Oncology – Urological
RCT: Five-Fraction SBRT Noninferior to Conventional Radiotherapy in Localized Prostate Cancer
20 Oct, 2024 | 15:46h | UTCBackground: Prostate cancer poses a significant global health challenge, with radiotherapy being a common curative treatment for localized disease. Hypofractionation, delivering higher doses per session over fewer treatments, has potential benefits in efficacy and convenience. While moderately hypofractionated radiotherapy is established, the efficacy of stereotactic body radiotherapy (SBRT) delivering radiation in just five fractions remains uncertain.
Objective: To assess whether five-fraction SBRT is noninferior to conventionally or moderately hypofractionated radiotherapy regarding freedom from biochemical or clinical failure in patients with low-to-intermediate-risk localized prostate cancer.
Methods: In this phase 3, international, open-label randomized controlled trial (PACE-B), 874 men with stage T1–T2 prostate cancer, Gleason score ≤3+4, and prostate-specific antigen (PSA) ≤20 ng/mL were randomized 1:1 to receive SBRT (36.25 Gy in 5 fractions over 1–2 weeks) or control radiotherapy (78 Gy in 39 fractions over 7.5 weeks or 62 Gy in 20 fractions over 4 weeks). Androgen-deprivation therapy was not permitted. The primary endpoint was freedom from biochemical or clinical failure.
Results: Between August 2012 and January 2018, 874 patients were randomized (433 to SBRT and 441 to control radiotherapy) at 38 centers. Median age was 69.8 years, median PSA was 8.0 ng/mL, and 91.6% had intermediate-risk disease. At a median follow-up of 74.0 months, the 5-year incidence of freedom from biochemical or clinical failure was 95.8% in the SBRT group and 94.6% in the control group (unadjusted HR 0.73; 90% CI, 0.48 to 1.12; P=0.004 for noninferiority). Cumulative incidence of late Radiation Therapy Oncology Group (RTOG) grade 2 or higher genitourinary toxic effects at 5 years was higher with SBRT (26.9% vs. 18.3%; P<0.001), while gastrointestinal toxic effects were similar between groups (10.7% vs. 10.2%; P=0.94). Overall survival did not differ significantly (HR for death, 1.41; 95% CI, 0.90 to 2.20).
Conclusions: Five-fraction SBRT was noninferior to conventional or moderately hypofractionated radiotherapy in terms of biochemical or clinical failure in patients with low-to-intermediate-risk localized prostate cancer. SBRT may be an effective treatment option but is associated with a higher incidence of medium-term genitourinary toxic effects.
Implications for Practice: SBRT offers equivalent oncologic efficacy with the convenience of fewer treatment sessions, potentially reducing patient burden and healthcare resource utilization. Clinicians should consider SBRT for eligible patients but must inform them about the increased medium-term risk of genitourinary toxic effects.
Study Strengths and Limitations: Strengths include a large sample size, multicenter design, standardized radiotherapy protocols, and exclusion of hormonal therapy, minimizing confounding factors. Limitations involve the applicability of findings only to patients similar to those in the trial; some may now opt for active surveillance, and results may not extend to higher-risk populations.
Future Research: Further studies are needed to evaluate long-term outcomes of SBRT, its role in higher-risk patients, and strategies to mitigate genitourinary toxic effects.
RCT: MRI-Guided Biopsy Reduces Overdiagnosis of Clinically Insignificant Prostate Cancer
26 Sep, 2024 | 12:22h | UTCBackground: Overdiagnosis of clinically insignificant prostate cancer is a significant issue in population-based screening programs, primarily when prostate-specific antigen (PSA) testing is followed by systematic biopsy. Magnetic resonance imaging (MRI)-guided biopsies, which avoid systematic biopsies in men with negative MRI results, have shown potential in reducing unnecessary cancer diagnoses. However, long-term data are needed to confirm the safety and efficacy of this approach.
