Molecular substratification of bladder cancer: moving towards individualized patient management
Despite advances in surgical techniques, perioperative therapies and postoperative management, outcomes for patients with bladder cancer have largely remained unchanged. Current management of bladder cancer still relies on pathologic staging that does not always reflect the risk for an individual patient. Studies assessing molecular alterations in individual tumors are offering insights into the myriad of cellular pathways that are deregulated in bladder tumorigenesis and progression. Alterations in pathways involved in cell-cycle regulation, apoptosis, cell signaling, angiogenesis and tumor-cell invasion have been shown t...
Source: Therapeutic Advances in Urology - May 9, 2016 Category: Urology & Nephrology Authors: Mitra, A. P. Tags: Reviews Source Type: research
Novel immunotherapeutic approaches to the treatment of urothelial carcinoma
Immunotherapy has long played a role in urothelial cancers with the use of bacille Calmette Guérin (BCG) being a mainstay in the treatment of nonmuscle invasive bladder cancer. Novel therapeutic approaches have not significantly impacted mortality in this population and so a renaissance in immunotherapy has resulted. This includes recombinant BCG, oncolytic viruses, monoclonal antibodies, vaccines, and adoptive T-cell therapy. Herein, we provide a review of the current state of the art and future therapies regarding immunotherapeutic strategies for urothelial carcinoma. (Source: Therapeutic Advances in Urology)
Source: Therapeutic Advances in Urology - May 9, 2016 Category: Urology & Nephrology Authors: Muthigi, A., George, A. K., Brancato, S. J., Agarwal, P. K. Tags: Reviews Source Type: research
Collagenase Clostridium histolyticum in the management of Peyronies disease: a review of the evidence
Conclusion:
Overall, evidence indicates that CCH is a valuable, effective, and safe minimally invasive treatment option for men with PD. (Source: Therapeutic Advances in Urology)
Source: Therapeutic Advances in Urology - May 9, 2016 Category: Urology & Nephrology Authors: Traore, E. J., Wang, W., Yafi, F. A., Hellstrom, W. J. G. Tags: Reviews Source Type: research
Evidence of the efficacy and safety of the thulium laser in the treatment of men with benign prostatic obstruction
In 2005, the high power thulium laser was introduced for the surgical treatment of benign prostatic obstruction. It has several properties that confer theoretical advantages over other lasers used for the same indication, such as technical versatility and a relatively small zone of thermal damage. Studies using the 70–150 W thulium laser systems demonstrate good efficacy of these procedures with low morbidity and few complications even in higher risk patients. Different techniques have been employed to treat the prostate with this technology, including enucleation, vapoenucleation, vaporization and resection. Compara...
Source: Therapeutic Advances in Urology - May 9, 2016 Category: Urology & Nephrology Authors: Barbalat, Y., Velez, M. C., Sayegh, C. I., Chung, D. E. Tags: Reviews Source Type: research
Clinical experience with radium-223 in the treatment of patients with advanced castrate-resistant prostate cancer and symptomatic bone metastases
The treatment of metastatic castrate-resistant prostate cancer (mCRPC) has grown over the past decade. The majority of patients develop bone metastases, which pose a significant burden on morbidity and mortality, especially skeletal-related events. Whilst demonstrating a favourable safety profile and improving symptoms, radiopharmaceuticals have until recently failed to show a survival benefit. However, since the large phase III randomized ALSYMPCA trial, the calcium mimetic properties of radium-223 (Ra223) have improved patients’ quality of life and improved survival whilst keeping toxicities to a minimum. This revi...
Source: Therapeutic Advances in Urology - May 9, 2016 Category: Urology & Nephrology Authors: Hague, C., Logue, J. P. Tags: Reviews Source Type: research
Risk factors for infectious readmissions following radical cystectomy: results from a prospective multicenter dataset
Conclusion:
Readmission following RC is a common occurrence and infectious complications drive readmission in almost half of the cases. Current smoking was the only independent risk factor for an infectious readmission. Counseling patients in smoking cessation prior to the procedure may provide an avenue for quality improvement to limit readmissions. (Source: Therapeutic Advances in Urology)
Source: Therapeutic Advances in Urology - May 9, 2016 Category: Urology & Nephrology Authors: Hemal, S., Krane, L. S., Richards, K. A., Liss, M., Kader, A. K., Davis, R. L. Tags: Original Research Source Type: research
Erratum
to "Management of idiopathic retroperitoneal fibrosis from the urologist’s perspective" by Surcel Cristian, Mirvald Cristian, Pavelescu Cristian, Gingu Constantin, Carmen Savu, Emre Huri and Ioanel Sinescu, Therapeutic Advances in Urology, 2015 April; 7(2): 85–99. doi: 10.1177/1756287214565637. (Source: Therapeutic Advances in Urology)
Source: Therapeutic Advances in Urology - February 29, 2016 Category: Urology & Nephrology Tags: Erratum Source Type: research
An update on the role of testosterone replacement therapy in the management of hypogonadism
While US testosterone prescriptions have tripled in the last decade with lower trends in Europe, debate continues over the risks, benefits and appropriate use of testosterone replacement therapy (TRT). Some authors blame advertising and the availability of more convenient formulations whilst other have pointed out that the routine testing of men with erectile dysfunction (a significant marker of cardiovascular risk) and those with diabetes would inevitably increase the diagnosis of hypogonadism and lead to an increase in totally appropriate prescribing. They commented that this was merely an appropriate correction of previ...
