidence of upper urinary tract cancer in Taiwan: A birth cohort study. Cancer Med 2023; 12:15350-15357. [PMID: 37392179 PMCID: PMC10417072 DOI: 10.1002/cam4.6084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Revised: 04/22/2023] [Accepted: 05/04/2023] [Indexed: 07/03/2023] Open
Abstract
BACKGROUND Taiwan has one of the highest incidences of upper tract urothelial cancer (UTUC) worldwide, especially in women; however, no nationwide, long-term follow-up study has evaluated this. METHODS We investigated the incidence of UTUC in Taiwan using data from the national population-based Taiwan Cancer Registry database (1985-2019). We divided the birth cohort into nine 5-year age groups and calculated the age-specific incidence for these groups according to the corresponding birth years. RESULTS The average annual percent change in the incidence of renal pelvis cancer from 1985 to 2019 showed sex-specific differences, with 3.5% and 5.3% increases in the incidences in men and women, respectively. The age-specific incidence rate for renal pelvis cancer among women showed a gradual increase in the group with older women as well as an increase over time in each age group. The results of a birth cohort analysis revealed that younger cohorts had higher incidence rates of renal pelvis cancer than older cohorts did. CONCLUSION We demonstrated that the incidence of UTUC is unusually high among older Taiwanese women and that younger cohorts have a high risk of UTUC than older cohorts.
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Affiliation(s)
- Yu‐Hsuan Chang
- School of MedicineFu‐Jen Catholic UniversityNew Taipei CityTaiwan
| | - Wan‐Lun Hsu
- Data Science Center, College of MedicineFu‐Jen Catholic UniversityNew Taipei CityTaiwan
- Master Program of Big Data Analysis in Biomedicine, College of MedicineFu‐Jen Catholic UniversityNew Taipei CityTaiwan
| | - Yu‐Kwang Lee
- Department of Surgery, Division of General SurgeryNational Taiwan University HospitalTaipeiTaiwan
| | - Chun‐Ju Chiang
- Graduate Institute of Epidemiology and Preventive Medicine, College of Public HealthNational Taiwan UniversityTaipeiTaiwan
| | - Ya‐Wen Yang
- Graduate Institute of Epidemiology and Preventive Medicine, College of Public HealthNational Taiwan UniversityTaipeiTaiwan
| | - San‐Lin You
- School of MedicineFu‐Jen Catholic UniversityNew Taipei CityTaiwan
- Data Science Center, College of MedicineFu‐Jen Catholic UniversityNew Taipei CityTaiwan
| | - Yong‐Chen Chen
- Data Science Center, College of MedicineFu‐Jen Catholic UniversityNew Taipei CityTaiwan
- Master Program of Big Data Analysis in Biomedicine, College of MedicineFu‐Jen Catholic UniversityNew Taipei CityTaiwan
| | - Tai‐Shuan Lai
- Department of Internal MedicineNational Taiwan University HospitalTaipeiTaiwan
- Department of Internal Medicine, College of MedicineNational Taiwan UniversityTaipeiTaiwan
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Kumar R, Matulewicz R, Mari A, Moschini M, Ghodoussipour S, Pradere B, Rink M, Autorino R, Desai MM, Gill I, Cacciamani GE. Impact of smoking on urologic cancers: a snapshot of current evidence. World J Urol 2023; 41:1473-1479. [PMID: 37093319 PMCID: PMC10241723 DOI: 10.1007/s00345-023-04406-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Accepted: 04/06/2023] [Indexed: 04/25/2023] Open
Abstract
PURPOSE The purpose of this paper is to present evidence regarding the associations between smoking and the following urologic cancers: prostate, bladder, renal, and upper tract urothelial cancer (UTUC). METHODS This is a narrative review. PubMed was queried for evidence-based analyses and trials regarding the associations between smoking and prostate, bladder, renal, and UTUC tumors from inception to September 1, 2022. Emphasis was placed on articles referenced in national guidelines and protocols. RESULTS Prostate-multiple studies associate smoking with higher Gleason score, higher tumor stage, and extracapsular invasion. Though smoking has not yet been linked to tumorigenesis, there is evidence that it plays a role in biochemical recurrence and cancer-specific mortality. Bladder-smoking is strongly associated with bladder cancer, likely due to DNA damage from the release of carcinogenic compounds. Additionally, smoking has been linked to increased cancer-specific mortality and higher risk of tumor recurrence. Renal-smoking tobacco has been associated with tumorigenesis, higher tumor grade and stage, poorer mortality rates, and a greater risk of tumor recurrence. UTUC-tumorigenesis has been associated with smoking tobacco. Additionally, more advanced disease, higher stage, lymph node metastases, poorer survival outcomes, and tumor recurrence have been linked to smoking. CONCLUSION Smoking has been shown to significantly affect most urologic cancers and has been associated with more aggressive disease, poorer outcomes, and tumor recurrence. The role of smoking cessation is still unclear, but appears to provide some protective effect. Urologists have an opportunity to engage in primary prevention by encouraging cessation practices.
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Affiliation(s)
- Raj Kumar
- The Catherine and Joseph Aresty Department of Urology, USC Institute of Urology, Keck School of Medicine, University of Southern California, Los Angeles, USA
| | - Richard Matulewicz
- Department of Surgery, Urology Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Andrea Mari
- Department of Urology, Careggi Hospital, University of Florence, Florence, Italy
| | - Marco Moschini
- Department of Urology, La Croix du Sud Hospital, 31130, Quint Fonsegrives, France
| | - Saum Ghodoussipour
- Bladder and Urothelial Cancer Program, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, USA
| | - Benjamin Pradere
- Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria
| | - Michael Rink
- Department of Urology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Riccardo Autorino
- Division of Urology, Department of Surgery, Virginia Commonwealth University, Richmond, VA, USA
| | - Mihir M Desai
- The Catherine and Joseph Aresty Department of Urology, USC Institute of Urology, Keck School of Medicine, University of Southern California, Los Angeles, USA
| | - Inderbir Gill
- The Catherine and Joseph Aresty Department of Urology, USC Institute of Urology, Keck School of Medicine, University of Southern California, Los Angeles, USA
| | - Giovanni E Cacciamani
- The Catherine and Joseph Aresty Department of Urology, USC Institute of Urology, Keck School of Medicine, University of Southern California, Los Angeles, USA.
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Singh AM, Guevara-Patino JA, Wang X, Li R, Sonpavde G, Jain RK. Antibody-Drug Conjugates in the Treatment of Urothelial Cancer. BioDrugs 2023:10.1007/s40259-023-00606-5. [PMID: 37256534 DOI: 10.1007/s40259-023-00606-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/08/2023] [Indexed: 06/01/2023]
Abstract
Antibody-drug conjugates (ADCs) have transformed the treatment landscape in oncology and become an essential therapeutic modality. In urothelial carcinoma (UC), the two ADCs that have been especially successful in clinical practice are enfortumab vedotin and sacituzumab govitecan. These drugs are currently approved as monotherapy for later lines of treatment in locally advanced or metastatic UC and have had a significant impact for patients with limited treatment options. Combinational trials, as well as additional ADCs, are currently being investigated in the treatment of UC for subsequent lines of therapy as overall survival rates remain dismal.
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Affiliation(s)
- Avani M Singh
- Department of Hematology and Oncology, University of South Florida/Moffitt Cancer Center, Tampa, FL, USA
| | | | - Xuefeng Wang
- Department of Bioinformatics, H. Lee Moffitt Cancer Center, Tampa, FL, USA
| | - Roger Li
- Department of Genitourinary Oncology, H. Lee Moffitt Cancer Center, 12902 USF Magnolia Drive, Tampa, FL, 33647, USA
| | - Guru Sonpavde
- Division of Medical Oncology, Advent Health Cancer Institute, Orlando, FL, USA
| | - Rohit K Jain
- Department of Genitourinary Oncology, H. Lee Moffitt Cancer Center, 12902 USF Magnolia Drive, Tampa, FL, 33647, USA.