Objective: To evaluate whether MRI-targeted biopsies, when combined with PSA screening, can reduce the detection of clinically insignificant prostate cancer without compromising the identification of clinically significant or advanced disease.
Methods: This population-based, randomized trial in Sweden (GÖTEBORG-2) enrolled 13,153 men aged 50-60 years who underwent PSA screening. Men with PSA levels ≥3 ng/mL were randomized into two groups: (1) MRI-targeted biopsy only in cases with suspicious lesions, or (2) systematic biopsy in all cases with PSA elevation. Screening occurred every 2, 4, or 8 years depending on PSA levels, with follow-up for up to four years. The primary outcome was the detection of clinically insignificant prostate cancer, and secondary outcomes included clinically significant and advanced or high-risk prostate cancer.
Results: After a median follow-up of 3.9 years, the detection of clinically insignificant prostate cancer was significantly lower in the MRI-targeted biopsy group (2.8%) compared to the systematic biopsy group (4.5%), with a relative risk (RR) of 0.43 (95% CI, 0.32-0.57; P < 0.001). The relative risk of detecting clinically significant cancer was 0.84 (95% CI, 0.66-1.07), indicating no significant difference between the two groups. Advanced or high-risk cancers were detected in 15 men in the MRI group and 23 men in the systematic group (RR, 0.65; 95% CI, 0.34-1.24). Severe adverse events occurred in five patients (three in the systematic biopsy group, two in the MRI-targeted biopsy group).
Conclusions: Omitting biopsies in men with negative MRI results substantially reduced the diagnosis of clinically insignificant prostate cancer without increasing the risk of missing clinically significant or advanced cancers. MRI-targeted biopsy strategies can effectively limit overdiagnosis while maintaining safety in screening programs.
Implications for Practice: MRI-targeted biopsies offer a promising strategy to reduce unnecessary cancer diagnoses and avoid overtreatment in prostate cancer screening. Clinicians should consider integrating MRI into prostate cancer screening algorithms, especially in cases with elevated PSA but no MRI-detected lesions. This approach may also decrease biopsy-related complications and patient anxiety.
Study Strengths and Limitations: Strengths of this trial include its population-based design, large sample size, and thorough follow-up. Limitations include its single-center setting in Sweden, which may limit generalizability to more diverse populations, and a modest participation rate of 50%.
Future Research: Further studies should assess the cost-effectiveness of widespread MRI use in prostate cancer screening and explore its utility in diverse populations. Investigations into novel biomarkers that could further refine patient selection for MRI-targeted biopsy are also warranted.
RCT: Perioperative Durvalumab Plus Neoadjuvant Chemotherapy Improved Survival in Muscle-Invasive Bladder Cancer
18 Sep, 2024 | 15:22h | UTCBackground: Neoadjuvant cisplatin-based chemotherapy followed by radical cystectomy is the standard treatment for cisplatin-eligible patients with muscle-invasive bladder cancer (MIBC). Despite this approach, approximately 50% of patients experience recurrence within 3 years. Combining immunotherapy with chemotherapy may enhance outcomes, and durvalumab, a PD-L1 inhibitor, has shown promise when added to chemotherapy in previous studies.
Objective: To evaluate whether perioperative durvalumab combined with neoadjuvant gemcitabine–cisplatin improves event-free survival (EFS) and overall survival (OS) compared to neoadjuvant chemotherapy alone in cisplatin-eligible patients with operable MIBC.
Methods: In the phase 3, open-label, randomized NIAGARA trial, 1063 cisplatin-eligible patients with MIBC (clinical stage T2-T4aN0-1M0) were randomized 1:1 to receive either perioperative durvalumab plus neoadjuvant gemcitabine–cisplatin followed by radical cystectomy and adjuvant durvalumab (durvalumab group, n=533) or neoadjuvant gemcitabine–cisplatin followed by radical cystectomy alone (comparison group, n=530). The primary endpoints were EFS and pathological complete response (pCR). The key secondary endpoint was OS.
