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Seiler R, Egger M, De Menna M, Wehrli S, Minoli M, Radić M, Lyatoshinsky P, Hösli R, Blarer J, Abt D, Kruithof-de Julio M. Guidance of adjuvant instillation in intermediate-risk non-muscle invasive bladder cancer by drug screens in patient derived organoids: a single center, open-label, phase II trial. BMC Urol 2023; 23:89. [PMID: 37170307 PMCID: PMC10176900 DOI: 10.1186/s12894-023-01262-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Accepted: 04/27/2023] [Indexed: 05/13/2023] Open
Abstract
BACKGROUND In intermediate-risk non-muscle invasive bladder cancer (NMIBC) clinical guidelines suggest an adjuvant instillation with a chemotherapeutic agent. However, the agent and regimen are not clearly defined. Worldwide, less than 15% of patients receive this adjuvant chemotherapeutic instillation. We recently developed a pipeline for the generation of patient derived organoids (PDO) in NMIBC. In this phase II trial, we aim to use our in vitro pipeline to select the most effective drug for chemotherapeutic instillation in NMIBC patients. METHODS Patients with first diagnosis of intermediate-risk NMIBC that are directed to transurethral resection of bladder tumor (TURBT) are enrolled. During TURBT, tumor is sampled, and specimens are directed to generate PDO. Once the PDO are formed, drug screens on them for Epirubicin, Mitomycin C, Gemcitabine and Docetaxel are performed. The drug with the highest antitumor activity in vitro will then be selected for 6 adjuvant intravesical instillations once weekly. Thereafter, patients are followed according to clinical guidelines by cystoscopy. DISCUSSION The aim of this trial is to use drug screens in PDO to precise treatment selection for adjuvant instillation therapies in patients with intermediate-risk NMIBC. The ultimate goal of this trial is to reduce the risk of cancer recurrence. In the future, we aim to conduct clinical multicenter trials with an increased sample size, a broader panel of compounds and a focus on the reduction of cancer recurrence by precision delivery of care. Trial registration NCT05024734.
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Affiliation(s)
- Roland Seiler
- Department of Urology, Hospital Center Biel, Spitalzentrum Biel, Vogelsang 84, 2501, Biel, Switzerland.
- Department for BioMedical Research, Translational Organoid Resource Core, University of Bern, Bern, Switzerland.
| | - Martin Egger
- Department of Urology, Hospital Center Biel, Spitalzentrum Biel, Vogelsang 84, 2501, Biel, Switzerland
| | - Marta De Menna
- Department for BioMedical Research, Translational Organoid Resource Core, University of Bern, Bern, Switzerland
| | - Saskia Wehrli
- Department of Urology, Hospital Center Biel, Spitalzentrum Biel, Vogelsang 84, 2501, Biel, Switzerland
| | - Martina Minoli
- Department for BioMedical Research, Translational Organoid Resource Core, University of Bern, Bern, Switzerland
| | - Martina Radić
- Department for BioMedical Research, Translational Organoid Resource Core, University of Bern, Bern, Switzerland
| | - Pavel Lyatoshinsky
- Department of Urology, Hospital Center Biel, Spitalzentrum Biel, Vogelsang 84, 2501, Biel, Switzerland
- Department of Urology, St. Gallen Cantonal Hospital, St. Gallen, Switzerland
| | - Raphael Hösli
- Department of Pharmacy, Hospital Center Biel, Biel, Switzerland
| | - Jennifer Blarer
- Department of Urology, Hospital Center Biel, Spitalzentrum Biel, Vogelsang 84, 2501, Biel, Switzerland
| | - Dominik Abt
- Department of Urology, Hospital Center Biel, Spitalzentrum Biel, Vogelsang 84, 2501, Biel, Switzerland
| | - Marianna Kruithof-de Julio
- Department for BioMedical Research, Translational Organoid Resource Core, University of Bern, Bern, Switzerland