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Xie D, Jiang B, Wang S, Wang Q, Wu G. The mechanism and clinical application of DNA damage repair inhibitors combined with immune checkpoint inhibitors in the treatment of urologic cancer. Front Cell Dev Biol 2023; 11:1200466. [PMID: 37305685 PMCID: PMC10248030 DOI: 10.3389/fcell.2023.1200466] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Accepted: 05/18/2023] [Indexed: 06/13/2023] Open
Abstract
Urologic cancers such as kidney, bladder, prostate, and uroepithelial cancers have recently become a considerable global health burden, and the response to immunotherapy is limited due to immune escape and immune resistance. Therefore, it is crucial to find appropriate and effective combination therapies to improve the sensitivity of patients to immunotherapy. DNA damage repair inhibitors can enhance the immunogenicity of tumor cells by increasing tumor mutational burden and neoantigen expression, activating immune-related signaling pathways, regulating PD-L1 expression, and reversing the immunosuppressive tumor microenvironment to activate the immune system and enhance the efficacy of immunotherapy. Based on promising experimental results from preclinical studies, many clinical trials combining DNA damage repair inhibitors (e.g., PARP inhibitors and ATR inhibitors) with immune checkpoint inhibitors (e.g., PD-1/PD-L1 inhibitors) are underway in patients with urologic cancers. Results from several clinical trials have shown that the combination of DNA damage repair inhibitors with immune checkpoint inhibitors can improve objective rates, progression-free survival, and overall survival (OS) in patients with urologic tumors, especially in patients with defective DNA damage repair genes or a high mutational load. In this review, we present the results of preclinical and clinical trials of different DNA damage repair inhibitors in combination with immune checkpoint inhibitors in urologic cancers and summarize the potential mechanism of action of the combination therapy. Finally, we also discuss the challenges of dose toxicity, biomarker selection, drug tolerance, drug interactions in the treatment of urologic tumors with this combination therapy and look into the future direction of this combination therapy.
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Affiliation(s)
| | | | | | - Qifei Wang
- *Correspondence: Guangzhen Wu, ; Qifei Wang,
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Badoiu SC, Greabu M, Miricescu D, Stanescu-Spinu II, Ilinca R, Balan DG, Balcangiu-Stroescu AE, Mihai DA, Vacaroiu IA, Stefani C, Jinga V. PI3K/AKT/mTOR Dysregulation and Reprogramming Metabolic Pathways in Renal Cancer: Crosstalk with the VHL/HIF Axis. Int J Mol Sci 2023; 24:8391. [PMID: 37176098 PMCID: PMC10179314 DOI: 10.3390/ijms24098391] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Revised: 04/26/2023] [Accepted: 05/04/2023] [Indexed: 05/15/2023] Open
Abstract
Renal cell carcinoma (RCC) represents 85-95% of kidney cancers and is the most frequent type of renal cancer in adult patients. It accounts for 3% of all cancer cases and is in 7th place among the most frequent histological types of cancer. Clear cell renal cell carcinoma (ccRCC), accounts for 75% of RCCs and has the most kidney cancer-related deaths. One-third of the patients with ccRCC develop metastases. Renal cancer presents cellular alterations in sugars, lipids, amino acids, and nucleic acid metabolism. RCC is characterized by several metabolic dysregulations including oxygen sensing (VHL/HIF pathway), glucose transporters (GLUT 1 and GLUT 4) energy sensing, and energy nutrient sensing cascade. Metabolic reprogramming represents an important characteristic of the cancer cells to survive in nutrient and oxygen-deprived environments, to proliferate and metastasize in different body sites. The phosphoinositide 3-kinase-AKT-mammalian target of the rapamycin (PI3K/AKT/mTOR) signaling pathway is usually dysregulated in various cancer types including renal cancer. This molecular pathway is frequently correlated with tumor growth and survival. The main aim of this review is to present renal cancer types, dysregulation of PI3K/AKT/mTOR signaling pathway members, crosstalk with VHL/HIF axis, and carbohydrates, lipids, and amino acid alterations.
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Affiliation(s)
- Silviu Constantin Badoiu
- Department of Anatomy and Embryology, Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, 8 Eroii Sanitari Blvd, 050474 Bucharest, Romania;
| | - Maria Greabu
- Department of Biochemistry, Faculty of Dentistry, Carol Davila University of Medicine and Pharmacy, 8 Eroii Sanitari Blvd, Sector 5, 050474 Bucharest, Romania;
| | - Daniela Miricescu
- Department of Biochemistry, Faculty of Dentistry, Carol Davila University of Medicine and Pharmacy, 8 Eroii Sanitari Blvd, Sector 5, 050474 Bucharest, Romania;
| | - Iulia-Ioana Stanescu-Spinu
- Department of Biochemistry, Faculty of Dentistry, Carol Davila University of Medicine and Pharmacy, 8 Eroii Sanitari Blvd, Sector 5, 050474 Bucharest, Romania;
| | - Radu Ilinca
- Department of Medical Informatics and Biostatistics, Faculty of Dentistry, Carol Davila University of Medicine and Pharmacy, 8 Eroii Sanitari Blvd, 050474 Bucharest, Romania;
| | - Daniela Gabriela Balan
- Department of Physiology, Faculty of Dentistry, Carol Davila University of Medicine and Pharmacy, 8 Eroii Sanitari Blvd, 050474 Bucharest, Romania; (D.G.B.); (A.-E.B.-S.)
| | - Andra-Elena Balcangiu-Stroescu
- Department of Physiology, Faculty of Dentistry, Carol Davila University of Medicine and Pharmacy, 8 Eroii Sanitari Blvd, 050474 Bucharest, Romania; (D.G.B.); (A.-E.B.-S.)
| | - Doina-Andrada Mihai
- Department of Diabetes, Nutrition and Metabolic Diseases, Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, 8 Eroii Sanitari Blvd, 050474 Bucharest, Romania;
| | - Ileana Adela Vacaroiu
- Department of Nephrology, Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania;
| | - Constantin Stefani
- Department of Family Medicine and Clinical Base, Dr. Carol Davila Central Military Emergency University Hospital, 134 Calea Plevnei, 010825 Bucharest, Romania;
| | - Viorel Jinga
- Department of Urology, “Prof. Dr. Theodor Burghele” Hospital, 050653 Bucharest, Romania
- “Prof. Dr. Theodor Burghele” Clinical Hospital, University of Medicine and Pharmacy Carol Davila, 050474 Bucharest, Romania
- Medical Sciences Section, Academy of Romanian Scientists, 050085 Bucharest, Romania
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Liao CI, Fang HC, Lee PT, Hsu CY, Chen CL, Huang CW, Chen XY, Ou SH, Tsai CT, Chou KJ. Trends in the incidence of urothelial carcinoma in Taiwan after the ban on aristolochic acid-containing Chinese herbal preparations, 2001-2018: a national population-based cohort study. J Cancer Res Clin Oncol 2023:10.1007/s00432-023-04771-6. [PMID: 37061628 DOI: 10.1007/s00432-023-04771-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Accepted: 04/08/2023] [Indexed: 04/17/2023]
Abstract
PURPOSE Urothelial carcinoma (UC) of the bladder (BUC) and the upper urinary tract (UTUC) are the two most common UCs. The incidence of UTUC in Taiwan is the highest worldwide. Aristolochic acid (AA) was identified as the main cause of UTUC in Taiwan. To explore trends in the incidence of UC in Taiwan after the ban on Chinese herbal preparations containing AA in 2003. METHODS We used data from the Taiwanese National Health Insurance Research Database-linked Taiwanese National Cancer Registry for 2001-2018. UC was defined in accordance with the International Classification of Disease for Oncology. The age-standardized incidence was calculated on the basis of the World Health Organization standard population. Trends in the incidence were calculated as the annual percent change (APC) by using the Joinpoint regression program. RESULTS Over the investigated period, the incidence of UC decreased at an average annual percent change (AAPC) of - 1.19% (95% CI - 1.47 ~ - 0.91, P < 0.001). However, the incidence in UTUC significantly increased, with the AAPC being 1.47% (95% CI 1.03 ~ 1.90, P < 0.001). In contrast, the incidence of BUC significantly decreased, with the overall AAPC being - 1.92% (95% CI - 2.3 ~ - 1.54, P < 0. 001). From 2001 to 2018, the overall incidence of UCs and BUC decreased in Taiwan, but the incidence of UTUC significantly increased. CONCLUSION We suggest to apply the same review standards of new drug development process to herbal preparations and incorporate them into the adverse drug reaction or poison surveillance system. Most importantly, raise public awareness of the potential toxicity of phytotherapy.