Results: At a median follow-up of 42.3 months, the estimated EFS at 24 months was 67.8% (95% CI, 63.6–71.7) in the durvalumab group versus 59.8% (95% CI, 55.4–64.0) in the comparison group (hazard ratio [HR] for progression, recurrence, not undergoing cystectomy, or death, 0.68; 95% CI, 0.56–0.82; P<0.001). The estimated OS at 24 months was 82.2% (95% CI, 78.7–85.2) in the durvalumab group versus 75.2% (95% CI, 71.3–78.8) in the comparison group (HR for death, 0.75; 95% CI, 0.59–0.93; P=0.01). Grade 3 or 4 treatment-related adverse events occurred in 40.6% of patients in the durvalumab group and 40.9% in the comparison group. Radical cystectomy was performed in 88.0% of patients in the durvalumab group and 83.2% in the comparison group.
Conclusions: Perioperative durvalumab combined with neoadjuvant chemotherapy significantly improved event-free and overall survival compared to neoadjuvant chemotherapy alone in cisplatin-eligible patients with operable MIBC.
Implications for Practice: Adding perioperative durvalumab to neoadjuvant chemotherapy may represent a new option for cisplatin-eligible patients with MIBC, offering improved survival outcomes without increasing significant adverse events or delaying surgery.
Study Strengths and Limitations: Strengths include the large sample size and randomized, phase 3 design. Limitations encompass the open-label design and inability to isolate the effects of neoadjuvant versus adjuvant durvalumab. Additionally, the trial was conducted before the widespread use of adjuvant nivolumab, potentially affecting the generalizability of the results.
Future Research: Further studies are needed to delineate the relative contributions of neoadjuvant and adjuvant durvalumab and to explore biomarkers such as circulating tumor DNA to guide treatment decisions.
RCT: Stereotactic Body Radiotherapy Reduced Incontinence and Sexual Dysfunction vs. Prostatectomy in Localized Prostate Cancer
18 Sep, 2024 | 10:51h | UTCBackground: Men with localized prostate cancer have several treatment options, including prostatectomy and radiotherapy. Patient-reported outcomes (PROs) are crucial in guiding treatment decisions due to potential impacts on quality of life. However, randomized data comparing stereotactic body radiotherapy (SBRT) with prostatectomy are lacking.
Objective: To compare patient-reported urinary, bowel, and sexual outcomes at 2 years following SBRT versus prostatectomy in men with low- to intermediate-risk localized prostate cancer.
Methods: In the phase 3 PACE-A randomized controlled trial conducted in the UK from 2012 to 2022, 123 men with National Comprehensive Cancer Network (NCCN) low- to intermediate-risk localized prostate cancer were randomized 1:1 to receive either SBRT (36.25 Gy in five fractions) or prostatectomy. Androgen deprivation therapy was not permitted. The co-primary outcomes were the number of absorbent urinary pads used daily and the Expanded Prostate Index Composite (EPIC-26) bowel domain score at 2 years. Secondary outcomes included clinician-reported toxicity and sexual function.
Results: Among 110 men who received treatment (median age 65.5 years; median PSA 7.9 ng/ml; 92% intermediate-risk), 50 underwent prostatectomy and 60 received SBRT. At 2 years, 50% of prostatectomy patients reported using one or more urinary pads daily compared to 6.5% of SBRT patients (p < 0.001; difference 43%, 95% CI 25%–62%). Bowel domain scores were better for prostatectomy (median 100) than for SBRT (median 87.5; p < 0.001; mean difference 8.9, 95% CI 4.2–13.7). Sexual function scores were worse for prostatectomy (median 18) compared to SBRT (median 62.5; p < 0.001). Clinician-reported genitourinary and gastrointestinal toxicities were low in both groups.
Conclusions: SBRT was associated with significantly less urinary incontinence and sexual dysfunction but slightly worse bowel function compared to prostatectomy at 2 years in men with localized prostate cancer.
