Volume 16 Issue 10, October 2019

Intensifying systemic therapy improves outcomes in metastatic prostate cancer. As apalutamide and enzalutamide join abiraterone and docetaxel as treatment options for patients, the choice of therapy for individual patients becomes more complex. We anticipate precision targeted and immune therapies will build on the advances of recently completed large-scale trials.

The US Preventive Services Task Force has issued a grade A recommendation that clinicians offer pre-exposure prophylaxis (PrEP) to people at high risk of acquiring HIV. Currently, many fewer individuals receive PrEP than those who would benefit from it; whether PrEP can have a real impact on reducing the global burden of HIV is yet to be determined.

Urogenital tuberculosis can be easily overlooked owing to non-specific symptoms, varying manifestations and a lack of awareness of the disease. In this Review, Muneer and colleagues provide a comprehensive overview of the epidemiology, pathogenesis, clinical features, diagnosis and management of this disease.

Intravesical chemotherapy is a mainstay of treatment for non-muscle-invasive bladder cancer; however, the biology of the bladder means that intravesical therapy is limited by washout of the agent during voiding and systemic effects caused by absorption through the bladder wall. In this Review, the authors consider novel approaches to improving the pharmacokinetics of intravesical chemotherapy, such as chemohyperthermia, sustained release devices, and nanoparticle conjugation.

Schneider et al. review the multifaceted immunoregulatory responses in the pathophysiology and treatment of bladder cancer, focusing on immune checkpoints and the various immune cells of the tumour microenvironment. They discuss alterations of these immune regulators, their clinical relevance and therapeutic targeting strategies.