Source: Therapeutic Advances in Urology - February 29, 2016 Category: Urology & Nephrology Authors: Hackett, G. Tags: Reviews Source Type: research
'Mini, ultra, micro - nomenclature and cost of these new minimally invasive percutaneous nephrolithotomy (PCNL) techniques
New minimally invasive percutaneous nephrolithotomy (PCNL) techniques have changed the management of renal stones. We discuss the technological advances in PCNL and explain the meaning, requirements and set up costs for each of these ‘newer’ techniques. (Source: Therapeutic Advances in Urology)
Source: Therapeutic Advances in Urology - February 29, 2016 Category: Urology & Nephrology Authors: Wright, A., Rukin, N., Smith, D., De la Rosette, J., Somani, B. K. Tags: Reviews Source Type: research
The role of neoadjuvant therapy in the management of locally advanced renal cell carcinoma
In the past decade, the armamentarium of targeted therapy agents for the treatment of metastatic renal cell carcinoma (RCC) has significantly increased. Improvements in response rates and survival, with more manageable side effects compared with interleukin 2/interferon immunotherapy, have been reported with the use of targeted therapy agents, including vascular endothelial growth factor (VEGF) receptor tyrosine kinase inhibitors (sunitinib, sorafenib, pazopanib, axitinib), mammalian target of rapamycin (mTOR) inhibitors (everolimus and temsirolimus) and VEGF receptor antibodies (bevacizumab). Current guidelines reflect th...
Source: Therapeutic Advances in Urology - February 29, 2016 Category: Urology & Nephrology Authors: Borregales, L. D., Adibi, M., Thomas, A. Z., Wood, C. G., Karam, J. A. Tags: Reviews Source Type: research
Androgen deprivation therapy and cardiovascular disease: what is the linking mechanism?
The past decade has brought increased awareness of the potential adverse effects of androgen deprivation therapy (ADT) in men with prostate cancer. Arguably the most important and controversial of these is the increased risk of cardiovascular morbidity and mortality. Although multiple observational studies have shown that men treated with ADT are at increased risk of developing atherosclerotic cardiovascular disease, our understanding of the biological mechanisms that might underlie this phenomenon is still evolving. In this review, we discuss some of the mechanisms that have been proposed to date, including ADT-induced me...
Source: Therapeutic Advances in Urology - February 29, 2016 Category: Urology & Nephrology Authors: Zareba, P., Duivenvoorden, W., Leong, D. P., Pinthus, J. H. Tags: Reviews Source Type: research
A review of the efficacy and safety of mirodenafil in the management of erectile dysfunction
Erectile dysfunction (ED) is a common disorder that can jeopardize quality of life and the partnership of patients and their sexual partners. The advent of oral phosphodiesterase type 5 inhibitors (PDE5Is) has revolutionized a treatment for ED, and they are recognized as the first-line therapy for ED, regardless of its etiology. Mirodenafil, a second-generation PDE5I, has biochemical profiles such as high affinity for PDE5 and high selectivity for PDE5 over other PDE isoforms, compared to other existing PDE5Is such as sildenafil, vardenafil and tadalafil. Available evidence has suggested that doses of 50 and 100 mg miroden...
Source: Therapeutic Advances in Urology - February 29, 2016 Category: Urology & Nephrology Authors: Cho, M. C., Paick, J.-S. Tags: Reviews Source Type: research
Managing chronic bladder diseases with the administration of exogenous glycosaminoglycans: an update on the evidence
Although the pathophysiology of acute chronic cystitis and other ‘sensory’ disorders, i.e. painful bladder syndrome (PBS) or interstitial cystitis (IC), often remains multifactorial, there is a wide consensus that such clinical conditions may arise from a primary defective urothelium lining or from damaged glycosaminoglycans (GAGs). A ‘cascade’ of events starting from GAG injury, which fails to heal, may lead to chronic bladder epithelial damage and neurogenic inflammation. To restore the GAG layer is becoming the main aim of new therapies for the treatment of chronic cystitis and PBS/IC. Preliminar...
Source: Therapeutic Advances in Urology - February 29, 2016 Category: Urology & Nephrology Authors: Lazzeri, M., Hurle, R., Casale, P., Buffi, N., Lughezzani, G., Fiorini, G., Peschechera, R., Pasini, L., Zandegiacomo, S., Benetti, A., Taverna, G., Guazzoni, G., Barbagli, G. Tags: Reviews Source Type: research
An update on the use of transdermal oxybutynin in the management of overactive bladder disorder
Antimuscarinic medications are used to treat nonneurogenic overactive bladder refractory to nonpharmacologic therapy. Side effects such as dry mouth, constipation, blurred vision, dizziness, and impaired cognition limit the tolerability of therapy and are largely responsible for high discontinuation rates. Oxybutynin is a potent muscarinic receptor antagonist whose primary metabolite after first-pass hepatic metabolism is considered largely responsible for its associated anticholinergic side effects. Transdermal administration of medications bypasses hepatic processing. Specifically with oxybutynin, whose low molecular wei...
Source: Therapeutic Advances in Urology - February 29, 2016 Category: Urology & Nephrology Authors: Cohn, J. A., Brown, E. T., Reynolds, W. S., Kaufman, M. R., Milam, D. F., Dmochowski, R. R. Tags: Reviews Source Type: research
Degarelix monotherapy compared with luteinizing hormone-releasing hormone (LHRH) agonists plus anti-androgen flare protection in advanced prostate cancer: an analysis of two randomized controlled trials
Conclusions:
Degarelix monotherapy produced a more favorable effect on PSA PFS outcomes than a LHRH agonist + AA flare protection therapy in patients with prostate cancer when a case-control analysis was used to compensate for differences between treatment groups. (Source: Therapeutic Advances in Urology)
Source: Therapeutic Advances in Urology - February 29, 2016 Category: Urology & Nephrology Authors: Iversen, P., Damber, J.-E., Malmberg, A., Persson, B.-E., Klotz, L. Tags: Original Research Source Type: research