Implications for Practice: These findings provide preliminary evidence to inform treatment decisions for men with low- to intermediate-risk localized prostate cancer. SBRT may offer advantages in reducing urinary incontinence and sexual dysfunction, which are significant considerations for patients. Clinicians should also discuss the potential for increased bowel symptoms with SBRT.
Study Strengths and Limitations: Strengths include the randomized design, use of contemporary treatment modalities, and comprehensive assessment of PROs. Limitations involve the small sample size due to slow recruitment, differential dropout rates, and incomplete PRO responses at the 2-year mark.
Future Research: Larger-scale randomized trials are needed to confirm these findings, assess long-term outcomes beyond 2 years, and evaluate the impact on disease control and quality of life.
RCT: Olanzapine Improves Nausea and Vomiting Control in Moderately Emetogenic Chemotherapy but Increases Somnolence
7 Sep, 2024 | 19:28h | UTCStudy Design and Population: This phase 3, multicenter, open-label randomized clinical trial involved 560 chemotherapy-naive patients aged 18 years or older with solid malignant tumors. The trial, conducted at three institutes in India, compared the efficacy of adding olanzapine to standard antiemetic therapy in patients receiving moderately emetogenic chemotherapy (MEC) based on oxaliplatin, carboplatin, or irinotecan.
Main Findings: The group receiving olanzapine in addition to standard antiemetic therapy showed significantly higher complete response (CR) rates (91% vs 82%, P = .005) compared to the observation group. The olanzapine group also demonstrated superior control of nausea (96% vs 87%, P < .001) and chemotherapy-induced nausea and vomiting (CINV) (96% vs 91%, P = .02). The use of rescue medications was significantly lower in the olanzapine group. Grade 1 somnolence occurred in 10% of patients receiving olanzapine but was absent in the observation group.
Implications for Practice: The results support the inclusion of olanzapine in antiemetic regimens for MEC to improve CINV outcomes. However, mild somnolence should be considered when prescribing olanzapine as part of antiemetic prophylaxis. Further research could explore dose optimization to minimize adverse effects.
Reference: Ostwal, V. et al. (2024). Olanzapine as antiemetic prophylaxis in moderately emetogenic chemotherapy: a phase 3 randomized clinical trial. JAMA Network Open. DOI: http://doi.org/10.1001/jamanetworkopen.2024.26076
Link: https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2822027
RCT: : Belzutifan Improves Progression-Free Survival and Objective Response Compared to Everolimus in Advanced Renal-Cell Carcinoma – N Engl J Med
24 Aug, 2024 | 16:48h | UTCStudy Design and Population: This phase 3, multicenter, open-label trial included 746 participants with advanced clear-cell renal-cell carcinoma who had previously undergone immune checkpoint and antiangiogenic therapies. Participants were randomly assigned to receive either belzutifan (120 mg daily) or everolimus (10 mg daily) until disease progression or intolerable toxicity occurred.
Main Findings: The median progression-free survival was identical at 5.6 months for both groups. However, at 18 months, a significantly higher percentage of participants in the belzutifan group (24.0%) remained progression-free compared to the everolimus group (8.3%, P=0.002). Belzutifan also led to a significantly higher objective response rate (21.9% vs. 3.5%, P<0.001). Median overall survival was similar between the groups, with no significant difference (21.4 months vs. 18.1 months, P=0.20).
Implications for Practice: Belzutifan offers a substantial benefit in progression-free survival and objective response rate over everolimus in patients with advanced renal-cell carcinoma post previous therapies. It was well-tolerated, with safety comparable to everolimus, suggesting its potential as a preferred treatment option in this patient population.
Deep Learning Model Noninferior to Radiologists in Detecting Clinically Significant Prostate Cancer at MRI – Radiology
10 Aug, 2024 | 21:31h | UTCStudy Design and Population: This retrospective study evaluated the performance of a deep learning (DL) model for detecting clinically significant prostate cancer (csPCa) using multiparametric MRI (mpMRI) images from 5215 patients (5735 examinations) with a mean age of 66 years. The study included patients who underwent prostate MRI between January 2017 and December 2019 at a single academic institution. The DL model was trained on T2-weighted, diffusion-weighted, and contrast-enhanced MRI sequences, with pathologic diagnosis as the reference standard.