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Affiliation(s)
- Cheng-I Liao
- School of Medicine, National Yang Ming Chiao Tung University, Taipei, 112, Taiwan
- Department of Obstetrics and Gynecology, Pingtung Veterans General Hospital, Pingtung, 900, Taiwan
| | - Hua-Chang Fang
- Division of Nephrology, Department of Internal Medicine, Kaohsiung Veterans General Hospital, 386 Ta-Chung 1st Rd, 813, Kaohsiung, Taiwan
- School of Medicine, National Yang Ming Chiao Tung University, Taipei, 112, Taiwan
- School of Medicine, National Sun Yat-sen University, Kaohsiung, 804, Taiwan
| | - Po-Tsang Lee
- Division of Nephrology, Department of Internal Medicine, Kaohsiung Veterans General Hospital, 386 Ta-Chung 1st Rd, 813, Kaohsiung, Taiwan
- School of Medicine, National Yang Ming Chiao Tung University, Taipei, 112, Taiwan
- School of Medicine, National Sun Yat-sen University, Kaohsiung, 804, Taiwan
| | - Chih-Yang Hsu
- Division of Nephrology, Department of Internal Medicine, Kaohsiung Veterans General Hospital, 386 Ta-Chung 1st Rd, 813, Kaohsiung, Taiwan
- School of Medicine, National Yang Ming Chiao Tung University, Taipei, 112, Taiwan
- School of Medicine, National Sun Yat-sen University, Kaohsiung, 804, Taiwan
| | - Chien-Liang Chen
- Division of Nephrology, Department of Internal Medicine, Kaohsiung Veterans General Hospital, 386 Ta-Chung 1st Rd, 813, Kaohsiung, Taiwan
- School of Medicine, National Yang Ming Chiao Tung University, Taipei, 112, Taiwan
- School of Medicine, National Sun Yat-sen University, Kaohsiung, 804, Taiwan
| | - Chien-Wei Huang
- Division of Nephrology, Department of Internal Medicine, Kaohsiung Veterans General Hospital, 386 Ta-Chung 1st Rd, 813, Kaohsiung, Taiwan
- School of Medicine, National Yang Ming Chiao Tung University, Taipei, 112, Taiwan
- School of Medicine, National Sun Yat-sen University, Kaohsiung, 804, Taiwan
| | - Xin-You Chen
- Division of Nephrology, Department of Internal Medicine, Kaohsiung Veterans General Hospital, 386 Ta-Chung 1st Rd, 813, Kaohsiung, Taiwan
- School of Medicine, National Yang Ming Chiao Tung University, Taipei, 112, Taiwan
- School of Medicine, National Sun Yat-sen University, Kaohsiung, 804, Taiwan
| | - Shih-Hsiang Ou
- School of Medicine, National Yang Ming Chiao Tung University, Taipei, 112, Taiwan
- Department of Internal Medicine, Pingtung Veterans General Hospital, Pingtung, 900, Taiwan
| | - Chun-Teng Tsai
- Division of Nephrology, Department of Internal Medicine, Kaohsiung Veterans General Hospital, 386 Ta-Chung 1st Rd, 813, Kaohsiung, Taiwan
| | - Kang-Ju Chou
- Division of Nephrology, Department of Internal Medicine, Kaohsiung Veterans General Hospital, 386 Ta-Chung 1st Rd, 813, Kaohsiung, Taiwan.
- School of Medicine, National Yang Ming Chiao Tung University, Taipei, 112, Taiwan.
- School of Medicine, National Sun Yat-sen University, Kaohsiung, 804, Taiwan.
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Huang H, Zhang Y, Chen Z, Zeng X, Hu Z, Yang C. Neoadjuvant therapy with Disitamab vedotin in treating muscle-invasive bladder cancer: A case report. Heliyon 2023; 9:e15157. [PMID: 37123934 PMCID: PMC10130214 DOI: 10.1016/j.heliyon.2023.e15157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2022] [Revised: 03/22/2023] [Accepted: 03/28/2023] [Indexed: 04/05/2023] Open
Abstract
Purpose Platinum-based regimens are regarded as the preferred alternative for neoadjuvant chemotherapy for muscle-invasive bladder cancer (MIBC) patients. However, some patients cannot tolerate platinum-based regimens. We report an MIBC case with severe renal insufficiency treated by neoadjuvant therapy with gemcitabine and Disitamab Vedotin. Materials and Methods A 68-year-old man with severe renal insufficiency was admitted to our department and diagnosed with cT3N0M0 MIBC. Immunohistochemical staining of the biopsy tissues showed human epidermal growth factor receptor 2 expression (1+). This patient received neoadjuvant therapy with gemcitabine 1600 mg and DV 120 mg intravenously every three weeks 3 times. We compared the imaging results of the patient before and after neoadjuvant therapy. In addition, the white blood cell count, alanine aminotransferase, aspartate aminotransferase, and serum creatinine were followed up during neoadjuvant therapy. Abnormal symptoms such as hair loss, fatigue, and hypoesthesia were also recorded. Results According to the imaging examinations, the lesions were significantly reduced after receiving neoadjuvant therapy. Significant adverse side effects did not occur during neoadjuvant therapy. Conclusions In this T3N0M0 cisplatin-ineligible patient, gemcitabine combined with DV as neoadjuvant therapy achieved radiological partial response, and no significant adverse events were observed during neoadjuvant therapy.
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Population characteristics, management, and survival outcomes in muscle-invasive urothelial carcinoma undergoing radical resection: the MINOTAUR study. World J Urol 2023; 41:1069-1075. [PMID: 36929410 PMCID: PMC10018592 DOI: 10.1007/s00345-023-04335-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Accepted: 02/07/2023] [Indexed: 03/18/2023] Open
Abstract
PURPOSE To describe the incidence, management, and survival outcomes of patients with muscle-invasive urothelial carcinoma (MIUC) undergoing radical surgery (RS) in France. METHODS We relied on a non-interventional real-world retrospective study based on French National Hospitalization Database. Adults with MIUC with a first RS between 2015 and 2020 were selected. Subpopulations of patients with RS performed in 2015 and 2019 (pre-COVID-19) were extracted, according to cancer site: muscle-invasive bladder cancer (MIBC) or upper tract urothelial carcinoma (UTUC). Disease-free and overall survival (DFS, OS - Kaplan-Meier) were assessed on the 2015 subpopulation. RESULTS Between 2015 and 2020, 21,295 MIUC patients underwent a first RS. Of them, 68.9% had MIBC, 28.9% UTUC, and 2.2% both cancers. Apart from fewer men among UTUC (70.2%) than MIBC patients (90.1%), patients' demographic (mean age ~ 73 years) and clinical characteristics were similar whatever the cancer site or year of first RS. In 2019, RS alone was the most frequent treatment, occurring in 72.3% and 92.6% in MIBC and UTUC, respectively. Between 2015 and 2019, neoadjuvant use rate increased from 13.8% to 22.2% in MIBC, and adjuvant use rate increased from 3.7% to 6.3% in UTUC. Finally, median [95% confidence interval] DFS times were 16.0 [14.0-18.0] and 27.0 [23.0-32.0] months among MIBC and UTUC, respectively. CONCLUSION Among patients with resected MIUC annually, RS alone remained the main treatment. Neoadjuvant and adjuvant use increased between 2015 and 2019. Nonetheless, MIUC remains of poor prognosis, highlighting an unmet medical need, notably among patients at high risk of recurrence.
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Jain RK, Singh AM, Wang X, Guevara-Patiño JA, Sonpavde G. Emerging monoclonal antibody therapies in the treatment of metastatic urothelial carcinoma. Expert Opin Emerg Drugs 2023; 28:17-26. [PMID: 36882977 DOI: 10.1080/14728214.2023.2186398] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/09/2023]
Abstract
INTRODUCTION The treatment landscape for advanced-stage, unresectable or metastatic urothelial carcinoma (mUC) has shifted dramatically over a short period of time, with new therapeutic agents available for clinical use. However, despite these recent advances in the field, mUC continues to be a disease with significant morbidity and mortality and remains generally incurable. While platinum-based therapy remains the backbone of therapy, many patients are ineligible for chemotherapy or have failed initial chemotherapy treatment. In post-platinum treated patients, immunotherapy and antibody drug conjugates have provided incremental advances, but agents with better therapeutic index guided by precision medicine are needed. AREAS COVERED This article covers the available monoclonal antibody therapies in mUC excluding immunotherapy and antibody drug conjugates. Included are a review of data utilizing monoclonal antibodies targeting VEG-F, HER-2, FGFR, and KIR-2 in the setting of mUC. A literature search from 6/2022- 9/2022 was performed utilizing PubMed with key terms including urothelial carcinoma, monoclonal antibody, VEG-F, HER-2, FGFR. EXPERT OPINION Often used in combination with immunotherapy or other therapeutic agents, monoclonal antibody therapies have exhibited efficacy in mUC in early trials. Upcoming clinical trials will further explore their full clinical utility in treating mUC patients.
