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Urinary Bladder Neoplasms: HELP
Articles from Vancouver
Based on 114 articles published since 2008
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These are the 114 published articles about Urinary Bladder Neoplasms that originated from Vancouver during 2008-2019.
 
+ Citations + Abstracts
Pages: 1 · 2 · 3 · 4 · 5
1 Editorial Critical Questions To Optimize Intravesical Therapy for Non-muscle-invasive Bladder Cancer. 2018

Black, Peter. ·Urological Sciences, University of British Columbia, Vancouver, Canada. Electronic address: peter.black@ubc.ca. ·Eur Urol Focus · Pubmed #30262197.

ABSTRACT: -- No abstract --

2 Editorial Editorial: Managing locally advanced bladder cancer. Third International Bladder Cancer Network seminars series. 2018

Black, Peter C / Goebell, Peter J / Kamat, Ashish M / Nawroth, Roman / Schmitz-Dräger, Bernd J. ·Department of Urologic Sciences, University of British Columbia, Vancouver, BC, Canada. · Department of Urology, Friedrich-Alexander University, Erlangen, Germany. · Department of Urology, University of Texas MD Anderson Cancer Center, Houston, TX. · Department of Urology, Klinikum rechts der Isar, Technische Universität München, Munich, Germany. · Department of Urology, Friedrich-Alexander University, Erlangen, Germany; MVZ Urologie24, Nürnberg, Germany. Electronic address: bernd_sd@yahoo.de. ·Urol Oncol · Pubmed #29548621.

ABSTRACT: -- No abstract --

3 Editorial Seeking the Molecular Truth in Bladder Cancer: Biology=Genome×(Transcriptome) 2017

Black, Peter C. ·Department of Urologic Sciences, University of British Columbia, Vancouver, Canada. Electronic address: pblack@mail.ubc.ca. ·Eur Urol · Pubmed #28427785.

ABSTRACT: -- No abstract --

4 Editorial Editorial Comment to Robotic transmural ablation of bladder tumors using high-intensity focused ultrasound: Experimental study. 2016

Todenhöfer, Tilman / Seiler, Roland. ·Department of Urology, University Hospital, Tübingen, Germany. tilman.todenhoefer@med.uni-tuebingen.de. · Vancouver Prostate Centre, University of British Columbia, Vancouver, British Columbia, Canada. tilman.todenhoefer@med.uni-tuebingen.de. · Vancouver Prostate Centre, University of British Columbia, Vancouver, British Columbia, Canada. · Department of Urology, University of Bern, Bern, Switzerland. ·Int J Urol · Pubmed #27043951.

ABSTRACT: -- No abstract --

5 Editorial Evolving concepts in muscle-invasive bladder cancer. 2016

Black, Peter C / Kassouf, Wassim. ·Department of Urologic Sciences, Vancouver Prostate Centre, University of British Columbia, Level 6, 2775 Laurel St, Vancouver, BC, V5Z 1M9, Canada. pblack@mail.ubc.ca. · Department of Surgery (Urology), McGill University Health Center, 1001 Decarie Blvd, D02.7210, Montreal, QC, H4A 3J1, Canada. wassim.kassouf@muhc.mcgill.ca. ·World J Urol · Pubmed #26743671.

ABSTRACT: -- No abstract --

6 Editorial Fine-tuning Risk Stratification for Non-Muscle-invasive Bladder Cancer. 2016

Black, Peter C. ·Department of Urologic Sciences, University of British Columbia, Vancouver, British Columbia, Canada. Electronic address: pblack@mail.ubc.ca. ·Eur Urol · Pubmed #26256521.

ABSTRACT: -- No abstract --

7 Editorial Bladder tumor resection: doing it right. 2014

Black, Peter. ·Department of Urologic Sciences, University of British Columbia, Vancouver, British Columbia, Canada. ·J Urol · Pubmed #24647080.

