Volume 14 Issue 5, May 2017

Determining what constitutes a low level of testosterone is a major point of confusion in the field of testosterone deficiency — also known as hypogonadism. A recent article adds to the controversy by proposing a new, lower threshold for normal testosterone concentrations on the basis of harmonized reference ranges.

Intermittent sunitinib treatment is a feasible first-line approach in patients with renal cell carcinoma (RCC), providing a median progression-free survival duration of 37.6 months. Cyclic re-introduction of sunitinib after a treatment break might increase the duration of a response owing to resistance to tyrosine kinase inhibitors being largely dependent on reversible changes in gene expression. Biomarkers are needed to enable selection of the best candidates for intermittent treatment.

Patient-derived xenograft (PDX) models can maintain the original histology and the molecular and genetic characteristics of the source tumour. Thus, PDX models have advantages over conventional models for drug development and treatment decisions in personalized medicine. In this Review, the authors discuss the potential of PDX models for both basic and clinical urological research.

Part of the innate immune response, inflammasomes are multiprotein intracellular complexes that detect pathogens and activate the proinflammatory cytokines IL-1β and IL-18, via caspase-1, and induce pyroptosis. The effector pathways of the inflammasome can act at different levels to prevent or resolve infection, or eliminate the infectious agent itself. In this Review, the authors discuss the role of inflammasomes in the pathogenesis of UTI and consider how better understanding of their mechanisms might lead to new diagnostic and therapeutic approaches for UTI.

Timely and accurate identification and determination of the antimicrobial susceptibility of uropathogens is central to the management of UTIs and antimicrobial stewardship. In this Review, Davenport and colleagues discuss emerging technologies including biosensors, microfluidics, and other integrated platforms that could improve UTI diagnosis and treatment choice.

Semantic heterogeneity exists regarding terminology for active surveillance (AS) for prostate cancer. A panel of leading specialists in prostate cancer and AS involved in the Movember Foundation's Global Action Plan Prostate Cancer Active Surveillance (GAP3) consortium participated in a consensus-forming project to reach international consensus on definitions of terms related to this management option. This standard terminology could support multidisciplinary communication, reduce the extent of variations in clinical practice and optimize clinical decision making.