Volume 12 Issue 12, December 2015

In a recent issue of JAMA, Lewis et al. present long-term data on the likelihood of a link between pioglitazone and the risk of bladder cancer and ten other cancers. Their findings contradict previous concerns regarding the safety of pioglitazone, and add to the controversy surrounding interpretation of rare adverse events associated with prescription drugs.

The results of the phase III CHAARTED trial investigating androgen deprivation therapy (ADT) plus docetaxel for men with metastatic hormone-sensitive prostate cancer challenge the long-established standard of care of ADT alone for these men. The next step will be to integrate these results into clinical practice.

Studies using rodent and adult human prostate stem-progenitor cell models indicate that exposure to bisphenol A (BPA) during development increases susceptibility of the prostate gland to premalignancy later in life. A novel human organoid model has now been generated to study the effects of BPA on embryonic human prostate development.

The WHO recommends voluntary medical male circumcision (VMMC) throughout East and Southern Africa, in order to reduce heterosexual HIV acquisition. In this Review, Tobian et al. consider how evidence has informed policy in this field and describe the conventional surgical procedures available. They also discuss new devices that might help to accelerate the scale-up of adult VMMC in these regions, and note the features that would be present in the 'ideal' device.

Female urethral diverticula are rare, benign, epithelium-lined outpouchings of the urethra. Patients can present with a multitude of symptoms that are often confused with other diagnoses, leading to delayed diagnosis or misdiagnosis. In this Review, Greenwell and Spilotros describe the diagnosis and treatment of urethral diverticula in women and discuss possible adverse events and complications related to treatment.

Survival of patients with muscle-invasive bladder cancer is poor and none of the targeted agents that are approved for cancer therapy have been approved for the treatment of bladder cancer. However, many novel targeted agents have been investigated in animal models of bladder cancer. This Review provides a comprehensive overview of targeted therapies for bladder cancer that have been investigated in animal models and have potential for clinical application.

Neural control of micturition is a complex process, involving input from many different brain regions. In this Review, Derek Griffiths describes a simplified model of neural control of micturition that incorporates current knowledge, largely derived from functional brain imaging studies of humans and experimental animals. Consideration is also given to the effects of treatments of urinary urgency on neural control of micturition.

Cancer evolution is often depicted using a tree model and many current therapies target gene mutations mapped to the tree trunk. Here, Wei and Hsieh propose a novel paradigm—the river model—and examine how this model might describe phenotypically convergent events to better guide effective cancer control in renal cell carcinoma and overcome treatment-resistance that eventually develops in most patients.