Pazopanib in the treatment of advanced renal cell carcinoma
Pazopanib is an orally available multitargeted tyrosine kinase inhibitor (a class of targeted therapies) that inhibits tumor angiogenesis and cell proliferation. The safety and efficacy of pazopanib (noninferior to sunitinib for progression-free survival) in patients with advanced or metastatic renal cell carcinoma (mRCC) have been demonstrated in several clinical trials. However, in addition to therapeutic efficacy, treatment choices should also take into account health-related quality of life (HRQoL) aspects of cancer therapy. Here, we summarize the HRQoL findings related to pazopanib use, based on patient-reported outco...
Source: Therapeutic Advances in Urology - January 6, 2016 Category: Urology & Nephrology Authors: Cella, D., Beaumont, J. L. Tags: Reviews Source Type: research
Testosterone deficiency in the aging male
Treatment for hypogonadism is on the rise, particularly in the aging population. Yet treatment in this population represents a unique challenge to clinicians. The physiology of normal aging is complex and often shares the same, often vague, symptoms of hypogonadism. In older men, a highly prevalent burden of comorbid medical conditions and polypharmacy complicates the differentiation of signs and symptoms of hypogonadism from those of normal aging, yet this differentiation is essential to the diagnosis of hypogonadism. Even in older patients with unequivocally symptomatic hypogonadism, the clinician must navigate the poten...
Source: Therapeutic Advances in Urology - January 6, 2016 Category: Urology & Nephrology Authors: McBride, J. A., Carson, C. C., Coward, R. M. Tags: Reviews Source Type: research
The efficacy and tolerability of mirabegron, a {beta}3 adrenoceptor agonist, in patients with symptoms of overactive bladder
Mirabegron, is the only β-3 adrenoreceptor (AR) agonist available for the treatment of overactive bladder (OAB). To assess the efficacy and tolerability of this novel drug therapy, two phase II and six phase III Astellas-sponsored trials have been conducted with over 10,500 adults with OAB recruited. Of these, seven were randomized, double blind, 12-week placebo controlled studies and the other was for 12 months and not placebo controlled. The evidence described would suggest that mirabegron is as efficacious as most antimuscarinics, including tolterodine extended release (ER) 4 mg, compared with placebo with regard t...
Source: Therapeutic Advances in Urology - January 6, 2016 Category: Urology & Nephrology Authors: Thiagamoorthy, G., Kotes, S., Zacche, M., Cardozo, L. Tags: Reviews Source Type: research
The role of mycobacterial cell wall nucleic acid complex in the treatment of bacillus Calmette-Guerin failures for non-muscle-invasive bladder cancer
Conclusion:
Based on analysis of available published data, MCNA offers a durable response for a small proportion of patients that have failed prior intravesical therapy. There still exists a large unmet need for nonsurgical treatment options for patients with NMIBC who have failed adjuvant intravesical therapies. (Source: Therapeutic Advances in Urology)
Source: Therapeutic Advances in Urology - January 6, 2016 Category: Urology & Nephrology Authors: Packiam, V. T., Pearce, S. M., Steinberg, G. D. Tags: Reviews Source Type: research
Fixed-dose combination therapy with dutasteride and tamsulosin in the management of benign prostatic hyperplasia
Despite their multifactorial etiology, male lower urinary tract symptoms (LUTS) have been traditionally associated with benign prostatic enlargement (BPE) because of benign prostatic hyperplasia (BPH). Several pharmaceutical therapies have been used to manage LUTS, with α1-adrenergic receptor antagonists (α1-blockers) and inhibitors of 5α-reductase (5α-RIs) representing the most commonly prescribed agents currently in use for LUTS treatment. Due to their different modes of action, combined use of α1-blockers and 5α-RIs has been proven to offer more optimal control of symptoms and better ...
