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Reis H, Szarvas T, Grünwald V. [Predictive biomarkers in oncologic uropathology]. DER PATHOLOGE 2019; 40:264-275. [PMID: 31073639 DOI: 10.1007/s00292-019-0606-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
BACKGROUND Tumors of the genitourinary system are common. In recent years, our understanding of their molecular background and therefore the number of potential predictive biomarkers has massively increased. OBJECTIVES The aim of the current work is to give an overview of recent (molecular) developments and predictive biomarkers in urologic oncology and to give a perspective of what might become relevant in the future of the field. MATERIAL AND METHODS We considered the recent literature and study data and combined it with our own expertise in tumors of the urinary system, kidneys, and prostate. RESULTS AND CONCLUSIONS The molecular subtypes of muscle-invasive urothelial bladder cancer (MIBC) hold a predictive and prognostic significance and correlate with clinicopathological features. Immune therapy with checkpoint inhibitors (CPI) has a major role in urothelial carcinoma (UC), but also in renal cell carcinoma and a subgroup of prostate cancers. The first-line use in UC is restricted to PD-L1-"positive" cases (≥IC2/3, CPS ≥ 10). Further predictive markers are currently under evaluation, while the predictive significance of tumor mutational burden (TMB) is under debate. In addition to a subgroup of renal cell carcinomas, a subgroup of prostate carcinomas with alterations in the DNA repair system might benefit from a customized therapy approach (PARP inhibitors, platin-containing chemotherapy). The multitude of potentially therapy-relevant molecular alterations and related predictive biomarkers calls for the implementation of sophisticated molecular analyses in daily routine. This will lead to an even more rapid dynamic in the field of genitourinary pathology.
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Affiliation(s)
- H Reis
- Institut für Pathologie, Westdeutsches Tumorzentrum Essen, Universitätsmedizin Essen, Universität Duisburg-Essen, Hufelandstr. 55, 45147, Essen, Deutschland.
| | - T Szarvas
- Klinik für Urologie, Westdeutsches Tumorzentrum Essen, Universitätsmedizin Essen, Universität Duisburg-Essen, Essen, Deutschland.,Klinik für Urologie, Semmelweis-Universität, Budapest, Ungarn
| | - V Grünwald
- Interdisziplinäre Uroonkologie des Westdeutschen Tumorzentrums Essen, Klinik für Urologie, Innere Medizin (Tumorforschung), Universitätsmedizin Essen, Universität Duisburg-Essen, Essen, Deutschland
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Menezes GLG, Pijnappel RM, Meeuwis C, Bisschops R, Veltman J, Lavin PT, van de Vijver MJ, Mann RM. Downgrading of Breast Masses Suspicious for Cancer by Using Optoacoustic Breast Imaging. Radiology 2018; 288:355-365. [PMID: 29664342 DOI: 10.1148/radiol.2018170500] [Citation(s) in RCA: 59] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Purpose To assess the ability of optoacoustic (OA) ultrasonography (US) to help correctly downgrade benign masses classified as Breast Imaging Reporting and Data System (BI-RADS) 4a and 4b to BI-RADS 3 or 2. Materials and Methods OA/US technology uses laser light to detect relative amounts of oxygenated and deoxygenated hemoglobin in and around suspicious breast masses. In this prospective, multicenter study, results of 209 patients with 215 breast masses classified as BI-RADS 4a or 4b at US are reported. Patients were enrolled between 2015 and 2016. Masses were first evaluated with US with knowledge of previous clinical information and imaging results, and from this information a US imaging-based probability of malignancy (POM) and BI-RADS category were assigned to each mass. The same masses were then re-evaluated at OA/US. During the OA/US evaluation, radiologists scored five OA/US features, and then reassigned an OA/US-based POM and BI-RADS category for each mass. BI-RADS downgrade and upgrade percentages at OA/US were assessed by using a weighted sum of the five OA feature scores. Results At OA/US, 47.9% (57 of 119; 95% CI: 0.39, 0.57) of benign masses classified as BI-RADS 4a and 11.1% (three of 27; 95% CI: 0.03, 0.28) of masses classified as BI-RADS 4b were correctly downgraded to BI-RADS 3 or 2. Two of seven malignant masses classified as BI-RADS 4a at US were incorrectly downgraded, and one of 60 malignant masses classified as BI-RADS 4b at US was incorrectly downgraded for a total of 4.5% (three of 67; 95% CI: 0.01, 0.13) false-negative findings. Conclusion At OA/US, benign masses classified as BI-RADS 4a could be downgraded in BI-RADS category, which would potentially decrease biopsies negative for cancer and short-interval follow-up examinations, with the limitation that a few masses may be inappropriately downgraded.
