Abstract:
:Targeted therapy has changed the treatment of metastatic renal cell carcinoma (mRCC). However, it is unclear if patients need to start systemic therapy immediately or if treatment can be deferred. Identification of the appropriate time to discontinue therapy is also uncertain. We reviewed treatment guidelines and trials evaluating targeted agents for mRCC to assess the evidence regarding commencing and discontinuing therapy for mRCC. Guidelines recommend that patients with mRCC receive targeted agents; however, they do not address when therapy should start. Risk factors based on Memorial Sloan-Kettering Cancer Center (MSKCC) or Heng criteria can be used to stratify patients. MSKCC prognostic factors include Karnofsky performance status (< 80%), high lactate dehydrogenase levels, low hemoglobin levels, high serum calcium levels, and time from diagnosis to start of therapy < 1 year. In patients with poor and intermediate risk (≥ 3 and 1-2 factors, respectively) and/or with high tumor burden, targeted therapy should commence as soon as possible. In patients with MSKCC good-risk disease and few disease symptoms, active surveillance may be appropriate. Regular monitoring is required so that treatment can be initiated upon evidence of active disease. Second-line therapy is usually commenced after disease progression; however, because of the limitations of radiologic assessment of response to targeted therapies, other factors may need to be considered to guide decisions regarding stopping or switching therapy. These include scenarios such as a mixed response to therapy. For selected patients at favorable risk, active surveillance may be feasible; however, strict monitoring is required.
journal_name
Clin Genitourin Cancerjournal_title
Clinical genitourinary cancerauthors
Powles T,Albers Pdoi
10.1016/j.clgc.2012.06.002subject
Has Abstractpub_date
2012-12-01 00:00:00pages
213-8issue
4eissn
1558-7673issn
1938-0682pii
S1558-7673(12)00161-9journal_volume
10pub_type
杂志文章,评审abstract::We present a case of a 73-year-old female with metastatic renal cell carcinoma, clear cell histologic subtype, who developed pruritic rash after 2 weeks of 25 mg weekly infusions of temsirolimus. Rash was located on bilateral antecubital areas and posterior knees. Skin biopsy showed spongiotic dermatitis with eosinoph...
journal_title:Clinical genitourinary cancer
pub_type: 杂志文章
doi:10.3816/CGC.2009.n.019
更新日期:2009-08-01 00:00:00
abstract:INTRODUCTION:The aims of the present study were to compare the clinicopathologic characteristics between type 1 and type 2 papillary renal cell carcinoma (pRCC) and to evaluate the effect of the subclassification of pRCC on the oncologic outcomes after surgery. MATERIALS AND METHODS:The records of 274 patients with pR...
journal_title:Clinical genitourinary cancer
pub_type: 杂志文章
doi:10.1016/j.clgc.2016.07.020
更新日期:2017-04-01 00:00:00
abstract:OBJECTIVE:Second-line systemic therapy for advanced urothelial carcinoma (UC) has substantial unmet needs, and current agents show dismal activity. Second-line trials of metastatic UC have used response rate (RR) and median progression-free survival (PFS) as primary endpoints, which may not reflect durable benefits. A ...
journal_title:Clinical genitourinary cancer
pub_type: 杂志文章,meta分析
doi:10.1016/j.clgc.2013.09.002
更新日期:2014-04-01 00:00:00
abstract:INTRODUCTION:Tumor stage and grade represent the best established predictors for the prognosis of upper tract urothelial carcinoma (UTUC). However, controversies still exist regarding the role of tumor necrosis, location, and multifocality in the prognosis of UTUC. We share our experience with 305 patients, reporting o...
journal_title:Clinical genitourinary cancer
pub_type: 杂志文章
doi:10.1016/j.clgc.2016.04.017
更新日期:2016-12-01 00:00:00
abstract:BACKGROUND:The purpose of this study was to compare perioperative and oncologic outcomes between laparoscopic radical cystectomy (LRC) and robot-assisted radical cystectomy (RARC) for bladder cancer (BCa). MATERIALS AND METHODS:Patients who underwent LRC or RARC with curative intent for BCa between January 2011 and De...