Source: Therapeutic Advances in Urology - January 6, 2016 Category: Urology & Nephrology Authors: Dimitropoulos, K., Gravas, S. Tags: Reviews Source Type: research
Tasquinimod in the treatment of castrate-resistant prostate cancer - current status and future prospects
Treatment options have significantly expanded in recent years for men with metastatic castration-resistant prostate cancer (mCRPC), with the routine use of immunotherapy (sipuleucel-T) and novel hormonal agents such as enzalutamide and abiraterone acetate prior to taxane-based chemotherapy or radium-223 radiotherapy. A number of immune checkpoints limit the immune response of the host to metastatic tumor progression in prostate cancer, one of which is an immunosuppressive and pro-angiogenic cell called the myeloid-derived suppressor cell (MDSC). Tasquinimod is a small molecular oral inhibitor of S100A9, a key cell surface ...
Source: Therapeutic Advances in Urology - January 6, 2016 Category: Urology & Nephrology Authors: Mehta, A. R., Armstrong, A. J. Tags: Reviews Source Type: research
Combined laparoscopic pyelolithotomy and endoscopic pyelolithotripsy for staghorn calculi: long-term follow-up results from a case series
Conclusions:
Laparoscopic pyelolithotomy combined with endoscopic pyelolithotripsy could be a therapeutic option in cases where mini-invasive procedures, that is, extracorporeal shock wave lithotripsy, ureteroscopic lithotripsy, and percutaneous nephrolithotomy (PCNL) have failed. This technique has a high stone-clearance rate (75–100%) comparable with open surgery and PCNL. However, it could be technically demanding and should be performed by skilled laparoscopy surgeons. (Source: Therapeutic Advances in Urology)
Source: Therapeutic Advances in Urology - January 6, 2016 Category: Urology & Nephrology Authors: Pastore, A. L., Palleschi, G., Silvestri, L., Leto, A., Ripoli, A., Fuschi, A., Al Salhi, Y., Autieri, D., Petrozza, V., Carbone, A. Tags: Original Research Source Type: research
Histone deacetylase inhibitors in castration-resistant prostate cancer: molecular mechanism of action and recent clinical trials
Historically, androgen-deprivation therapy has been the cornerstone for treatment of metastatic prostate cancer. Unfortunately, nearly majority patients with prostate cancer transition to the refractory state of castration-resistant prostate cancer (CRPC). Newer therapeutic agents are needed for treating these CRPC patients that are unresponsive to androgen deprivation and/or chemotherapy. The histone deacetylase (HDAC) family of enzymes limits the expression of genomic regions by improving binding between histones and the DNA backbone. Modulating the role of HDAC enzymes can alter the cell’s regulation of proto-onco...
Source: Therapeutic Advances in Urology - November 13, 2015 Category: Urology & Nephrology Authors: Kaushik, D., Vashistha, V., Isharwal, S., Sediqe, S. A., Lin, M.-F. Tags: Reviews Source Type: research
Testosterone and prostate cancer: an evidence-based review of pathogenesis and oncologic risk
Testosterone plays a central role in male development and health. Likewise, androgen deficiency, or hypogonadism, is associated with a variety of symptoms including decreased energy, diminished libido and erectile dysfunction, among others. Male androgen levels steadily decline with age, and, in a subset of symptomatic older men, can result in late-onset hypogonadism (LOH). Over the last decade, increased awareness of hypogonadism among patients and providers has led to a significant rise in the use of testosterone replacement therapy (TRT) for hypogonadism, and especially in LOH. Accompanying the rise in TRT are concerns ...
Source: Therapeutic Advances in Urology - November 13, 2015 Category: Urology & Nephrology Authors: Michaud, J. E., Billups, K. L., Partin, A. W. Tags: Reviews Source Type: research
Targeting PD-1/PD-L1 in the treatment of metastatic renal cell carcinoma
Immunostimulatory therapies have been a cornerstone of treatment for metastatic renal cell carcinoma (RCC) since the 1990s. However, the use of traditional immunotherapeutic approaches for RCC, such as high-dose interleukin-2 and interferon-α, has been limited by significant systemic toxicities and the need to deliver these therapies at centers of expertise. Furthermore, in spite of the success of these immunostimulatory therapies for some patients with RCC, it is clear that most patients fail to respond to cytokine therapy. More effective immune therapy for RCC has therefore been necessary. The interaction between p...