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Affiliation(s)
- Rohit K Jain
- Department of Genitourinary Oncology, H. Lee Moffitt Cancer Center, Tampa, FL, USA
| | - Avani M Singh
- Department of Genitourinary Oncology, H. Lee Moffitt Cancer Center, Tampa, FL, USA
| | - Xuefeng Wang
- Department of Immunology, H. Lee Moffitt Cancer Center, Tampa, FL, USA
| | | | - Guru Sonpavde
- Division of Medical Oncology, Advent Health Cancer Institute, Orlando, FL, USA
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Li T, Jiang N, Bai Y, Liu T, Zhao Z, Xu X, Zhang Y, Wei F, Sun R, Liu S, Li J, Guo H, Yang R. Prediction of immune infiltration and prognosis for patients with urothelial bladder cancer based on the DNA damage repair-related genes signature. Heliyon 2023; 9:e13661. [PMID: 36873527 PMCID: PMC9976330 DOI: 10.1016/j.heliyon.2023.e13661] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2022] [Revised: 01/30/2023] [Accepted: 02/07/2023] [Indexed: 02/15/2023] Open
Abstract
Objectives To analyze the correlations between the expression and effect of DNA damage repair genes and the immune status and clinical outcomes of urothelial bladder cancer (BLCA) patients. In addition, we evaluate the efficacy and value of utilizing the DNA damage repair genes signature as a prognosis model for BLCA. Methods Two subtype groups (C1 and C2) were produced based on the varied expression of DNA damage repair genes. Significantly differentiated genes and predicted enriched gene pathways were obtained between the two subtypes. Seven key genes were obtained from the DNA damage repair-related genes and a 7-gene signature prognosis model was established based on the key genes. The efficacy and accuracy of this model in prognosis prediction was evaluated and verified in two independent databases. Also, the difference in biological functions, drug sensitivity, immune infiltration and affinity between the high-risk group and low-risk group was analyzed. Results The DNA damage repair gene signature could significantly differentiate the BLCA into two molecular subgroups with varied genetic expression and enriched gene pathways. Seven key genes were screened out from the 232 candidate genes for prognosis prediction and a 7-gene signature prognosis model was established based on them. Two independent patient cohorts (TCGA cohort and GEO cohort) were utilized to validate the efficacy of the prognosis model, which demonstrated an effective capability to differentiate and predict the overall survival of BLCA patients. Also, the high-risk group and low-risk group derived from the 7-gene model exhibited significantly differences in drug sensitivity, immune infiltration status and biological pathways enrichment. Conclusions Our established 7-gene signature model based on the DNA damage repair genes could serve as a novel prognosis predictive tool for BLCA. The differentiation of BLCA patients based on the 7-gene signature model may be of great value for the appropriate selection of specific chemotherapy agents and immune-checkpoint blockade therapy administration.
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Affiliation(s)
- Tianhang Li
- Department of Urology, Affiliated Nanjing Drum Tower Hospital, Medical School, Nanjing University, Nanjing, China
| | - Ning Jiang
- Nanjing Drum Tower Hospital Clinical College of Jiangsu University, Nanjing, China
| | - Yuhao Bai
- Nanjing Drum Tower Hospital Clinical College of Jiangsu University, Nanjing, China
| | - Tianyao Liu
- Department of Urology, Affiliated Nanjing Drum Tower Hospital, Medical School, Nanjing University, Nanjing, China
| | - Zihan Zhao
- Department of Urology, Affiliated Nanjing Drum Tower Hospital, Medical School, Nanjing University, Nanjing, China
| | - Xinyan Xu
- Department of Urology, Affiliated Nanjing Drum Tower Hospital, Medical School, Nanjing University, Nanjing, China
| | - Yulin Zhang
- Department of Urology, Affiliated Nanjing Drum Tower Hospital, Medical School, Nanjing University, Nanjing, China
| | - Fayun Wei
- Department of Urology, Affiliated Nanjing Drum Tower Hospital, Medical School, Nanjing University, Nanjing, China
| | - Rui Sun
- Department of Urology, Affiliated Nanjing Drum Tower Hospital, Medical School, Nanjing University, Nanjing, China
| | - Siyang Liu
- Department of Urology, Affiliated Nanjing Drum Tower Hospital, Medical School, Nanjing University, Nanjing, China
| | - Jiazheng Li
- Nanjing Drum Tower Hospital Clinical College of Nanjing University of Chinese Medicine, Nanjing, China
| | - Hongqian Guo
- Department of Urology, Affiliated Nanjing Drum Tower Hospital, Medical School, Nanjing University, Nanjing, China
| | - Rong Yang
- Department of Urology, Affiliated Nanjing Drum Tower Hospital, Medical School, Nanjing University, Nanjing, China
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Bellmunt J, Chang J, Pavilack-Kirker M, Cappelleri JC, Costa N, Esterberg E, Kearney M, Hitchens A, Candrilli SD, Ajmera M. Evaluating real-world characteristics of patients with advanced urothelial carcinoma eligible for avelumab maintenance therapy: a multi-country retrospective medical chart review. Clin Genitourin Cancer 2023:S1558-7673(23)00080-0. [PMID: 37149458 DOI: 10.1016/j.clgc.2023.03.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Revised: 03/22/2023] [Accepted: 03/25/2023] [Indexed: 04/03/2023]
Abstract
INTRODUCTION Urothelial carcinoma (UC) is a malignancy of the urothelium that encompasses the renal pelvis, bladder, and urethra. Current treatment guidelines for advanced (ie, locally advanced or metastatic) UC recommend using avelumab maintenance therapy in patients with nonprogressive disease following first-line platinum-based chemotherapy. This study aimed to assess the representativeness of the patient population in the JAVELIN Bladder 100 (JB-100) trial, which examined the efficacy and safety of avelumab first-line maintenance, vs. real-world patients with advanced UC that had not progressed with first-line platinum-based chemotherapy treated between 2015 and 2018 by reviewing demographic and clinical characteristics. PATIENTS AND METHODS A medical chart review (MCR) study collected demographics and treatment characteristics for patients with advanced UC in the United States, the United Kingdom, and France. Data were analyzed descriptively for review with data collected from patients enrolled in JB-100. RESULTS Clinical characteristics were consistent between JB-100 and the MCR. Most patients were male, received 4 to 6 cycles of platinum-based chemotherapy, and had an Eastern Cooperative Oncology Group performance status of 0 or 1. All patients in the MCR had either stable disease or a response with platinum-based chemotherapy (∼75% achieved a complete or partial response). Fewer than half (42.5%) of all patients in the MCR received subsequent therapy. CONCLUSION Patient demographics, clinical characteristics, and treatment patterns from a MCR of patients with advanced UC that had not progressed following first-line platinum-based chemotherapy appeared similar to data from patients enrolled in JB-100. Future studies should examine whether real-world outcomes are consistent with findings from JB-100. CLINICALTRIALS GOV IDENTIFIER NCT02603432.
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Matsubara N, Yonese J, Kojima T, Azuma H, Matsumoto H, Powles T, Rosenberg JE, Petrylak DP, Matsangou M, Wu C, Campbell M, Yamashiro M. Japanese subgroup analysis of EV-301: An open-label, randomized phase 3 study to evaluate enfortumab vedotin versus chemotherapy in subjects with previously treated locally advanced or metastatic urothelial carcinoma. Cancer Med 2023; 12:2761-2771. [PMID: 36052536 PMCID: PMC9939146 DOI: 10.1002/cam4.5165] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Revised: 07/22/2022] [Accepted: 08/02/2022] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND Enfortumab vedotin (EV) is an antibody-drug conjugate showing significant overall survival (OS) benefit versus chemotherapy for patients with previously treated locally advanced or metastatic urothelial carcinoma (la/mUC) in EV-301. This subgroup analysis was conducted to further analyze the efficacy and safety in a Japanese population. METHODS In the open-label, phase 3 EV-301 trial, patients with la/mUC were randomized 1:1 to EV 1.25 mg/kg on Days 1, 8, and 15 for 28-day cycles or investigator-preselected standard chemotherapy (SC; docetaxel or paclitaxel for patients in Japan) on Day 1 of each 21-day cycle. Primary endpoint was OS and secondary efficacy endpoints included progression-free survival (PFS) and overall response rate (ORR). Safety/tolerability was also evaluated. RESULTS As of the July 15, 2020 cut-off date for the interim analysis, the Japanese subgroup included 86 patients (EV: n = 36; SC: n = 50). Median OS was 15.18 months for EV and 10.55 months for SC (HR: 0.437 [95% CI: 0.209, 0.914]). Median PFS was 6.47 months for EV and 5.39 months for SC (HR: 0.464 [95% CI: 0.258, 0.835]). Confirmed ORR was 34.4% for EV and 21.3% for SC. A higher proportion of patients receiving SC versus EV had treatment-related adverse events (TRAEs; 97.9% vs. 91.7%, respectively), including grade ≥ 3 TRAEs (75.0% vs. 63.9%). CONCLUSIONS This subgroup analysis confirmed that EV, with consistent efficacy and safety/tolerability in the EV-301 Japanese subgroup and overall study population, represents an important treatment option for previously treated patients with la/mUC.
