Reviews & Analysis

The Notch pathway has been shown to act in both an oncogenic and a tumour-suppressive manner depending on its cellular context, and blocking or restoring the Notch pathway could offer a novel therapeutic target in patients with bladder cancer. In this Review, the authors describe what is known about Notch in cancer and discuss the role and potential of this signalling pathway in bladder cancer.

Male infertility is a multifactorial pathological condition, and its genetic landscape is highly complex. Here, Krausz and Riera-Escamilla describe our current understanding of the genetics of male infertility and the clinical implications of this knowledge.

In this Perspectives, the authors present a new model of urothelial carcinogenesis that incorporates the role of telomerase activation. They also highlight the potential of targeting telomerase as a therapeutic approach for bladder cancer.

Bladder cancer molecular subtypes are promising for predicting patient outcomes. In contrast to most reports to date that used unsupervised clustering methods, a new study has demonstrated the value of a tumour differentiation signature based on normal biological expression patterns characteristic of basal or differentiated urothelial cells.

Refers to Mo, Q. et al. Prognostic power of a tumour differentiation gene signature for bladder urothelial carcinomas. J. Natl Cancer Inst. https://doi.org/10.1093/jnci/djx243 (2018)

Prostate MRI has reached the point of being a mature technology with an established clinical need, so the modality is here to stay. Accordingly, it is incumbent upon the radiology community to find practical solutions for the ongoing variability in interpretation and diagnostic performance of this technique.

The past decade has witnessed an accelerated trend towards freeze-all or frozen embryo transfer cycles in reproductive medicine. However, the results of two recent randomized controlled trials seem to indicate that this deliberate shift in practice towards frozen embryo transfer cycles was premature and perhaps even misguided.

In this Review, Lotti and Maggi discuss the correlations between sexual dysfunction and male infertility, focusing on the associations between reproductive, sexual, psychological, and general health.

A recent study suggests modulation of luteinizing hormone signalling within the hypothalamic–pituitary–gonadal axis and downstream transcriptional effects caused by sustained ibuprofen use. However, this study cannot be used to draw any clinical conclusions regarding effects of ibuprofen on male androgenic or reproductive health. Thus, the andrological effects of its use remain unclear and would benefit from further investigation.

Different methods for detecting circulating tumour cells (CTCs) in the blood of patients with cancer yield distinct results with regard to cell counts and CTC subpopulations. This observation underlines the urgent need for comprehensive standardization and validation of novel CTC technologies in order to facilitate their introduction into clinical practice.

The International Society of Paediatric Oncology–Renal Tumour Study Group (SIOP–RTSG) has developed a new protocol for the diagnosis and treatment of childhood renal tumours, the UMBRELLA SIOP–RTSG 2016 (the UMBRELLA protocol). In this Consensus Statement, members of the SIOP–RTSG outline the rationale for the recommendations for treatment of CCSK in the protocol.

Preventative use of serum PSA screening is controversial and generally undertaken as a shared decision between doctor and patient. A new study identifies a link between individuals' numeracy, or facility with quantitative concepts, and their understanding of the risk reduction benefits of PSA testing.

Neuroendocrine prostate cancers (NEPCs) are androgen independent and aggressive and have characteristics of epithelial–mesenchymal plasticity and stem-like cell properties. This Review describes the link between lineage plasticity and an emergent NEPC phenotype and how this knowledge can aid in the development of novel therapeutics.

Genomic aberrations of thePTENtumour suppressor are among the most common in prostate cancer. In this Review, the authors describe the roles of PTEN, consider how PTEN status could act as a potential prognostic and predictive biomarker, and discuss the potential of PTEN and its downstream pathways as a therapeutic target.

Lee and Gujar review the potential of virotherapy to increase the effectiveness of immunotherapies in prostate cancer. They discuss how oncolytic viruses can improve anticancer immunological responses and strategies for combining virotherapy with other immunotherapies to obtain improved patient outcomes.

Metabolic syndrome is associated with increased cancer risk and progression at almost all sites, including the prostate in high-stage prostate cancer, but several reports have described an inverse relationship between metabolic syndrome and its components and low-stage incident prostate cancer. Here, Hammarsten et al. hypothesize that the inverse link between metabolic syndrome and its components and low-stage incident prostate cancer might simply be the result of bias mechanisms.

Clinical conditions that cause poor bladder compliance, reduced capacity, and incontinence can require bladder augmentation or use of regenerative techniques and scaffolds. Replicating an organ that is under frequent mechanical loading and unloading needs particular attention to its biomechanical requirements. In this Review, the authors describe the biomechanics of the bladder and discuss how different scaffolds and techniques can be assessed to determine the best possible approach to bladder augmentation.

In this Review, Colaco et al. describe applications of 3D printing relevant to urology, which include the generation of inorganic models for surgical planning and education, the production of inorganic prostheses and devices, and 3D printing for bioengineering of organic structures.

Labiaplasty is attracting increasing attention in the media and in online forums. How to manage a request for this surgery is controversial, and the indications for and outcomes of labiaplasty have not yet been systematically assessed. In this Review, Özer and colleagues discuss our current knowledge of this surgery.

Compérat et al. review problematic aspects in the pathological assessment of urothelial tumours, evaluating unresolved questions in bladder cancer grading, staging, and tissue handling. They also discuss the incorporation of new molecular and genomic markers into the routine histological work-up.

Treatment paradigms for advanced renal cell carcinoma (RCC) continue to be challenged and refined. Recent studies in metastatic RCC have demonstrated the efficacy of first-line cabozantinib and the safety and efficacy of dual checkpoint blockade; in the adjuvant setting, pazopanib failed to improve progression-free survival in high-risk localized RCC compared with placebo.