journal_title:Clinical genitourinary cancer
pub_type: 杂志文章
doi:10.1016/j.clgc.2019.06.007
更新日期:2019-10-01 00:00:00
abstract:BACKGROUND:Everolimus is an approved agent for use after disease progression with vascular endothelial growth factor receptor-tyrosine kinase inhibitors (VEGFR-TKIs) in patients with metastatic renal cell carcinoma. With recently published trials showing efficacy of nivolumab and cabozantinib in the second-line therapy...
journal_title:Clinical genitourinary cancer
pub_type: 杂志文章
doi:10.1016/j.clgc.2015.12.011
更新日期:2016-04-01 00:00:00
abstract::Systemic treatment of men with metastatic prostate cancer is rapidly evolving. Androgen deprivation therapy remains the first-line treatment for advanced disease and the backbone of sequential strategies. For patients with extensive metastatic disease the addition of docetaxel markedly improves survival. In case patie...
journal_title:Clinical genitourinary cancer
pub_type: 杂志文章,评审
doi:10.1016/j.clgc.2015.01.008
更新日期:2015-08-01 00:00:00
abstract:BACKGROUND:Limited information is available about the effect of bleomycin administration on the development of pulmonary toxicity in metastatic germ cell tumors (GCT). PATIENTS AND METHODS:A literature search was conducted to identify randomized trials of first-line chemotherapy for GCT. We conducted univariate and mu...
journal_title:Clinical genitourinary cancer
pub_type: 杂志文章,meta分析
doi:10.1016/j.clgc.2016.08.021
更新日期:2017-04-01 00:00:00
abstract:PURPOSE:Anemia is a common morbidity of advanced prostate cancer, and prostate cancer treatment and has been associated with a worse overall survival and reduced quality of life in patients with prostate cancer. We sought to determine if infrequent dosing of darbepoetin alfa is safe and effective in treating anemia in ...
journal_title:Clinical genitourinary cancer
pub_type: 杂志文章
doi:10.3816/CGC.2007.n.012
更新日期:2007-06-01 00:00:00
abstract:BACKGROUND:The objective of this study was to evaluate differences in tolerability in patients with metastatic castration-resistant prostate cancer treated with enzalutamide (ENZA) or abiraterone acetate plus prednisone (AA+P). PATIENTS AND METHODS:This was a phase IV, prospective, open-label, multicenter, real-world ...
journal_title:Clinical genitourinary cancer
pub_type: 杂志文章,多中心研究
doi:10.1016/j.clgc.2019.07.017
更新日期:2019-12-01 00:00:00
abstract:BACKGROUND:The programmed death-1 (PD-1) pathway negatively regulates T-cell activation and has an important role in regulating antitumor host immunity. Monoclonal antibodies directed against PD-1 or the PD-1 ligand (PD-L1) have shown activity in several tumor types with preliminary data suggesting a relationship betwe...
journal_title:Clinical genitourinary cancer
pub_type: 杂志文章
doi:10.1016/j.clgc.2015.12.002
更新日期:2016-04-01 00:00:00
abstract:INTRODUCTION:Clinical T1 (cT1) bladder cancer is associated with high rates of recurrence, upstaging, and progression. Guidelines recommend that these patients be treated with adjuvant intravesical Bacillus Calmette-Guérin immunotherapy (BCG) or upfront radical cystectomy (RC). We analyzed the National Cancer Database ...
journal_title:Clinical genitourinary cancer
pub_type: 杂志文章
doi:10.1016/j.clgc.2019.01.007
更新日期:2019-06-01 00:00:00
abstract:INTRODUCTION:Penectomy for PC is useful in staging, disease prognosis, and treatment. Limited studies have evaluated its surgical complications. We sought to assess these complications and determine predictive models to create a novel risk score for penectomy complications. PATIENTS AND METHODS:A retrospective review ...
journal_title:Clinical genitourinary cancer
pub_type: 杂志文章
doi:10.1016/j.clgc.2018.09.018
更新日期:2019-02-01 00:00:00
abstract:PURPOSE:Similar to other molecularly targeted agents, temsirolimus, an inhibitor of mammalian target of rapamycin, has shown promising activity in advanced renal cell carcinoma. However, only a subset of patients appears to derive significant tumor responses. In an effort to identify potential predictors of response to...