- Department for BioMedical Research, Urology Research Laboratory, University of Bern, 3008, Bern, Switzerland
- Department of Urology, Inselspital, Bern University Hospital, 3010, Bern, Switzerland
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Lyatoshinsky P, Pratsinis M, Markert E, Schmid HP, Müllhaupt G. Spindle cell/pleomorphic lipoma of the seminal vesicle: First description of a rare benign mesenchymal tumor. Urol Case Rep 2023; 47:102337. [PMID: 36816611 PMCID: PMC9929669 DOI: 10.1016/j.eucr.2023.102337] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2023] [Revised: 01/20/2023] [Accepted: 01/24/2023] [Indexed: 01/31/2023] Open
Abstract
We describe the first case of a spindle cell/pleomorphic lipoma of the seminal vesicle. A 6.2cm large mass originating from the left seminal vesicle was incidentally detected on imaging for peripheral arterial disease. A transrectal ultrasound-guided biopsy was negative for malignancy. We proceeded with a robotic tumor resection due to the size of the mass and sarcomatoid features present on MR imaging. The final pathological work-up revealed a spindle cell/pleomorphic lipoma, immunohistochemical staining was performed with no malignant features detected, in particular no signs of an atypical lipomatous tumor. Ejaculatory function was preserved with reduced volume at 6-weeks follow-up.
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Affiliation(s)
- Pavel Lyatoshinsky
- Department of Urology, Institute for Medicine, University St. Gallen, St. Gallen, Switzerland,Corresponding author.
| | - Manolis Pratsinis
- Department of Urology, Institute for Medicine, University St. Gallen, St. Gallen, Switzerland,Department of Urology, University of California-Davis Medical Center, Sacramento, CA, USA
| | - Eva Markert
- Department of Pathology, Institute for Medicine, University St. Gallen, St. Gallen, Switzerland
| | - Hans-Peter Schmid
- Department of Urology, Institute for Medicine, University St. Gallen, St. Gallen, Switzerland
| | - Gautier Müllhaupt
- Department of Urology, Institute for Medicine, University St. Gallen, St. Gallen, Switzerland
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Abt D, Lyatoshinsky P, Schmid HP, Müllhaupt G. Prostatic Artery Embolisation: Do We Still Need It and for Whom? Eur Urol Focus 2022; 8:384-387. [PMID: 35484049 DOI: 10.1016/j.euf.2022.04.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Revised: 04/06/2022] [Accepted: 04/12/2022] [Indexed: 11/04/2022]
Abstract
Prostatic artery embolisation (PAE) is now endorsed by international evidence-based guidelines as a treatment for lower urinary tract symptoms presumed secondary to benign prostatic obstruction (LUTS/BPO) for selected patients. PAE is a truly minimally invasive technique, with proven efficacy and safety demonstrated for the short- to mid-term. As it has a unique treatment approach (endovascular instead of transurethral), its profile and ideal application differ clearly from other treatments for LUTS/BPO, which must be considered for patient selection. This mini review examines the role of PAE in the treatment of LUTS/BPO on the basis of current evidence. PATIENT SUMMARY: For properly selected patients, prostatic artery embolisation (PAE), in which arteries feeding the prostate are blocked in a nonsurgical procedure, is one of the treatment options for obstruction of urine outflow caused by benign enlargement of the prostate. This article examines the role of PAE according to the evidence available in the literature.
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Affiliation(s)
- Dominik Abt
- Department of Urology, Spitalzentrum Biel, Centre Hospitalier Bienne, Biel, Switzerland.