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Affiliation(s)
- Nobuaki Matsubara
- Department of Medical OncologyNational Cancer Center Hospital EastChibaJapan
| | - Junji Yonese
- Department of UrologyCancer Institute Hospital, Japanese Foundation for Cancer ResearchTokyoJapan
| | | | - Haruhito Azuma
- Department of UrologyOsaka Medical and Pharmaceutical UniversityOsakaJapan
| | - Hiroaki Matsumoto
- Department of UrologyYamaguchi University, School of MedicineUbeJapan
| | - Thomas Powles
- Barts Cancer Institute, CRUK Experimental Cancer Medicine CentreLondonUK
| | - Jonathan E. Rosenberg
- Department of Medicine, Division of Solid Tumor OncologyGenitourinary Oncology Service, Memorial Sloan Kettering Cancer CenterNew YorkNew YorkUSA
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Chan TC, Shiue YL, Li CF. The biological impacts of CEBPD on urothelial carcinoma development and progression. Front Oncol 2023; 13:1123776. [PMID: 36776299 PMCID: PMC9914172 DOI: 10.3389/fonc.2023.1123776] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Accepted: 01/05/2023] [Indexed: 01/28/2023] Open
Abstract
Urothelial carcinoma (UC), which includes urinary bladder urothelial carcinoma (UBUC) and upper tract urothelial carcinoma (UTUC), is one of the most common malignancies worldwide. Accordingly, a comprehensive understanding of the underlying mechanism governing UC development is compulsory. Aberrant CCAAT/enhancer-binding protein delta (CEBPD), a transcription factor, displays an oncogene or tumor suppressor depending on tumor type and microenvironments. However, CEBPD has been reported to possess a clear oncogenic function in UC through multiple regulation pathways. Genomic amplification of CEBPD triggered by MYC-driven genome instability is frequently examined in UC that drives CEBPD overexpression. Upregulated CEBPD transcriptionally suppresses FBXW7 to stabilize MYC protein and further induces hexokinase II (HK2)-related aerobic glycolysis that fuels cell growth. Apart from the MYC-dependent pathway, CEBPD also downregulates the level of hsa-miR-429 to enhance HK2-associated glycolysis and induce angiogenesis driven by vascular endothelial growth factor A (VEGFA). Additionally, aggressive UC is attributed to the tumor metastasis regulated by CEBPD-induced matrix metalloproteinase-2 (MMP2) overexpression. Furthermore, elevated CEBPD induced by cisplatin (CDDP) is identified to have dual functions, namely, CDDP-induced chemotherapy resistance or drive CDDP-induced antitumorigenesis. Given that the role of CEBPD in UC is getting clear but pending a more systemic reappraisal, this review aimed to comprehensively discuss the underlying mechanism of CEBPD in UC tumorigenesis.
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Affiliation(s)
- Ti-Chun Chan
- Department of Medical Research, Chi Mei Medical Center, Tainan, Taiwan,National Health Research Institutes, National Institute of Cancer Research, Tainan, Taiwan
| | - Yow-Ling Shiue
- Institute of Precision Medicine, National Sun Yat-Sen University, Kaohsiung, Taiwan,*Correspondence: Yow-Ling Shiue, ; Chien-Feng Li,
| | - Chien-Feng Li
- Department of Medical Research, Chi Mei Medical Center, Tainan, Taiwan,National Health Research Institutes, National Institute of Cancer Research, Tainan, Taiwan,Department of Clinical Medicine, Chi Mei Medical Center, Tainan, Taiwan,*Correspondence: Yow-Ling Shiue, ; Chien-Feng Li,
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Chen Z, Chen D, Song Z, Lv Y, Qi D. Mapping the tumor microenvironment in bladder cancer and exploring the prognostic genes by single-cell RNA sequencing. Front Oncol 2023; 12:1105026. [PMID: 36741702 PMCID: PMC9893503 DOI: 10.3389/fonc.2022.1105026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Accepted: 12/29/2022] [Indexed: 01/20/2023] Open
Abstract
Despite substantial advances in the treatment using immune checkpoint inhibitors (ICIs), the clinical expected therapeutic effect on bladder cancer has not been achieved, in which the tumor microenvironment (TME) occupies a notable position. In this research, 10X single-cell RNA-sequencing technology was conducted to analyze seven primary bladder tumor tissues (three non-muscle-invasive bladder cancer (NMIBC) and four muscle-invasive bladder cancer (MIBC)) and seven corresponding normal tissues adjacent to cancer; eight various cell types were identified in the bladder cancer (BC) TME, and a complete TME atlas in bladder cancer was made. Moreover, bladder cancer epithelial cells were further subdivided into 14 subgroups, indicating a high intra-tumoral heterogeneity. Additionally, the differences between NMIBC and MIBC were compared based on differential gene expression heatmap, copy number variation (CNV) distribution heatmap, Gene Ontology (GO) enrichment analysis, and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analysis. Weighted gene co-expression network analysis (WGCNA), protein-protein interaction (PPI) network mutual analysis, and the Kaplan-Meier survival prognosis analysis were used to identify six key genes associated with the prognosis of bladder cancer: VEGFA, ANXA1, HSP90B1, PSMA7, PRDX6, and PPP1CB. The dynamic change of the expression distribution of six genes on the pseudo-time axis was further verified by cell pseudo-time analysis.
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Hassan WA, ElBanna AK, Noufal N, El-Assmy M, Lotfy H, Ali RI. Significance of tumor-associated neutrophils, lymphocytes, and neutrophil-to-lymphocyte ratio in non-invasive and invasive bladder urothelial carcinoma. J Pathol Transl Med 2023; 57:88-94. [PMID: 36623816 PMCID: PMC10028012 DOI: 10.4132/jptm.2022.11.06] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Accepted: 11/06/2022] [Indexed: 01/11/2023] Open
Abstract
Background Tumor-infiltrating neutrophils and lymphocytes play essential roles in promoting or combating various neoplasms. This study aimed to investigate the association between tumor-infiltrating neutrophils and lymphocytes and the neutrophil-to-lymphocyte ratio in the progression of urothelial carcinoma. Methods A total of 106 patients diagnosed with urothelial carcinoma were was. Pathological examination for tumor grade and stage and for tumor-infiltrating neutrophils, both CD4 and CD8+ T lymphocytes, as well as the neutrophil- to-lymphocyte ratio were evaluated. Results The presence of neutrophils and the neutrophil-to-lymphocyte ratio correlated with high-grade urothelial neoplasms. In both low- and high-grade tumors, the lymphocytes increased during progression from a non-invasive neoplasm to an early-invasive neoplasm. CD8+ T lymphocytes increased in low-grade non-muscle-invasive tumors compared to non-invasive tumors. Additionally, there was a significant decrease in CD8+ T lymphocytes during progression to muscle-invasive tumors. Conclusions Our results suggest that tumor-infiltrating neutrophils and CD8+ T lymphocytes have a significant effect on tumor grade and progression.