Main Findings: The DL model achieved an area under the receiver operating characteristic curve (AUC) of 0.89 on the internal test set and 0.86 on an external test set, demonstrating noninferiority to radiologists, who had AUCs of 0.89 and 0.84, respectively. Additionally, the combination of the DL model and radiologists improved diagnostic performance (AUC of 0.89). Gradient-weighted class activation maps (Grad-CAMs) effectively localized csPCa lesions, overlapping with true-positive cases in 92% of internal test set and 97% of external test set cases.
Implications for Practice: The DL model showed comparable performance to experienced radiologists in detecting csPCa at MRI, suggesting its potential to assist radiologists in improving diagnostic accuracy and reducing interobserver variability. Future research should focus on integrating the model into clinical workflows and assessing its impact on biopsy targeting.
RCT: Impact of single PSA screening invitation on 15-year prostate cancer mortality – JAMA
25 May, 2024 | 19:01h | UTCStudy Design and Population: This study is a secondary analysis of the Cluster Randomized Trial of PSA Testing for Prostate Cancer (CAP), which focused on the long-term effects of prostate-specific antigen (PSA) screening on prostate cancer mortality. It involved 415,357 men aged 50 to 69 years from 573 primary care practices across England and Wales. Participants were randomized to either receive a single invitation for a PSA screening or to a control group receiving standard practice without invitation. The follow-up period concluded on March 31, 2021, after a median duration of 15 years.
Main Findings: The intervention group, which received one PSA screening invitation, showed a prostate cancer mortality rate of 0.69% compared to 0.78% in the control group, translating to a rate ratio of 0.92 and demonstrating a statistically significant but modest reduction in death from prostate cancer. Additionally, the screening led to increased detection rates of low-grade and localized prostate cancer. However, there were no significant differences in detection of more advanced cancer stages between the two groups. All-cause mortality rates were similar across both groups.
Implications for Practice: While the introduction of a single PSA screening invitation was associated with a slight decrease in prostate cancer mortality over 15 years, the absolute reduction was small. These findings suggest that while PSA screening can detect cancer earlier, its impact on long-term survival is limited and should be weighed against the potential for overdiagnosis and overtreatment. Future strategies in prostate cancer screening might need to focus more on risk stratification and personalized screening approaches to maximize benefits and minimize unnecessary interventions.
Reference (link to abstract – $ for full-text):
AUA/ASCO/SUO Updated guidelines for muscle-invasive urothelial bladder cancer
1 May, 2024 | 21:40h | UTCThe 2024 update to the muscle-invasive bladder cancer (MIBC) guidelines provides a risk-assessed framework for the treatment of this high-risk patient group, which constitutes about 25% of all bladder cancer diagnoses. These guidelines, revised through the AUA amendment process, integrate new research findings from May 2020 to November 2023, involving a rigorous review of 3739 abstracts and 46 full-text articles. Key updates include refined protocols for neoadjuvant and adjuvant chemotherapy, radical cystectomy, and multi-modal bladder-preserving therapies. Recommendations are categorized based on evidence strength, ranging from high to low, and are supplemented by clinical principles and expert opinions in areas lacking robust data. This structured approach aims to enhance clinical outcomes by updating practitioners on optimal management strategies and emphasizing the need for ongoing research to refine these recommendations.