Source: Therapeutic Advances in Urology - November 13, 2015 Category: Urology & Nephrology Authors: Weinstock, M., McDermott, D. Tags: Reviews Source Type: research
Management of carcinoma in situ of the bladder: best practice and recent developments
Management of carcinoma in situ of the bladder remains a complex and challenging endeavor due to its high rate of recurrence and progression. Although it is typically grouped with other nonmuscle invasive bladder cancers, its higher grade and aggressiveness make it a unique clinical entity. Intravesical bacillus Calmette-Guérin is the standard first-line treatment given its superiority to other agents. However, high rates of bacillus Calmette-Guérin failure highlight the need for additional therapies. Radical cystectomy has traditional been the standard second-line therapy, but additional intravesical therapi...
Source: Therapeutic Advances in Urology - November 13, 2015 Category: Urology & Nephrology Authors: Tang, D. H., Chang, S. S. Tags: Reviews Source Type: research
Hexaminolevulinate hydrochloride in the detection of nonmuscle invasive cancer of the bladder
Clinical trials have shown that hexaminolevulinate (HAL) fluorescence cystoscopy improves the detection of bladder tumors compared with standard white-light cystoscopy, resulting in more efficacious treatment. However, some recent meta-analyses report controversially on recurrence-free rates with this procedure. A systematic review of literature was performed from December 2014 to January 2015 using the PubMed, Embase and Cochrane databases for controlled trials on photodynamic diagnosis (PDD) with HAL. A total of 154 publications were found up to January 2015. Three of the authors separately reviewed the records to evalua...
Source: Therapeutic Advances in Urology - November 13, 2015 Category: Urology & Nephrology Authors: Di Stasi, S. M., De Carlo, F., Pagliarulo, V., Masedu, F., Verri, C., Celestino, F., Riedl, C. Tags: Reviews Source Type: research
Diseases masking and delaying the diagnosis of urogenital tuberculosis
As urogenital tuberculosis (UGTB) has no specific clinical features, it is often overlooked. To identify some of the reasons for misdiagnosing UGTB we performed a systematic review. We searched in Medline/PubMed papers with keywords ‘urogenital tuberculosis, rare’ and ‘urogenital tuberculosis, unusual’. ‘Urogenital tuberculosis, rare’ presented 230 articles and ‘urogenital tuberculosis, unusual’ presented 81 articles only, a total of 311 papers. A total of 34 papers were duplicated and so were excluded from the review. In addition, we excluded from the analysis 33 papers on e...
Source: Therapeutic Advances in Urology - November 13, 2015 Category: Urology & Nephrology Authors: Kulchavenya, E., Kholtobin, D. Tags: Reviews Source Type: research
Muscle-invasive urothelial bladder cancer: an update on systemic therapy
Urothelial carcinoma is a common malignancy that carries a poor prognosis when the disease includes muscle invasion. Metastatic urothelial carcinoma is almost uniformly fatal. The evidence behind treatment options in the neoadjuvant, adjuvant and metastatic settings are discussed in this manuscript, with a focused review of standard and investigational cytotoxic, targeted, and immunotherapy approaches. We have focused especially on neoadjuvant cisplatin-based therapy (supported by level one evidence) and on novel immunotherapy agents such as checkpoint inhibitors, which have shown great promise in early clinical studies. (...
Source: Therapeutic Advances in Urology - November 13, 2015 Category: Urology & Nephrology Authors: Knollman, H., Godwin, J. L., Jain, R., Wong, Y.-N., Plimack, E. R., Geynisman, D. M. Tags: Reviews Source Type: research
Celecoxib for the prevention of nonmuscle invasive bladder cancer: results from a matched control study
Conclusions:
Our data support a clinical benefit of celecoxib and encourage future trials in which COX-2 inhibitors may be tested in selected patients with NMIBC. (Source: Therapeutic Advances in Urology)
Source: Therapeutic Advances in Urology - November 13, 2015 Category: Urology & Nephrology Authors: Pagliarulo, V., Ancona, P., Martines, I., Spadavecchia, R., Di Stasi, S., Alba, S., Cormio, L., Fanizza, C., Salerno, A., Carrieri, G., Pagliarulo, A. Tags: Original Research Source Type: research
