Review Articles

Genetic and ancestral factors, molecular pathways involving androgen and non-androgen receptor signalling, inflammation, epigenetics, the tumour microenvironment and tumour metabolism are posited as biological factors that potentially contribute to racial disparities in Black men with prostate cancer.

Senescent stromal fibroblasts exhibit a senescence-associated secretory phenotype, which can promote prostate cancer development, progression and resistance to therapy. Targeting senescent cells via senotherapeutics might be an attractive preventive or therapeutic option for prostate cancer.

Here, the authors describe the history of the efforts to expand knowledge of Wilms tumour biology, genetics, embryonal origin and associated syndromic and familial conditions, and to clinically apply prognostic biomarkers and development of preclinical models.

In this Review, the authors provide an overview of currently available diagnostic liquid biopsy biomarkers for renal cell carcinoma, comparing clinical potential and limitations of the three most promising liquid biomarkers: circulating tumour cells, extracellular vesicles and cell-free DNA.

Rare male sexual disorders — including post-finasteride syndrome, restless genital syndrome, post-orgasmic illness syndrome, post-SSRI sexual dysfunction, hard–flaccid syndrome, sleep-related painful erections and post-retinoid sexual dysfunction — are under-recognized and under-treated, leading to considerable morbidity, with adverse effects on individuals’ sexual health and relationships. The literature surrounding such disorders is scarce and their aetiology has not been fully elucidated. In this Review, the authors discuss possible aetiologies of these disorders, as well as the need for clinician awareness and large-scale studies to better understand how to best serve patients.

In this Review, we summarize preclinical evidence of antitumour effects upon CTLA4 inhibition. We also describe the clinical development of anti-CTLA4 in urothelial cancer. Ongoing phase III trials could establish the efficacy of anti-CTLA4 therapy and change current urothelial cancer guidelines.

In this Review, the authors provide an overview of the main bioinformatics tools available for urologists. The main applications of bioinformatics in the field of urological oncology, as well as in benign urological disease, are discussed, with a special focus on molecular characterization of disease physiopathology and response to treatment. Challenges and future perspectives in the field are also discussed.

Bacteria infecting tumour cells might be a promising target for triggering antitumour immune responses. Here, the authors discuss the influence of urinary tract infections on kidney and bladder cancer immunosurveillance and consider the urobiome and the effects of antibiotics.

Approximately two-thirds of small, indeterminate lesions of the testes might be benign and not require radical orchidectomy. Management strategies are evolving to include vigilant active surveillance and excisional biopsy of the lesion with further management guided by histological outcome.

In this Review, the authors present the history of cytoreductive nephrectomy, discuss controversial results from clinical trials and assess future perspectives about the role of surgery in the management pathway of patients with metastatic renal cell carcinoma.

Known modifiable risk factors for renal cell carcinoma (RCC) include smoking, obesity and hypertension. Moreover, a potential association between other factors such as diet, dyslipidaemia and physical activity with RCC incidence is also starting to be explored. In this Review, the authors describe the most relevant modifiable risk factors for RCC, discussing the potential implications for prevention and screening programmes.

Urine markers enable non-invasive acquisition of tumour information. The evolution towards multiplex approaches addresses bladder cancer heterogeneity and expands clinical application scenarios for urinary biomarkers. This Review provides a comprehensive overview of current status, limitations and perspectives of various urine markers.

Effects of prostate cancer treatment in sex and gender minority groups, which include gay and bisexual men, transgender women, or transfeminine people, can include altered sexual function in relation to receptive anal and neovaginal intercourse and changes to patients’ role-in-sex, as well as changes in sexual pleasure related to the loss of the prostate as a source of sexual pleasure. In this Review, the authors discuss the prostate as a sexual organ and consider the effects of prostate cancer treatment in patients from these under-represented groups, as well as discussing the need for openness and counselling in patients from sexual and gender minorities.

Current evidence suggests that adipose stromal cells, a component of peri-prostatic white adipose tissue and the tumour microenvironment, have an important role in driving aggressive prostate cancer in obesity. These cells are potential targets of therapies to suppress cancer aggressiveness in obesity.

In this Review, the authors examine the prevalence of middle lobe enlargement in benign prostatic hyperplasia (BPH). The clinical significance, presentation, pathophysiology and assessment of middle lobe obstruction is discussed. The spectrum of management options in BPH is reviewed and their applicability in middle lobe enlargement debated.

In this Review, the authors summarize the roles of the androgen receptor in bladder cancer development and progression, and describe the clinical applications of these roles.

In this Review, Reyes et al. provide an overview of the embryology and genetics of typical sex development, before discussing the clinical manifestations, genetic causes and phenotypic complexity of differences in sex development.

Non-invasive liquid biopsies such as plasma circulating tumour DNA (ctDNA) and urinary tumour DNA (utDNA) are promising tools for urothelial carcinoma diagnosis and management. In this Review, the authors provide an overview of the different liquid biopsy technologies available, and discuss the current state as well as future perspectives of ctDNA and utDNA application in urothelial carcinoma clinical care.

In this Review, the authors provide an overview of the role of calcium as a driver of prostate cancer onset and progression, and discuss the most current therapies targeting the calcium signalling machinery to treat this malignancy.

In this Review, Nolla and colleagues discuss the use of patient-reported outcome measures (PROMs) to assess health-related quality of life in six immunotherapy versus sunitinib clinical trials for advanced renal cell carcinoma and, following this discussion, make recommendations for future PROM use in clinical trials.