journal_title:Clinical genitourinary cancer
pub_type: 杂志文章
doi:10.3816/CGC.2007.n.020
更新日期:2007-09-01 00:00:00
abstract:BACKGROUND:Partial nephrectomy (PN) is the standard treatment for localized renal tumors. Laparoscopic PN (LPN) after selective embolization of tumor (LPNE) in a hybrid operating room has been developed to make LPN easier and safer. The aim of this study was to compare outcomes of LPNE and robot-assisted PN (RAPN). PA...
journal_title:Clinical genitourinary cancer
pub_type: 杂志文章
doi:10.1016/j.clgc.2018.07.005
更新日期:2018-12-01 00:00:00
abstract:BACKGROUND:Piritrexim is reported to have a response rate of 38% in patients with chemotherapy-naive disease and 23% for second-line therapy after chemotherapy failure. We report the results of a multiinstitutional, open-label, 2-stage, phase II study that further evaluates oral piritrexim in patients with urothelial c...
journal_title:Clinical genitourinary cancer
pub_type: 杂志文章,多中心研究
doi:10.3816/CGC.2008.n.005
更新日期:2008-03-01 00:00:00
abstract:BACKGROUND:Serum testosterone measurement is recommended to assess the efficacy of androgen deprivation therapy (ADT) and to diagnose castration resistance in patients with prostate cancer (PCa). Currently, the accepted castrate level of serum testosterone is 50 ng/dL. Liquid chromatography and tandem mass spectrometry...
journal_title:Clinical genitourinary cancer
pub_type: 杂志文章
doi:10.1016/j.clgc.2017.10.025
更新日期:2018-04-01 00:00:00
abstract:BACKGROUND:The purpose of this study was to compare the efficacy of 2 bacillus Calmette-Guérin (BCG) strains, BCG-Tice and BCG-Moreau, in the treatment of non-muscle-invasive bladder cancer (NMIBC). MATERIALS AND METHODS:We retrospectively reviewed clinical data from patients treated with BCG for NMIBC at 3 academic c...
journal_title:Clinical genitourinary cancer
pub_type: 杂志文章,多中心研究
doi:10.1016/j.clgc.2019.10.021
更新日期:2020-02-01 00:00:00
abstract:INTRODUCTION:We compared retrograde extraperitoneal open radical cystoprostatectomy (REORC) and robot-assisted radical cystoprostatectomy with intracorporeal diversion (iRARC) and have reported the early perioperative outcomes. PATIENTS AND METHODS:REORC and iRARC were each performed at a different tertiary high-volum...
journal_title:Clinical genitourinary cancer
pub_type: 杂志文章
doi:10.1016/j.clgc.2019.12.006
更新日期:2020-06-01 00:00:00
abstract::Effective options are lacking for progressive castration-refractory prostate cancer (CRPC) after conventional chemotherapy. Sunitinib is an orally administered multitargeted tyrosine kinase inhibitor that is approved multinationally for renal cell carcinoma and gastrointestinal stromal tumors. A phase II trial was con...
journal_title:Clinical genitourinary cancer
pub_type: 杂志文章,多中心研究
doi:10.3816/CGC.2008.n.023
更新日期:2008-09-01 00:00:00
abstract:UNLABELLED:To identify the effects of diagnostic ureteroscopy on intravesical recurrence, 104 patients who had undergone radical nephroureterectomy were analyzed. The number of patients with intravesical recurrence was 34 (32.6%) at a mean of 37 months. Multivariate Cox model analysis revealed that delayed nephroureter...
journal_title:Clinical genitourinary cancer
pub_type: 杂志文章
doi:10.1016/j.clgc.2015.07.008
更新日期:2016-02-01 00:00:00
abstract:INTRODUCTION:The objective of this study was to examine the overall survival (OS) in patients diagnosed with high-grade T1 non-muscle-invasive bladder cancer treated with early radical cystectomy versus local treatment of the primary tumor, defined as endoscopic management with or without intravesical chemotherapy or i...