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Affiliation(s)
- Wael Abdo Hassan
- Department of Pathology, Faculty of Medicine, Suez Canal University, El Sheikh Zayed, Egypt
- Department of Basic Sciences, College of Medicine, Suliman Al Rajhi University, Al Bukairiyah, Saudi Arabia
| | - Ahmed Kamal ElBanna
- Department of Basic Sciences, College of Medicine, Suliman Al Rajhi University, Al Bukairiyah, Saudi Arabia
- Department of Anatomy, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
| | - Noha Noufal
- Department of Pathology, Faculty of Medicine, Suez Canal University, El Sheikh Zayed, Egypt
- Department of Basic Medical Sciences, College of Medicine, Dar Al Uloom University, Riyadh, Saudi Arabia
| | - Mohamed El-Assmy
- Department of Clinical Sciences, Suliman Al Rajhi University, Bukayriah, Saudi Arabia
| | - Hany Lotfy
- Department of Basic Sciences, College of Medicine, Suliman Al Rajhi University, Al Bukairiyah, Saudi Arabia
- Department of Microbiology and Immunology, Faculty of Medicine, Mansoura University, Mansoura, Egypt
| | - Rehab Ibrahim Ali
- Department of Pathology, College of Medicine, Jouf University, Al-Jawf, Saudi Arabia
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Yu EM, Mudireddy M, Biswas R, Aragon-Ching JB. The role of switch maintenance therapy in urothelial cancers. Ther Adv Urol 2023; 15:17562872221147760. [PMID: 36891217 PMCID: PMC9986508 DOI: 10.1177/17562872221147760] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2022] [Accepted: 12/09/2022] [Indexed: 01/15/2023] Open
Abstract
Maintenance therapy with immune checkpoint inhibitors (ICIs) has changed the treatment paradigm of metastatic urothelial carcinoma (mUC). The JAVELIN Bladder 100 trial established avelumab, one of several ICIs in use today, as a life-prolonging maintenance therapy for patients with advanced urothelial carcinoma. Platinum-based chemotherapy is most often used in the first-line treatment of mUC, and while response rates approach about 50%, disease control is usually short-lived upon completion of the standard three to six cycles of chemotherapy. Much progress has been made in recent years in the second-line space and beyond with the use of ICIs, antibody-drug conjugates (ADCs), and tyrosine kinase inhibitors (TKIs) in eligible patients at the time of disease progression post-platinum-based chemotherapy. However, many patients with progressive mUC after first-line chemotherapy suffer from rapid progression of disease, treatment toxicity with subsequent lines of therapy, and a limited life expectancy. Until the results of the JAVELIN Bladder 100 trial were presented in 2020, there were no maintenance strategies proven to be beneficial over best supportive care after disease control is achieved with first-line platinum-based chemotherapy. To date, standard of care frontline treatment of metastatic urothelial cancer remains to be four to six cycles of platinum-based chemotherapy followed by maintenance avelumab. This review summarizes the current evidence available on maintenance therapies in mUC, as well as several highly anticipated clinical trials that we hope will result in further progress in the management of this aggressive cancer and improve patient outcomes.
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Affiliation(s)
- Eun-mi Yu
- GU Medical Oncology, Inova Schar Cancer
Institute, Fairfax, VA, USA
| | - Mythri Mudireddy
- Department of Hematology and Oncology, Inova
Schar Cancer Institute, Fairfax, VA, USA
| | - Rakesh Biswas
- Department of Hematology and Oncology, Inova
Schar Cancer Institute, Fairfax, VA, USA
| | - Jeanny B. Aragon-Ching
- GU Medical Oncology, Inova Schar Cancer
Institute, 8081 Innovation Park Drive, Fairfax, VA 22031, USA
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Zein M, Nasrallah AA, Abou Heidar NF, Najdi J, Hneiny L, El Hajj A. Concurrent radical cystectomy and nephroureterectomy indications and outcomes: a systematic review and comparative analysis. Ther Adv Urol 2023; 15:17562872231171757. [PMID: 37188157 PMCID: PMC10176578 DOI: 10.1177/17562872231171757] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Accepted: 04/08/2023] [Indexed: 05/17/2023] Open
Abstract
Introduction Urothelial carcinoma can arise from the urinary bladder or from the upper urinary tract. In some instances, urinary bladder cancer (UBC) and upper tract urothelial carcinoma (UTUC) can be concurrently diagnosed, necessitating a combined radical cystectomy (RC) with radical nephroureterectomy (RNU). A systematic review was done on the combined procedure exploring outcomes and indications, in addition to a comparative analysis between the combined procedure and cystectomy alone. Methods For the systematic review, three databases (Embase, PubMed, and Cochrane) were queried, selecting only studies that included intraoperative and perioperative data. For the comparative analysis, using the NSQIP database, CPT codes for RC and RNU were used to identify two cohorts, one with RC and RNU and one with RC alone. A descriptive analysis was performed on all preoperative variables, and propensity score matching (PSM) was performed. Postoperative events were then compared between the two matched cohorts. Results For the systematic review, 28 relevant articles were included amounting to 947 patients who underwent the combined procedure. The most common indication was synchronous multifocal disease, the most common approach was open surgery, and the most common diversion technique was using an ileal conduit. Almost 28% of patients required blood transfusion and remained in the hospital for an average of 13 days. The most common postoperative complication was prolonged paralytic ileus. For the comparative analysis, 11,759 patients were included of which 97.5% underwent RC only and 2.5% underwent the combined procedure. After PSM, the cohort that had undergone the combined procedure showed an increased risk of renal injury, increased readmission rates, and increased reoperation rates. Whereas the cohort that had undergone RC only showed an increased risk of deep venous thrombosis (DVT), sepsis, or septic shock. Conclusion A combined RC and RNU is a treatment option for concurrent UCB and UTUC that should be cautiously utilized as it is associated with high morbidity and mortality. Patient selection, discussion of the risks and benefits of the procedure, and explanation of the available treatment options remain the most important pillars in managing patients with this complex disease.
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Affiliation(s)
| | | | | | - Jad Najdi
- American University of Beirut Medical Center,
Beirut, Lebanon
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Muacevic A, Adler JR, Mohd OB, Elayan R, Albakri K, Huneiti N, Daraghmeh F, Al-khatatbeh E, Al-thnaibat M. Etiologies, Gross Appearance, Histopathological Patterns, Prognosis, and Best Treatments for Subtypes of Renal Carcinoma: An Educational Review. Cureus 2022; 14:e32338. [PMID: 36627997 PMCID: PMC9825816 DOI: 10.7759/cureus.32338] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/08/2022] [Indexed: 12/13/2022] Open
Abstract
Of all primary renal neoplasms, 80-85% are renal cell carcinomas (RCCs), which develop in the renal cortex. There are more than 10 histological and molecular subtypes of the disease, the most frequent of which is clear cell RCC, which also causes most cancer-related deaths. Other renal neoplasms, including urothelial carcinoma, Wilms' tumor, and renal sarcoma, each affect a particular age group and have specific gross and histological features. Due to the genetic susceptibility of each of these malignancies, early mutation discovery is necessary for the early detection of a tumor. Furthermore, it is crucial to avoid environmental factors leading to each type. This study provides relatively detailed and essential information regarding each subtype of renal carcinoma.
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Doroud D, Hozouri H. Role of Intravesical BCG as a Therapeutic Vaccine for Treatment of Bladder Carcinoma. IRANIAN BIOMEDICAL JOURNAL 2022; 26:340-9. [PMID: 36369747 PMCID: PMC9763876 DOI: 10.52547/ibj.3676] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Accepted: 05/08/2022] [Indexed: 12/12/2022]
Abstract
Bacterial products have attracted much attention as potential antitumor agents, with the ability to provide direct tumoricidal effects, leading to the inhibition of tumor growth. Treatment of superficial bladder cancer with intravesical Bacillus Calmette-Guérin (BCG) has a more reduction potential than surgery in tumor recurrence rate. BCG, the gold standard for nonmuscle invasive bladder cancer, is manufactured from different strains and produced commercially with varied strengths. There are a few countries known as the manufacturer of this strategic biopharmaceutical product, and Iran as a member of the Eastern Mediterranean Region plays a vital role in supplying this vaccine. Studies have failed to uncover the exact mechanism of action of the intravesical; however, evidence points toward an immunogenic mechanism that proficiently modifies a biologic response and provokes the immune cells in order to kill and suppress tumors. Among various underlying mechanisms, BCG bacillus attachment to fibronectin through its fibronectin attachment protein is a pivotal mechanism for BCG tumoricidal activity.