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Affiliation(s)
- Gisela L G Menezes
- From the Department of Radiology and Nuclear Medicine, University Medical Center Utrecht, E01.132, P.O. Box 85500, 3508, GA Utrecht, Heidelberglaan 100, 3584 CX, Utrecht, the Netherlands (G.L.G.M., R.M.P.); Department of Radiology, Rijnstate Hospital, Arnhem, the Netherlands (C.M.); Department of Radiology, Albert Schweitzer Hospital, Dordrecht, the Netherlands (R.B.); Department of Radiology, Hospital Group Twente (ZGT), Almelo, the Netherlands (J.V.); Boston Biostatistics Research Foundation, Framingham, Mass (P.T.L.); Department of Pathology, Netherlands Cancer Institute, Amsterdam, the Netherlands (M.J.v.d.V.); and Department of Radiology, Radboud University Medical Center, Geert Grooteplein Zuid 10, 6525 GA, Nijmegen, the Netherlands (R.M.M.)
| | - Ruud M Pijnappel
- From the Department of Radiology and Nuclear Medicine, University Medical Center Utrecht, E01.132, P.O. Box 85500, 3508, GA Utrecht, Heidelberglaan 100, 3584 CX, Utrecht, the Netherlands (G.L.G.M., R.M.P.); Department of Radiology, Rijnstate Hospital, Arnhem, the Netherlands (C.M.); Department of Radiology, Albert Schweitzer Hospital, Dordrecht, the Netherlands (R.B.); Department of Radiology, Hospital Group Twente (ZGT), Almelo, the Netherlands (J.V.); Boston Biostatistics Research Foundation, Framingham, Mass (P.T.L.); Department of Pathology, Netherlands Cancer Institute, Amsterdam, the Netherlands (M.J.v.d.V.); and Department of Radiology, Radboud University Medical Center, Geert Grooteplein Zuid 10, 6525 GA, Nijmegen, the Netherlands (R.M.M.)
| | - Carla Meeuwis
- From the Department of Radiology and Nuclear Medicine, University Medical Center Utrecht, E01.132, P.O. Box 85500, 3508, GA Utrecht, Heidelberglaan 100, 3584 CX, Utrecht, the Netherlands (G.L.G.M., R.M.P.); Department of Radiology, Rijnstate Hospital, Arnhem, the Netherlands (C.M.); Department of Radiology, Albert Schweitzer Hospital, Dordrecht, the Netherlands (R.B.); Department of Radiology, Hospital Group Twente (ZGT), Almelo, the Netherlands (J.V.); Boston Biostatistics Research Foundation, Framingham, Mass (P.T.L.); Department of Pathology, Netherlands Cancer Institute, Amsterdam, the Netherlands (M.J.v.d.V.); and Department of Radiology, Radboud University Medical Center, Geert Grooteplein Zuid 10, 6525 GA, Nijmegen, the Netherlands (R.M.M.)
| | - Robertus Bisschops
- From the Department of Radiology and Nuclear Medicine, University Medical Center Utrecht, E01.132, P.O. Box 85500, 3508, GA Utrecht, Heidelberglaan 100, 3584 CX, Utrecht, the Netherlands (G.L.G.M., R.M.P.); Department of Radiology, Rijnstate Hospital, Arnhem, the Netherlands (C.M.); Department of Radiology, Albert Schweitzer Hospital, Dordrecht, the Netherlands (R.B.); Department of Radiology, Hospital Group Twente (ZGT), Almelo, the Netherlands (J.V.); Boston Biostatistics Research Foundation, Framingham, Mass (P.T.L.); Department of Pathology, Netherlands Cancer Institute, Amsterdam, the Netherlands (M.J.v.d.V.); and Department of Radiology, Radboud University Medical Center, Geert Grooteplein Zuid 10, 6525 GA, Nijmegen, the Netherlands (R.M.M.)