journal_title:Clinical genitourinary cancer
pub_type: 杂志文章
doi:10.1016/j.clgc.2020.03.013
更新日期:2020-12-01 00:00:00
abstract:UNLABELLED:The present multicenter phase II study evaluated the efficacy and safety of weekly docetaxel as second-line chemotherapy for metastatic urothelial carcinoma. Weekly docetaxel was well tolerated but demonstrated modest activity, with a response rate of 6%, a median progression-free survival (PFS) of 1.4 month...
journal_title:Clinical genitourinary cancer
pub_type: 杂志文章,多中心研究
doi:10.1016/j.clgc.2015.09.008
更新日期:2016-02-01 00:00:00
abstract:BACKGROUND:This study examined patient perception of information received, satisfaction with that information, and its relation to health-related quality of life (HRQoL) and clinical and demographic variables before, during, and after radiotherapy (RT) for localized prostate cancer. PATIENTS AND METHODS:In 2010, 2 que...
journal_title:Clinical genitourinary cancer
pub_type: 杂志文章
doi:10.1016/j.clgc.2013.11.001
更新日期:2014-06-01 00:00:00
abstract:BACKGROUND:Venous thromboembolic events (VTEs) frequently occur in cancer patients. Risk assessment models (RAMs) for cancer-associated thrombosis have been proposed. However, advanced urinary tract cancer (aUTC) was not adequately represented in these models. We studied the incidence of VTEs, the risk factors, and the...
journal_title:Clinical genitourinary cancer
pub_type: 杂志文章
doi:10.1016/j.clgc.2019.12.021
更新日期:2020-08-01 00:00:00
abstract:BACKGROUND:Nonurothelial carcinoma (UC) malignancies have traditionally been considered to have a more aggressive clinical course, and little is known about their response to neoadjuvant therapy. We examined the effect of neoadjuvant chemotherapy (NAC) on a large population of patients with bladder cancer (BCa) with di...
journal_title:Clinical genitourinary cancer
pub_type: 杂志文章
doi:10.1016/j.clgc.2020.01.007
更新日期:2020-10-01 00:00:00
abstract:OBJECTIVE:To prospectively assess the ideal dosing and the value of fluorescent sentinel lymph node (LN) detection with indocyanine green (ICG) for the detection of LN metastases in intermediate- and high-risk patients undergoing robot-assisted prostatectomy and extended pelvic LN dissection (ePLND). PATIENTS AND METH...
journal_title:Clinical genitourinary cancer
pub_type: 杂志文章
doi:10.1016/j.clgc.2016.10.014
更新日期:2017-08-01 00:00:00
abstract:BACKGROUND:Neoadjuvant radiotherapy (NART) for muscle-invasive bladder cancer (MIBC) is currently underused. However, the outcomes for MIBC have remained suboptimal. We investigated the relationship of NART to cause-specific mortality (CSM) and overall mortality (OM) among patients with a diagnosis of MIBC. MATERIALS ...
journal_title:Clinical genitourinary cancer
pub_type: 杂志文章
doi:10.1016/j.clgc.2015.02.014
更新日期:2015-08-01 00:00:00
abstract::Oncocytic neoplasms are rare tumors arising in the adrenal glands and usually considered as nonfunctional and benign. We report 4 cases of adrenal oncocytic neoplasm. The paucity of literature describing this entity increases the chance for misdiagnosis. Confirmatory diagnosis is by tissue sampling with adrenalectomy ...
journal_title:Clinical genitourinary cancer
pub_type: 杂志文章,评审
doi:10.1016/j.clgc.2018.10.011
更新日期:2019-02-01 00:00:00
abstract:BACKGROUND:Few reports have been published regarding the outcomes of patients who develop an undescended testicular malignancy (UTM). Our objective was to analyze the sociodemographic and survival outcomes of patients with UTM and those of with descended testicular malignancy (DTM). PATIENTS AND METHODS:All 17 registr...
journal_title:Clinical genitourinary cancer
pub_type: 杂志文章
doi:10.1016/j.clgc.2015.08.004
更新日期:2016-06-01 00:00:00