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Affiliation(s)
- Delaram Doroud
- Production and Research Complex, Pasteur Institute of Iran, Tehran, Iran
| | - Hamidreza Hozouri
- Department of Quality Management, Pasteur Institute of Iran, Tehran, Iran
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Teleka S, Orho-Melander M, Liedberg F, Melander O, Jirström K, Stocks T. Interaction between blood pressure and genetic risk score for bladder cancer, and risk of urothelial carcinoma in men. Sci Rep 2022; 12:18336. [PMID: 36316463 PMCID: PMC9622916 DOI: 10.1038/s41598-022-23225-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Accepted: 10/27/2022] [Indexed: 11/06/2022] Open
Abstract
There is substantial genetic predisposition to bladder cancer (BC). Recently, blood pressure (BP) was positively associated with BC risk in men, but the potential interaction with genetic susceptibility for BC is unknown. We investigated a weighted genetic risk score (wGRS) of 18 BC genetic variants, BP, and their interaction, in relation to incident urothelial cancer (UC, n = 385) risk in 10,576 men. We used Cox regression, the likelihood ratio test, and the relative excess risk for interaction to calculate hazard ratios (HR) of UC, multiplicative interaction and additive interaction respectively. There was evidence of a positive additive interaction between SBP and the wGRS in relation to aggressive (P = 0.02) but not non-aggressive (P = 0.60) UC. The HR of aggressive UC was for SBP ≥ 140 mmHg and the upper 50% of the wGRS combined 1.72 (95% CI 1.03-2.87) compared to the counterpart group. Additionally, the 20-year risk of aggressive UC in 60 year-old men was 0.78% in the low SBP/low wGRS group and 1.33% in the high SBP/high wGRS group. Our findings support a potential additive interaction between the wGRS and SBP on aggressive UC among men. If replicated, the findings on interaction may provide biological and public health insight to prevent aggressive UC.
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Affiliation(s)
- Stanley Teleka
- grid.8993.b0000 0004 1936 9457Department of Surgical Sciences, Uppsala University, Epihubben, Dag Hammarskjölds Väg 14 B, 75185 Uppsala, Sweden ,grid.4514.40000 0001 0930 2361Department of Clinical Sciences in Lund, Lund University, Lund, Sweden
| | - Marju Orho-Melander
- grid.4514.40000 0001 0930 2361Department of Clinical Sciences in Malmö, Lund University, Lund, Sweden
| | - Fredrik Liedberg
- grid.411843.b0000 0004 0623 9987Department of Urology, Skåne University Hospital Malmö, Malmö, Sweden ,grid.4514.40000 0001 0930 2361Department of Translational Medicine, Lund University, Malmö, Sweden
| | - Olle Melander
- grid.4514.40000 0001 0930 2361Department of Clinical Sciences in Malmö, Lund University, Lund, Sweden
| | - Karin Jirström
- grid.4514.40000 0001 0930 2361Department of Clinical Sciences in Lund, Lund University, Lund, Sweden
| | - Tanja Stocks
- grid.4514.40000 0001 0930 2361Department of Clinical Sciences in Lund, Lund University, Lund, Sweden
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Precision Medicine in the Treatment of Locally Advanced or Metastatic Urothelial Cancer: New Molecular Targets and Pharmacological Therapies. Cancers (Basel) 2022; 14:cancers14205167. [PMID: 36291950 PMCID: PMC9600273 DOI: 10.3390/cancers14205167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Accepted: 10/14/2022] [Indexed: 11/17/2022] Open
Abstract
Simple Summary Therapeutic breakthroughs in urothelial carcinoma have been occurring rapidly over the past 10 years. However, the resistance and prognosis of this disease is always quite a difficult health challenge. Trying to understand the new therapeutic perspectives is a priority to try to bring in new drug models that can counteract the advancing prognosis and inauspicious diagnosis. Abstract Many variants of urothelial cancer present diagnostic challenges and carry clinical implications that influence prognosis and treatment decisions. The critical issues of treatment-resistant clones are a crucial barrier to care in individuals affected by urothelial carcinoma. Laying the foundations for the resistance evolution, a wide mutational heterogeneity characterizes urothelial carcinoma, noticeable also in patients affected by a early stage disease. In recent years the growing knowledge of the pathogenesis and molecular paths underlying the onset and progression of urothelial cancer are leading to the development of new therapies based on immune checkpoints. Chemotherapy and immunotherapy both operate selectively by shaping the developmental trajectory of urothelial carcinoma in the course of the illness. To date, a promising new therapeutic treatment is represented by antibody-drug conjugates, therapeutic tools that exploit the targeted ability of an antibody to administer cytotoxic drugs directly to the tumor. Indeed, nowadays in the clinical setting there are several treatments available for the treatment of locally advanced or metastatic urothelial cancer, from classic chemotherapeutics such as Gemcitabine, Cisplatin and Carboplatin, Paclitaxel and Docetaxel, to Programmed cell death protein 1 (PD-1) or Programmed death-ligand 1 (PD-L1) inhibitors such as Atezolizumab, Avelumab, Nivolumab, Pembrolizumab, up to anti-nectin 4 Enfortumab Vedotin and Sacituzumab govitecan, which binds Tumor-associated calcium signal transducer 2 (Trop-2) and activates as a topoisomerase inhibitor. The aim of this work is to describe the molecular mechanisms underlying the onset of the urothelial cancer and provide an overview of the immunotherapies that can be used in the clinical setting to counteract it, deepening the efficacy and safety results of the pivotal studies and the place in therapy of these treatments.
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Yang H, Yan J. A systematic review of prognosis of ABO blood group and rhesus factor on outcomes in patients with bladder cancer. Medicine (Baltimore) 2022; 101:e30893. [PMID: 36181128 PMCID: PMC9524977 DOI: 10.1097/md.0000000000030893] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Bladder cancer (BC) is the 10th most common malignancy worldwide, and some studies reported that ABO blood type or/and rhesus factor has been identified as a prognostic oncologic marker for patients with BC. We carried out a systematic review to assess the prognosis of ABO blood group and rhesus factor on outcomes in patients with bladder cancer. METHODS We searched databases through February 2022 for studies assessing blood group on outcomes in patients with bladder cancer. RESULTS We included ten studies with 15,204 participants. We found that blood type A is relevant to non-muscle-invasive BC patients treated with transurethral resection of bladder tumor and blood type B patients have a lower incidence of disease recurrence and progression. Blood type O and non-O blood type have not been found to be related to disease recurrence. However, in multivariable analyses, blood type O and non-O blood type are associated with cancer-specific mortality (CSM). Other than that, blood type B doesn't have statistical significance for BC patients accepted radical cystectomy (RC). The same results showed in blood type AB non-muscle-invasive bladder cancer patients treated with RC. CONCLUSIONS Our study confirmed that a particular association of blood type for prognosis of patients with BC, and ABO blood group antigen expression can be suitable biomarkers for BC. We also found that rhesus factor has no impact on prognosis of BC patients.
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Affiliation(s)
- Haiming Yang
- Department of Interventional Therapy, Qinghai University, Xining, China
| | - Jingxin Yan
- Department of Interventional Therapy, Qinghai University, Xining, China
- Department of Postgraduate, Qinghai University, Xining, China
- *Correspondence: Jingxin Yan, Department of Interventional Therapy, Affiliated Hospital of Qinghai University, Xining 810001, China (e-mail: )
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Zhu J, Ai Q, Cheng Q, Shen D, Dong Z, Li J, Shen D, Wang W, Zhang X, Li H. Mutational signature and clonal relatedness of recurrent urothelial carcinomas with aristolochic acid. Front Oncol 2022; 12:990023. [PMID: 36185218 PMCID: PMC9516318 DOI: 10.3389/fonc.2022.990023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2022] [Accepted: 08/23/2022] [Indexed: 12/02/2022] Open
Abstract
Urothelial carcinomas (UCs) are malignant tumors that arise from the lower and upper urinary tract and are characterized by multiple recurrences. Aristolochic acid (AA) is a potent nephrotoxin and human carcinogen associated with UC. East Asian populations with a high UC prevalence have an unusual genome-wide AA-induced mutational pattern. To address the genomic differences and clonal relatedness between primary and recurrent tumors in the UCs with AA pattern, we investigated the genomic differences and tumor microenvironment (TME) of AA and non-AA UCs. 17 UC patients were recruited, with nine documented AA exposure. Eleven of them showed recurrence. After-surgery tissues of primary and paired recurrent tumors were collected. Capture-based targeted deep sequencing was performed using a commercial panel consisting of 520 cancer-related genes. Tumor-infiltrating lymphocytes (TILs) were identified with an immunofluorescence-based microenvironment analysis panel (MAP). Hierarchical clustering based on the COSMIC signatures confirmed two significant subtypes: AA Sig and non-AA Sig. AA Sig was associated with AA-containing herbal drug intake, recurrence, and higher tumor mutation burden (TMB). The clonal architecture of UCs revealed three types of clonal evolution patterns. Non-AA Sig cohort showed shared clonal origin of primary and recurrent tumors. AA Sig showed heterogeneity and had multiple independent origins. Recurrent tumors as second primary tumors in AA Sig showed immunoreactive TME, indicating a better response with immune checkpoint inhibitor therapy. The AA mutational signature and unique immune profiles are helpful molecular markers to distinguish AA exposure from other carcinogens. These results also provide new insights into the origin of recurrent UCs that could affect treatment strategies.