ABSTRACT: -- No abstract --

8 Review Current Clinical Trials in Non-muscle Invasive Bladder Cancer. 2018

Nykopp, Timo K / Batista da Costa, Jose / Mannas, Miles / Black, Peter C. ·Department of Surgery, Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland. · Vancouver Prostate Centre, Department of Urologic Sciences, University of British Columbia, Level 6, 2775 Laurel St, Vancouver, BC, V6N 2W6, Canada. · Vancouver Prostate Centre, Department of Urologic Sciences, University of British Columbia, Level 6, 2775 Laurel St, Vancouver, BC, V6N 2W6, Canada. pblack@mail.ubc.ca. ·Curr Urol Rep · Pubmed #30357541.

ABSTRACT: PURPOSE OF REVIEW: As our molecular understanding of bladder cancer continues to advance, more and more novel agents are entering clinical trials across the spectrum of bladder cancer stages. The clinical trial activity for non-muscle invasive bladder cancer (NMIBC) has been boosted further by the evolution of specific disease states that set more uniform inclusion criteria for clinical trial design. Here, we aimed to review the current clinical trials landscape in non-muscle invasive bladder cancer with respect to these disease states. RECENT FINDINGS: Most active clinical trials focus on high-risk NMIBC in either the BCG-naïve or BCG-unresponsive setting. Strict criteria to define the disease state and a clear pathway to drug registration have encouraged trials for patients with BCG-unresponsive NMIBC. The most promising potential breakthroughs for BCG-naïve patients include alternative BCG strains, immune-priming with intradermal BCG vaccination, and systemic immune checkpoint blockade. The latter therapy is also being actively investigated in multiple trials in BCG-unresponsive NMIBC, along with novel viral agents such as INSTILADRIN (nadofaragene firadenovec) and targeted agents such as oportuzumab monatox. After many years of relative stagnation, multiple new therapies currently under investigation in well-designed clinical trials appear poised for routine clinical implementation in the near future. These therapies should dramatically improve the outcome of patients with NMIBC. We can look forward to the challenges of biomarker-driven drug selection, optimal drug sequencing, and rational combination therapies.

9 Review Neoadjuvant treatment for muscle-invasive bladder cancer: The past, the present, and the future. 2018

Hermans, Tom J N / Voskuilen, Charlotte S / van der Heijden, Michiel S / Schmitz-Dräger, Bernd J / Kassouf, Wassim / Seiler, Roland / Kamat, Ashish M / Grivas, Petros / Kiltie, Anne E / Black, Peter C / van Rhijn, Bas W G. ·Department of Surgical Oncology (Urology), Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands. · Department of Medical Oncology, Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands. · Department of Urology, Friedrich-Alexander University, Erlangen, Germany; Department of Urology, Schön-Klinik, Nürnberg/Fürth, Germany. · Department of Surgery, Division of Urology, McGill University Health Center, Montreal, Canada. · Department of Urology, Inselspital, University of Bern, Bern, Switzerland. · Department of Urology, The University of Texas, MD Anderson Cancer Center, Houston, TX. · Department of Hematology and Medical Oncology, Taussig Cancer Institute, Cleveland Clinic, Cleveland, OH. · Department of Radiation Oncology, CRUK/MRC Oxford Institute for Radiation Oncology, University of Oxford, Oxford, United Kingdom. · Department of Urologic Sciences, Vancouver Prostate Centre, University of British Columbia, Vancouver, Canada. · Department of Surgical Oncology (Urology), Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands. Electronic address: basvanrhijn@hotmail.com. ·Urol Oncol · Pubmed #29128420.