| | - Pavel Lyatoshinsky
- Department of Urology, Spitalzentrum Biel, Centre Hospitalier Bienne, Biel, Switzerland
| | - Hans-Peter Schmid
- Department of Urology, School of Medicine, University of St. Gallen, St. Gallen, Switzerland
| | - Gautier Müllhaupt
- Department of Urology, School of Medicine, University of St. Gallen, St. Gallen, Switzerland
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Bilhim T, Betschart P, Lyatoshinsky P, Müllhaupt G, Abt D. Minimally Invasive Therapies for Benign Prostatic Obstruction: A Review of Currently Available Techniques Including Prostatic Artery Embolization, Water Vapor Thermal Therapy, Prostatic Urethral Lift, Temporary Implantable Nitinol Device and Aquablation. Cardiovasc Intervent Radiol 2022; 45:415-424. [DOI: 10.1007/s00270-021-03052-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2021] [Accepted: 12/21/2021] [Indexed: 02/06/2023]
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Koch M, Lyatoshinsky P, Mitulovic G, Bodner-Adler B, Lange S, Hanzal E, Umek W. Characteristics of the Urinary Proteome in Women with Overactive Bladder Syndrome: A Case-Control Study. J Clin Med 2021; 10:jcm10112446. [PMID: 34072980 PMCID: PMC8198757 DOI: 10.3390/jcm10112446] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Revised: 05/28/2021] [Accepted: 05/29/2021] [Indexed: 11/16/2022] Open
Abstract
Despite an estimated prevalence of 13% in women, the exact etiology of non-neurogenic overactive bladder syndrome is unclear. The aim of our study was to gain a better understanding of the pathophysiology of female overactive bladder syndrome by mapping the urinary proteomic profile. We collected urine samples of 20 patients with overactive bladder syndrome and of 20 controls. We used mass spectrometric analysis for label-free quantitation, Swissprot human database for data search, Scaffold for data allocation and the Reactome Knowledgebase for final pathway enrichment analysis. We identified 1897 proteins at a false discovery rate of 1% and significance level p < 0.001. Thirty-seven significant proteins of the case group and 53 of the control group met the criteria for further pathway analysis (p < 0.0003 and Log2 (fold change) >2). Significant proteins of the overactive bladder group were, according to the 25 most relevant pathways, mainly involved in cellular response to stress and apoptosis. In the control group, significant pathways mainly concerned immunological, microbial-protective processes and tissue- elasticity processes. These findings may suggest a loss of protective factors as well as increased cellular response to stress and apoptosis in overactive bladder syndrome.
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Affiliation(s)
- Marianne Koch
- Department of Obstetrics and Gynecology, Medical University of Vienna, 1090 Vienna, Austria; (B.B.-A.); (S.L.); (E.H.); (W.U.)
- Correspondence: ; Tel.: +43-1-404-002-9150
| | - Pavel Lyatoshinsky
- Department of Urology, Cantonal Hospital St Gallen, 9007 St Gallen, Switzerland;
| | - Goran Mitulovic
- Clinical Institute of Laboratory Medicine and Proteomics Core Facility, Medical University of Vienna, 1090 Vienna, Austria;
| | - Barbara Bodner-Adler
- Department of Obstetrics and Gynecology, Medical University of Vienna, 1090 Vienna, Austria; (B.B.-A.); (S.L.); (E.H.); (W.U.)
| | - Sören Lange
- Department of Obstetrics and Gynecology, Medical University of Vienna, 1090 Vienna, Austria; (B.B.-A.); (S.L.); (E.H.); (W.U.)
| | - Engelbert Hanzal
- Department of Obstetrics and Gynecology, Medical University of Vienna, 1090 Vienna, Austria; (B.B.-A.); (S.L.); (E.H.); (W.U.)
| | - Wolfgang Umek
- Department of Obstetrics and Gynecology, Medical University of Vienna, 1090 Vienna, Austria; (B.B.-A.); (S.L.); (E.H.); (W.U.)
- Karl Landsteiner Society, Institute for Special Gynecology and Obstetrics, 3100 St. Pölten, Austria
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Lyatoshinsky P, Pratsinis M, Abt D, Schmid HP, Zumstein V, Betschart P. Readability Assessment of Commonly Used German Urological Questionnaires. Curr Urol 2019; 13:87-93. [DOI: 10.1159/000499287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2018] [Accepted: 01/10/2019] [Indexed: 11/19/2022] Open
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