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Affiliation(s)
- Jie Zhu
- Senior Department of Urology, The Third Medical Center of Chinese People's Liberation Army General Hospital, Beijing, China
| | - Qing Ai
- Senior Department of Urology, The Third Medical Center of Chinese People's Liberation Army General Hospital, Beijing, China
| | - Qiang Cheng
- Senior Department of Urology, The Third Medical Center of Chinese People's Liberation Army General Hospital, Beijing, China
| | - Dan Shen
- Senior Department of Urology, The Third Medical Center of Chinese People's Liberation Army General Hospital, Beijing, China
| | - Zhouhuan Dong
- Department of Pathology, The First Medical Center of Chinese People's Liberation Army General Hospital, Beijing, China
| | - Jie Li
- Department of Pathology, The First Medical Center of Chinese People's Liberation Army General Hospital, Beijing, China
| | - Donglai Shen
- Senior Department of Urology, The Third Medical Center of Chinese People's Liberation Army General Hospital, Beijing, China
| | - Wei Wang
- Senior Department of Urology, The Third Medical Center of Chinese People's Liberation Army General Hospital, Beijing, China
| | - Xu Zhang
- Senior Department of Urology, The Third Medical Center of Chinese People's Liberation Army General Hospital, Beijing, China
- *Correspondence: Hongzhao Li, ; Xu Zhang,
| | - Hongzhao Li
- Senior Department of Urology, The Third Medical Center of Chinese People's Liberation Army General Hospital, Beijing, China
- *Correspondence: Hongzhao Li, ; Xu Zhang,
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Li T, Liu T, Zhao Z, Pan Y, Xu X, Zhang Y, Zhan S, Zhou S, Zhu W, Guo H, Yang R. Antifungal immunity mediated by C-type lectin receptors may be a novel target in immunotherapy for urothelial bladder cancer. Front Immunol 2022; 13:911325. [PMID: 36131933 PMCID: PMC9483128 DOI: 10.3389/fimmu.2022.911325] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2022] [Accepted: 07/18/2022] [Indexed: 11/29/2022] Open
Abstract
Immunotherapies, such as immune-checkpoint blockade and adoptive T-cell therapy, offer novel treatment options with good efficacy for patients with urothelial bladder cancer. However, heterogeneity and therapeutic resistance have limited the use of immunotherapy. Further research into immune-regulatory mechanisms in bladder cancer is urgently required. Emerging evidence demonstrates that the commensal microbiota and its interactions with host immunity play pivotal roles in a variety of physiological and pathological processes, including in cancer. The gut microbiota has been identified as a potentially effective target of treatment that can be synergized with immunotherapy. The urothelial tract is also a key site for multiple microbes, although the immune-regulatory role of the urinary microbiome in the process of carcinogenesis of bladder cancer remains to be elucidated. We performed a comprehensive analysis of the expression and biological functions of C-type lectin receptors (CLRs), which have been recognized as innate pathogen-associated receptors for fungal microbiota, in bladder cancer. In line with previous research on fungal colonization of the urothelial tract, we found that CLRs, including Dectin-1, Dectin-2, Dectin-3, and macrophage-inducible Ca2+-dependent lectin receptor (Mincle), had a significant association with immune infiltration in bladder cancer. Multiple innate and adaptive pathways are positively correlated with the upregulation of CLRs. In addition, we found a significant correlation between the expression of CLRs and a range of immune-checkpoint proteins in bladder cancer. Based on previous studies and our findings, we hypothesize that the urinary mycobiome plays a key role in the pathogenesis of bladder cancer and call for more research on CLR-mediated anti-fungal immunity against bladder cancer as a novel target for immunotherapy in urothelial bladder cancer.
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Affiliation(s)
- Tianhang Li
- Department of Urology, Affiliated Nanjing Drum Tower Hospital, Medical School, Nanjing University, Nanjing, China
| | - Tianyao Liu
- Department of Urology, Affiliated Nanjing Drum Tower Hospital, Medical School, Nanjing University, Nanjing, China
| | - Zihan Zhao
- Department of Urology, Affiliated Nanjing Drum Tower Hospital, Medical School, Nanjing University, Nanjing, China
| | - Yuchen Pan
- State Key Laboratory of Pharmaceutical Biotechnology, Division of Immunology, Medical School, Nanjing University, Nanjing, China
| | - Xinyan Xu
- Department of Urology, Affiliated Nanjing Drum Tower Hospital, Medical School, Nanjing University, Nanjing, China
| | - Yulin Zhang
- Department of Urology, Affiliated Nanjing Drum Tower Hospital, Medical School, Nanjing University, Nanjing, China
| | - Shoubin Zhan
- Jiangsu Engineering Research Center for microRNA Biology and Biotechnology, State Key Laboratory of Pharmaceutical Biotechnology, School of Life Sciences, Nanjing University, Nanjing, China
| | - Shengkai Zhou
- Jiangsu Engineering Research Center for microRNA Biology and Biotechnology, State Key Laboratory of Pharmaceutical Biotechnology, School of Life Sciences, Nanjing University, Nanjing, China
| | - Wenjie Zhu
- Department of Urology, Affiliated Nanjing Drum Tower Hospital, Medical School, Nanjing University, Nanjing, China
| | - Hongqian Guo
- Department of Urology, Affiliated Nanjing Drum Tower Hospital, Medical School, Nanjing University, Nanjing, China
- *Correspondence: Rong Yang, ; Hongqian Guo,
| | - Rong Yang
- Department of Urology, Affiliated Nanjing Drum Tower Hospital, Medical School, Nanjing University, Nanjing, China
- *Correspondence: Rong Yang, ; Hongqian Guo,
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Xue R, Zhao C, Chen D, Wang P, Xing W, Zeng W, Li Q. Potential influence of anaesthesia techniques on the recurrence and progression after resection of non-muscle-invasive bladder cancer: a propensity score-matched analysis. BMC Anesthesiol 2022; 22:263. [PMID: 35982423 PMCID: PMC9386928 DOI: 10.1186/s12871-022-01802-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Accepted: 08/08/2022] [Indexed: 11/10/2022] Open
Abstract
Background The non-muscle-invasive bladder cancer is a common malignancy of the urinary system. Many patients relapse after transurethral resection surgery. Different anaesthesia techniques may influence a patient’s immune system during the perioperative time. In this study, we examined the effects of different anaesthesia techniques on the prognosis of primary non-muscle-invasive bladder cancer after transurethral resection surgery. Methods In the period 2008 to 2017, a total of 926 patients suffered primary non-muscle-invasive bladder and underwent transurethral resection of bladder tumour surgery for the first time. These patients were divided into two groups according to the techniques that were used. There were 662 patients in the general anaesthesia group, who received propofol, opioid drugs (fentanyl family), non-depolarizing muscle relaxants, and sevoflurane, and 264 patients in the epidural anaesthesia group, who had an epidural catheter placed in the L2-L3 or L3-L4 interspace with a combination of lidocaine and ropivacaine or bupivacaine. We analyzed the influence factors that might affect prognosis and compared the recurrence-free survival time and the progression between the two groups. Results The differences between the two groups in recurrence rate and progression rate were not statistically significant. Progression-free survival time of the epidural anaesthesia group was longer. Multivariate regression analysis showed that anaesthesia techniques were not independent influencing factors for recurrence and progression. Conclusions It was not found that anaesthesia techniques affected the recurrence or progression of patients with primary non-muscle-invasive bladder cancer after transurethral resection of bladder tumour.
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Affiliation(s)
- Ruifeng Xue
- Department of Anaesthesiology, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, 510060, Guangdong, China
| | - Chongxi Zhao
- Department of Anaesthesiology, State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, 510060, Guangdong, China
| | - Dongtai Chen
- Department of Anaesthesiology, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, 510060, Guangdong, China
| | - Peizong Wang
- Department of Anaesthesiology, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, 510060, Guangdong, China
| | - Wei Xing
- Department of Anaesthesiology, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, 510060, Guangdong, China
| | - Weian Zeng
- Department of Anaesthesiology, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, 510060, Guangdong, China
| | - Qiang Li
- Department of Anaesthesiology, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, 510060, Guangdong, China.
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