Reference (link to free full-text):
Meta-Analysis: Efficacy of MRI in prostate cancer screening for reducing unnecessary biopsies
28 Apr, 2024 | 20:13h | UTCThis meta-analysis evaluated the effectiveness of incorporating magnetic resonance imaging (MRI) into prostate cancer screening pathways, compared to prostate-specific antigen (PSA)–only screening strategies. Analyzing data from 80,114 men across 12 studies, the findings demonstrate that MRI-based screening, particularly when using a sequential approach and a PI-RADS score ≥3 cutoff for biopsy, significantly increases the odds of detecting clinically significant prostate cancers (OR, 4.15) while reducing unnecessary biopsies (OR, 0.28) and detection of clinically insignificant cancers (OR, 0.34). Implementing a higher PI-RADS score of ≥4 further decreased the detection of insignificant cancers and biopsies performed, without impacting the detection rate of significant cancers. These results support the integration of MRI into screening programs to enhance diagnostic precision and reduce patient harm.
Reference (link to abstract – $ for full-text):
The Lancet Commission: Global projections and recommendations for managing the increasing burden of prostate cancer
27 Apr, 2024 | 18:42h | UTCThe Lancet Commission’s report on prostate cancer highlights the expected doubling of annual cases from 1.4 million in 2020 to 2.9 million by 2040, driven by demographic changes and increased life expectancy. This comprehensive analysis divides the issue into epidemiology, diagnostics, management of localized and advanced disease, emphasizing disparities between high-income countries (HICs) and low- and middle-income countries (LMICs). Key findings indicate that late diagnoses are common, particularly in LMICs, leading to worse outcomes. The Commission advocates for significant changes in the diagnostic pathways and increased use of current technologies tailored to available resources to improve outcomes. Education and awareness programs are recommended to facilitate early detection and shift the treatment paradigm from palliative to curative, focusing on surgery and radiotherapy. Without decisive action, the global mortality from prostate cancer is set to rise, highlighting the need for urgent interventions across all countries, with a special focus on underserved populations.
Reference:
RCT | No significant recurrence-free survival improvement with everolimus post-renal carcinoma surgery
3 Aug, 2023 | 13:17h | UTCAdjuvant everolimus after surgery for renal cell carcinoma (EVEREST): a double-blind, placebo-controlled, randomised, phase 3 trial – The Lancet (link to abstract – $ for full-text)
M-A | High-volume disease, T stage 4 show largest docetaxel benefit in prostate cancer
2 Aug, 2023 | 13:51h | UTCCommentaries:
Disease Volume and T Stage Affect Docetaxel/ADT Efficacy in Prostate Cancer – Cancer Network
Commentary on Twitter
NEW: A systematic review and meta-analysis of individual patient data from the STOPCAP M1 collaboration aims to obtain up-to-date estimates of the effects of docetaxel in patients with metastatic hormone-sensitive prostate cancer. #pcsmhttps://t.co/7mqXeIXMQ5 pic.twitter.com/A7AmjipnVq
— The Lancet Oncology (@TheLancetOncol) July 5, 2023
Single-arm study | Pembrolizumab plus Lenvatinib shows potential as first-line treatment for advanced non-clear-cell renal cell carcinoma
17 Jul, 2023 | 13:33h | UTCPembrolizumab plus lenvatinib as first-line therapy for advanced non-clear-cell renal cell carcinoma (KEYNOTE-B61): a single-arm, multicentre, phase 2 trial – The Lancet Oncology (link to abstract – $ for full-text)
RCT | Brachytherapy alone sufficient for intermediate-risk prostate cancer, no FFP improvement with additional EBRT
