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Neoadjuvant targeted therapy can be used in patients with unresectable locally advanced, locally recurrent or metastatic renal cell carcinoma to induce cytoreduction before surgical resection. The efficacy of this multimodal therapy is still unproven, however, and must be balanced against a potential higher risk of perioperative complications.
An article in The Journal of Urology addresses a frustrating feature of PSA-based prostate cancer screening, namely the fact that PSA is a fairly nonspecific marker for cancer. The authors provide a potential diagnostic test for the most common non-cancer diagnosis on prostate biopsy—asymptomatic inflammatory prostatitis (AIP)—and recommend its use as a means of avoiding unnecessary prostate biopsies.
Antimuscarinic therapy for children with overactive or neurogenic bladder is limited by its suboptimal efficacy and tolerability. New research suggests that double antimuscarinic treatment can improve continence and urodynamic parameters with an acceptable rate of adverse effects. Although the study was small and uncontrolled, it provides the impetus for larger randomized double-blind analyses.
The targeting of angiogenesis is a growing area of cancer therapy.In vivo imaging techniques allow the noninvasive evaluation of changes in tumor vasculature in response to antiangiogenic agents. Zee et al. provide an overview of MRI, CT, PET and ultrasound techniques, highlighting their application in renal, prostate and bladder cancer.
Current imaging modalities lack sufficient sensitivity and specificity for the noninvasive staging of lymph nodes in genitourinary cancers. In this Review, Mouli and colleagues from Northwestern University discuss the potential role of lymphotropic nanoparticles—which selectively accumulate in benign lymph nodes—in enhancing the MRI detection of nodal metastases.
In this Review, the authors discuss the potential of testicular germline stem cells as a substrate for cell-based therapies. Although at an early stage, research in this field is progressing rapidly. If their promise is fulfilled, such cells could be applied to a range of therapeutic indications, including tissue reconstruction and fertility restoration.
The publication last year of large trials of PSA screening in prostate cancer has rekindled interest in alternative noninvasive markers for this disease. Here, Ploussard and de la Taille discuss the range of potential urinary biomarkers in prostate cancer, and the current clinical data on their utility in disease detection and staging.
Renal medullary carcinoma has been almost exclusively diagnosed in patients with sickle cell anemia. O'Donnell et al. present a case of this rare and aggressive cancer in an adult with no detectable hemoglobinopathies. They describe both the histopathological features of the disease, and the systemic chemotherapies used to treat it.