| | - Jeroen Veltman
- From the Department of Radiology and Nuclear Medicine, University Medical Center Utrecht, E01.132, P.O. Box 85500, 3508, GA Utrecht, Heidelberglaan 100, 3584 CX, Utrecht, the Netherlands (G.L.G.M., R.M.P.); Department of Radiology, Rijnstate Hospital, Arnhem, the Netherlands (C.M.); Department of Radiology, Albert Schweitzer Hospital, Dordrecht, the Netherlands (R.B.); Department of Radiology, Hospital Group Twente (ZGT), Almelo, the Netherlands (J.V.); Boston Biostatistics Research Foundation, Framingham, Mass (P.T.L.); Department of Pathology, Netherlands Cancer Institute, Amsterdam, the Netherlands (M.J.v.d.V.); and Department of Radiology, Radboud University Medical Center, Geert Grooteplein Zuid 10, 6525 GA, Nijmegen, the Netherlands (R.M.M.)
| | - Philip T Lavin
- From the Department of Radiology and Nuclear Medicine, University Medical Center Utrecht, E01.132, P.O. Box 85500, 3508, GA Utrecht, Heidelberglaan 100, 3584 CX, Utrecht, the Netherlands (G.L.G.M., R.M.P.); Department of Radiology, Rijnstate Hospital, Arnhem, the Netherlands (C.M.); Department of Radiology, Albert Schweitzer Hospital, Dordrecht, the Netherlands (R.B.); Department of Radiology, Hospital Group Twente (ZGT), Almelo, the Netherlands (J.V.); Boston Biostatistics Research Foundation, Framingham, Mass (P.T.L.); Department of Pathology, Netherlands Cancer Institute, Amsterdam, the Netherlands (M.J.v.d.V.); and Department of Radiology, Radboud University Medical Center, Geert Grooteplein Zuid 10, 6525 GA, Nijmegen, the Netherlands (R.M.M.)
| | - Marc J van de Vijver
- From the Department of Radiology and Nuclear Medicine, University Medical Center Utrecht, E01.132, P.O. Box 85500, 3508, GA Utrecht, Heidelberglaan 100, 3584 CX, Utrecht, the Netherlands (G.L.G.M., R.M.P.); Department of Radiology, Rijnstate Hospital, Arnhem, the Netherlands (C.M.); Department of Radiology, Albert Schweitzer Hospital, Dordrecht, the Netherlands (R.B.); Department of Radiology, Hospital Group Twente (ZGT), Almelo, the Netherlands (J.V.); Boston Biostatistics Research Foundation, Framingham, Mass (P.T.L.); Department of Pathology, Netherlands Cancer Institute, Amsterdam, the Netherlands (M.J.v.d.V.); and Department of Radiology, Radboud University Medical Center, Geert Grooteplein Zuid 10, 6525 GA, Nijmegen, the Netherlands (R.M.M.)
| | - Ritse M Mann
- From the Department of Radiology and Nuclear Medicine, University Medical Center Utrecht, E01.132, P.O. Box 85500, 3508, GA Utrecht, Heidelberglaan 100, 3584 CX, Utrecht, the Netherlands (G.L.G.M., R.M.P.); Department of Radiology, Rijnstate Hospital, Arnhem, the Netherlands (C.M.); Department of Radiology, Albert Schweitzer Hospital, Dordrecht, the Netherlands (R.B.); Department of Radiology, Hospital Group Twente (ZGT), Almelo, the Netherlands (J.V.); Boston Biostatistics Research Foundation, Framingham, Mass (P.T.L.); Department of Pathology, Netherlands Cancer Institute, Amsterdam, the Netherlands (M.J.v.d.V.); and Department of Radiology, Radboud University Medical Center, Geert Grooteplein Zuid 10, 6525 GA, Nijmegen, the Netherlands (R.M.M.)
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