Urological cancer articles within Nature Reviews Urology

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  • Clinical Outlook |

    For many years, PSA has been the most commonly used biomarker for prostate cancer screening and diagnosis. Although serum PSA measurement is highly sensitive, this biomarker has several limitations. Citrate, a molecule closely linked to the unique metabolism of prostate cancer, has the potential to be used as a complementary biomarker alongside PSA.

    • Lucas Galey
    • , Ayokunle Olanrewaju
    •  & Étienne Audet-Walsh

  • News & Views |

    In the KEYNOTE-564 trial, patients with resected clear cell renal cell carcinoma at a high risk of relapse experienced disease-free survival and especially overall survival benefits following treatment with pembrolizumab, which in turn was established as the novel standard adjuvant therapy for these patients. Accurate patient selection is crucial. Managing post-pembrolizumab recurrence is challenging owing to limited evidence for guiding therapeutic decisions based on clinical features.

    • Francesco Massari
    • , Matteo Rosellini
    •  & Veronica Mollica

  • Review Article |

    Urothelial cancer is the tenth most diagnosed cancer worldwide, and between 5% and 10% of patients have metastatic disease at diagnosis. Furthermore, up to 50% of patients are ineligible for cisplatin, the first-line treatment option, and require alternative options. In this comprehensive Review, the authors discuss the current and future therapeutic options for advanced urothelial cancer, including chemotherapeutics, targeted therapies and antibody–drug conjugates, and consider how these agents might change patient management.

    • Giandomenico Roviello
    • , Matteo Santoni
    •  & Martina Catalano

  • Review Article |

    In this Review, the authors discuss hypoxia signalling and therapeutic strategies targeting this pathway in renal cell carcinoma, with a specific focus on clear cell renal cell carcinoma, in which hypoxia signalling is primarily driven by Von Hippel–Lindau tumour suppressor (VHL) loss.

    • Chengheng Liao
    • , Lianxin Hu
    •  & Qing Zhang

  • News & Views |

    Bladder cancer progression to microscopically distinct variants such as sarcomatoid, small cell, micropapillary and plasmacytoid is associated with more aggressive clinical behaviour than conventional carcinoma. Advances in molecular profiling led to the identification of molecular subtypes of bladder cancer and provided insights into disease progression to aggressive variants.

    • Bogdan Czerniak

  • Perspective |

    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.

    • Pham Hong Anh Cao
    • , Abishai Dominic
    •  & Elavarasan Subramani

  • Comment |

    Centralization of care for penile cancer has been underscored in the 2023 updated EAU–ASCO guidelines. Expertise consolidation enhances patient care, addressing penile cancer complexities from diagnosis to treatment. Centralization initiatives, like the European Reference Networks, and dedicated scientific societies have crucial roles in guiding centralized care pathways to ultimately improve patient outcomes.

    • Giuseppe Basile
    • , Andrea Necchi
    •  & Peter A. S. Johnstone

  • Comment |

    The growing global burden of genitourinary cancers is disproportionately shouldered by low- and middle-income countries. Medical journals offer an avenue for discourse among different stakeholders to strategize and identify solutions. Thus, achieving diversity in this context is crucial to put together a heterogeneous group of stakeholders with diverse personal and cultural experiences as well as distinct problem-solving approaches.

    • David J. Benjamin
    • , Zhaohui Arter
    •  & Arash Rezazadeh Kalebasty

  • Review Article |

    The evaluation and management of patients with small renal masses continue to evolve as new data-driven evidence emerges. Contemporary research in biomarkers, imaging, and machine learning shows promise in improving the understanding of small renal masses.

    • Yuzhi Wang
    • , Mohit Butaney
    •  & Brian R. Lane

  • Clinical Outlook |

    The combination of pembrolizumab and enfortumab vedotin shows promise as a first-line therapy for advanced urothelial carcinoma. Enfortumab vedotin targets nectin-4, in turn enhancing T cell and natural killer cell activity, inhibiting immunosuppressive pathways and impeding tumour evasion. This synergy with pembrolizumab shows potential in enhancing immunotherapy for these patients.

    • Matteo Santoni
    • , Hideki Takeshita
    •  & Joaquim Bellmunt

  • Review Article |

    Antiretroviral therapy means that people living with HIV (PLWH) now often have a long life expectancy. However, their risk of developing cancer — most notably virus-related cancers — has been increasing. In this Review, the authors discuss the risk of genitourinary cancers in PLWH, the inequity of health care access and consider how including PLWH in ongoing cancer trials can help to improve cancer care for this population.

    • Chalairat Suk-Ouichai
    • , Anna E. Coghill
    •  & Philippe E. Spiess

  • Review Article |

    In this Review, the authors discuss shared decision-making for prostate cancer screening in terms of definition, prevalence and methods, including decision aids. Facilitators and barriers to shared decision-making are also discussed.

    • Kelly R. Pekala
    • , Daniela K. Shill
    •  & Sigrid V. Carlsson

  • Review Article |

    In this Review, the authors examine the potential synergy between thermal ablation and intratumoural immunotherapy in treating localized prostate cancer. This combination could transform the traditionally cold immunological landscape of prostate cancer into a hot one, enhancing treatment efficacy.

    • Denis Séguier
    • , Eric S. Adams
    •  & Thomas J. Polascik

  • Review Article |

    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.

    • Jun Gong
    • , Daniel M. Kim
    •  & Stephen J. Freedland

  • Review Article |

    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.

    • Joakin O. Mori
    • , Isra Elhussin
    •  & Christopher M. Heaphy

  • Review Article |

    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.

    • Daniela Perotti
    • , Richard D. Williams
    •  & Kathy Pritchard-Jones

  • Review Article |

    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.

    • Richard C. Zieren
    • , Patricia J. Zondervan
    •  & Adriaan D. Bins

  • Review Article |

    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.

    • Chantal F. Stockem
    • , Matthew D. Galsky
    •  & Michiel S. van der Heijden

  • Review Article |

    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.

    • Ali Hashemi Gheinani
    • , Jina Kim
    •  & Rosalyn M. Adam

  • Perspective |

    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.

    • Paul Toren
    • , Anna Wilkins
    •  & Richard T. Bryan

  • Comment |

    Oligometastatic bladder cancer, defined as a cancer with limited metastases, is a potential target for curative metastasis-directed therapy in a multidisciplinary framework. The consensus definition of oligometastatic bladder cancer is a valuable starting point for clinical trials, but challenges remain in accurately characterizing metastatic burden with current imaging modalities and determining optimal strategies to treat patients with lymph node involvement.

    • Laura S. Mertens
    • , Sarah P. Psutka
    •  & Maria Carmen Mir

  • Perspective |

    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.

    • Nicolò Pernigoni
    • , Christina Guo
    •  & Andrea Alimonti

  • Review Article |

    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.

    • Anne-Gaëlle Goubet
    • , Mathieu Rouanne
    •  & Laurence Zitvogel

  • Review Article |

    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.

    • Daniel R. Dickstein
    • , Collin R. Edwards
    •  & Deborah C. Marshall

  • Review Article |

    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.

    • Jinbo Chen
    • , Chi-Ping Huang
    •  & Chawnshang Chang

  • Comment |

    Several newly approved therapies have substantially altered the treatment paradigm for multiple genitourinary cancers. Considering the existence of numerous possible treatment approaches, understanding which treatment attributes are most valued by each patient is crucial to physicians to recommend a cancer-directed treatment.

    • David J. Benjamin
    •  & Arash Rezazadeh Kalebasty

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