Reviews & Analysis

Ferroptosis induction is a promising new therapeutic strategy for advanced prostate cancer. In this Perspective, the authors discuss the interplay between ferroptosis and metabolism. Current efforts to target ferroptosis and combination therapies in prostate cancer, as well as emerging methods to monitor this process in patients, are also discussed.

In this Perspective, the authors discuss the idea of targeting histone modifications in bladder cancer, providing a comprehensive overview of findings from preclinical and translational studies. Clinical trials in which the efficacy of molecules targeting histone modifiers was assessed in bladder cancer are also discussed.

Bladder cancer outcomes are considered worse for women than for men, whereas incidence is three to four times higher in men than in women. Understanding biological phenomena and health-system factors driving these differences is essential to improve outcomes and develop novel treatment approaches.

In this Perspective, the authors highlight the ethical challenges of adopting artificial intelligence (AI) in urology and its influence on daily practice. Ethical principles for the application of AI in health care and urology are proposed to improve and oversee the use of such technologies.

The microbiota influences the body in homeostasis and disease, including cancer, and, although specific urinary and gut microbial species have been associated with an increased risk of prostate cancer, causal mechanistic data remain elusive. In this Perspective article, the authors discuss the roles of the microbiota in prostate carcinogenesis and progression, and consider how these might be leveraged for diagnosis and treatment of the disease.

In this Perspective, the author uses a comparative evolutionary approach to explain renal physiology. The kidney structure and the urinary collecting system are contextualized within the evolutionary and environmental selective pressures that might have contributed to renal evolution.

Body fluid-derived stem cells (BFSCs) have been used as a stem cell source in animal models of regenerative diseases. In this Perspective, the authors present the characteristics and immunomodulatory properties of different BFSCs, focusing on the therapeutic potential of these cells in the treatment of genitourinary conditions and discussing challenges in the clinical translation of BFCSs in urinary regeneration.

In this Perspective article, the authors summarize the roles of vitamins in calcium-containing kidney stone disease, and hypothesize implications for the gut microbiota in altering vitamin homeostasis by modulating vitamin absorption, production and chemical modification.

In this Perspective, current evidence to support de-escalation strategies of attenuated chemotherapy, radiotherapy and surgery for stage II seminoma to minimize the toxic effects of treatment is described and new potential de-escalation strategies are discussed.

Since its inception in 1922, prostate biopsy has undergone considerable changes in both technique and indication. In this Perspective, the authors describe the history of prostate biopsy and consider the role of imaging in prostate biopsy, now and in the future.

This Perspective covers existing patient-derived xenografts (PDXs) of prostate cancer, and their features and uses in basic and preclinical research. The authors also discuss the need for additional PDXs, and how collaboration in prostate cancer PDX research can be improved.

Combination treatment with androgen deprivation therapy plus chemotherapy or novel hormonal agents showed promising results for the treatment of patients with newly diagnosed metastatic prostate cancer. However, real-world data show a very low uptake of this therapy in clinical practice. In this Perspective, the authors discuss data and potential reasons behind this trend.

In this Perspective, the authors present clinical scenarios in which prostate hyperplasia and prostate cancer overlap, with a specific focus on holmium laser enucleation of the prostate (HoLEP). Variables associated with incidental prostate cancer detection at HoLEP and prostate cancer development after HoLEP, as well as the role of HoLEP in patients with biopsy-proven prostate cancer, are also discussed.

Adjuvant therapies in renal cell carcinoma (RCC) disrupt multiple steps of the metastatic cascade. Results from clinical trials to assess adjuvant treatment with immunotherapeutic agents in patients with resected clear cell RCC were promising, but the utility of tyrosine kinase inhibitors in this setting was not clearly shown. In this Perspective, the authors provide an overview of completed and ongoing clinical trials for adjuvant treatment of RCC, highlighting future directions and challenges in the field.

In this Perspective, the authors provide an overview of the roles of three genes, PBRM1, SETD2 and BAP1, which are commonly lost with chromosome 3p deletion in patients with clear cell renal cell carcinoma (ccRCC). The authors discuss the implication of these genes in cancer-related pathways and how an improved understanding of these mechanisms might help to develop potential new therapies in ccRCC.

Altered lipid metabolism is a visually obvious, distinguishing feature of clear-cell renal cell carcinoma. In this Perspective the authors describe the molecular mechanisms driving fatty acid accumulation and discuss potential therapeutic targets in this disease.

An association between infertility and poor somatic health exists, and infertility could be used as an indicator of a future pathological condition. However, the bidirectional relationship between infertility and poor health needs to be elucidated. In this Perspective, the authors discuss current advances and gaps in this area, focusing on lipid peroxidation and oxidative damage as potential molecular links between infertility and somatic health.

Lower urinary tract disorders (LUTDs) are common in the elderly, owing to age-related dysfunction of the lower urinary tract (LUT). An endogenous inhibitor of purine nucleoside phosphorylase, 8-aminoguanine, has been shown to reverse the effects of ageing on LUT biochemistry, structure and function, offering a novel potential treatment for LUTDs.

In this Perspective, the authors discuss the past, present and future of PSA screening for the early detection of aggressive prostate cancer and propose a way forward for the rational use of PSA testing as part of a risk-adapted screening strategy.

In this Review, the authors discuss racial differences in the prevalence of genetic mutations in the main molecular drivers of prostate cancer and provide input regarding the role of genomics in racial disparities observed in prostate cancer outcomes.