7 Jul, 2023 | 16:06h | UTCEffect of Brachytherapy With External Beam Radiation Therapy Versus Brachytherapy Alone for Intermediate-Risk Prostate Cancer: NRG Oncology RTOG 0232 Randomized Clinical Trial – Journal of Clinical Oncology (link to abstract – $ for full-text)
M-A | Increased risk of cognitive toxic effects and fatigue in prostate cancer treatment with second-generation antiandrogens
16 Jun, 2023 | 14:00h | UTCAssociation of Second-generation Antiandrogens With Cognitive and Functional Toxic Effects in Randomized Clinical Trials: A Systematic Review and Meta-analysis – JAMA Oncology (link to abstract – $ for full-text)
RCT | Talazoparib plus enzalutamide prolongs radiographic PFS vs. enzalutamide alone in metastatic castration-resistant prostate cancer
14 Jun, 2023 | 14:29h | UTCTalazoparib plus enzalutamide in men with first-line metastatic castration-resistant prostate cancer (TALAPRO-2): a randomised, placebo-controlled, phase 3 trial – The Lancet (link to abstract – $ for full-text)
Review | Screening for prostate cancer: evidence, ongoing trials, policies and knowledge gaps
13 Jun, 2023 | 13:52h | UTCScreening for prostate cancer: evidence, ongoing trials, policies and knowledge gaps – BMJ Oncology
RCT | Atezolizumab and cabozantinib combo fails to outperform cabozantinib alone in renal cell carcinoma
7 Jun, 2023 | 13:54h | UTCAtezolizumab plus cabozantinib versus cabozantinib monotherapy for patients with renal cell carcinoma after progression with previous immune checkpoint inhibitor treatment (CONTACT-03): a multicentre, randomised, open-label, phase 3 trial – The Lancet (free registration required)
Commentary from the author on Twitter (thread – click for more)
1/ Results from #CONTACT03 are out both @ASCO #ASCO23 and @TheLancet . The 1⃣st phase 3 trial to assess the efficacy of rechallenge with anti-PDL1 in ANY cancer type.
Kudos to @montypal, SC members, @roche, our patients, = for this phenomenal job. https://t.co/p7hYD4snXA pic.twitter.com/CXk1vqfB26— Toni Choueiri, MD (@DrChoueiri) June 5, 2023
M-A | Robot-assisted radical cystectomy versus open radical cystectomy
6 Jun, 2023 | 14:11h | UTC
Commentary from the author on Twitter (thread – click for more)
Our meta-analysis of 8 RCTS comparing open (ORC) and robot-assisted radical cystectomy (RARC) is now online on @EUplatinum 1/6https://t.co/b9TYe2yd9Y@JimCatto @Jkurol @drtanws @DrTanWP @SWilliams_MD @SBoorjian @roboturoloog @dipenjparekh @nikhilvasdevuro @ProfShamimKhan1 pic.twitter.com/M4u0iXTuwN
— Pramit Khetrapal (@p_khetrapal) May 10, 2023
SR | Management of lymph node–positive penile cancer
24 May, 2023 | 13:03h | UTCManagement of Lymph Node–positive Penile Cancer: A Systematic Review – European Urology
Epidemiology of bladder cancer in 2023: a systematic review of risk factors
22 May, 2023 | 13:23h | UTCEpidemiology of Bladder Cancer in 2023: A Systematic Review of Risk Factors – European Urology
RCT | Cabozantinib addition to nivolumab and ipilimumab extends progression-free survival in renal-cell carcinoma
18 May, 2023 | 13:38h | UTCCabozantinib plus Nivolumab and Ipilimumab in Renal-Cell Carcinoma – New England Journal of Medicine (link to abstract – $ for full-text)
Commentary: Cabozantinib in Renal-Cell Carcinoma – NEJM Resident 360
Commentary on Twitter
Clinical Pearls & Morning Reports: Cabozantinib in Renal-Cell Carcinoma. How did the addition of cabozantinib to nivolumab and ipilimumab affect outcomes in the trial by Choueiri et al.? https://t.co/x1FzWBiasr #MedEd #MedTwitter pic.twitter.com/w4sns1ifLG
— NEJM Resident 360 (@NEJMres360) May 16, 2023
M-A | First‐line therapy for adults with advanced renal cell carcinoma
12 May, 2023 | 13:33h | UTCSummary: Initial treatment for adults with advanced kidney cancer (renal cell carcinoma) – Cochrane Library
A review of modern imaging landscape for prostate cancer: a comprehensive clinical guide
9 May, 2023 | 14:34h | UTC