ABSTRACT: BACKGROUND: Approximately half of patients who undergo radical cystectomy (RC) for muscle-invasive bladder cancer (MIBC) will succumb to metastatic disease. We summarize the evidence for neoadjuvant radiation (NAR), chemo (NAC), and immunotherapy (checkpoint inhibition) prior to RC for MIBC. MATERIALS AND METHODS: Data were obtained by a search of PubMed, ClinicalTrials.gov, and Cochrane databases for English language articles published from 1925 up to 2017. RESULTS: NAC usage has increased over the last decade, while NAR is rarely administered. Although NAR results in downstaging, its impact on survival is inconclusive. Based on level I evidence, cisplatin-based NAC (CB-NAC) is considered standard of care in cT2-4aN0M0 MIBC. NAC results in a 6% absolute 10-year overall survival (OS) benefit. In-depth analyses of key randomized controlled trials showed that failure to correct for uniform staging, surgical variation, and patient selection compromises the ability to identify factors predictive of response to NAC. The benefit appears to be restricted to patients downstaged to ypT1N0 or less. In these patients, 5-year OS is 80% to 90%. Regarding a number needed to treat of 17, most patients with cT2-4aN0M0 MIBC will be exposed to toxicity without benefit. Possible approaches to reduce overtreatment are suggested in this article and include patient selection, the chosen NAC regimen, and emerging molecular data to predict responsiveness to NAC. Neoadjuvant immunotherapy with checkpoint inhibitors is a promising future perspective currently under investigation. CONCLUSIONS: Past studies on NAR show inconclusive results and NAR is rarely administered. Instead, CB-NAC is advised in eligible patients with cT2-4aN0M0 MIBC prior to RC. In the near future, predictive biomarkers will be the key to tailor the use of CB-NAC and reduce harm to nonresponders.

10 Review Systematic Review on the Fate of the Remnant Urothelium after Radical Cystectomy. 2017

Gakis, Georgios / Black, Peter C / Bochner, Bernard H / Boorjian, Stephen A / Stenzl, Arnulf / Thalmann, George N / Kassouf, Wassim. ·Department of Urology, Eberhard-Karls University of Tübingen, Germany. Electronic address: georgios.gakis@med.uni-tuebingen.de. · Department of Urologic Sciences, University of British Columbia, Vancouver, BC, Canada. · Urology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA. · Department of Urology, Mayo Clinic, Rochester, MN, USA. · Department of Urology, Eberhard-Karls University of Tübingen, Germany. · Department of Urology, Inselspital Bern, University of Bern, Switzerland. · Division of Urology, McGill University, Montreal, QC, Canada. ·Eur Urol · Pubmed #27720534.

ABSTRACT: CONTEXT: Urothelial carcinoma is considered a pan-urothelial disease. As such, the remnant urothelium in the upper urinary tract and urethra following radical cystectomy (RC) remains at risk for secondary urothelial tumors (SUTs). OBJECTIVE: To describe the incidence, diagnosis, treatment, and outcomes of patients with SUTs after RC. EVIDENCE ACQUISITION: A systematic search was conducted using PubMed database according to Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines to identify studies between 1970 and 2016 reporting on malignant diseases of the urothelium after RC for bladder cancer. The search strategy separated between upper and lower tract urothelial tumors. EVIDENCE SYNTHESIS: Of a total of 1069 studies, 57 were considered for evidence synthesis. SUTs occured in approximately 4-10% of patients after RC. Carcinoma in situ of the bladder, a history of nonmuscle invasive bladder cancer, and tumor involvement of the distal ureter are the strongest risk factors for secondary upper tract tumors. Risk factors for secondary urethral tumors represent urothelial malignancy in the prostatic urethra/prostate and bladder neck (in women), nonorthotopic diversions, and positive findings on permanent sections. The majority of patients (84%) with SUTs, presented with urothelial recurrence without evidence of metastasis. Of those, 84.0% were treated with surgery, 10.5% with systemic chemotherapy and/or radiotherapy, and 5.6% with topical chemotherapy and/or immunotherapy. After a median follow-up of 91 mo (range: 26-155), 65.9% of patients died of disease and 21.5% died of other causes. Detection and treatment of SUTs at an asymptomatic stage can reduce the risks of cancer-specfific and overall mortality by 30%. A limitation of the study is that the available data were retrospective. CONCLUSIONS: SUTs are rare oncological events and most patients have an adverse prognosis despite absence of distant disease at diagnosis. Therefore, surveillance of the remnant urothelium should be implemented for patients with histological features of panurothelial disease as it may improve timely detection and treatment. PATIENT SUMMARY: Secondary tumors of the renal pelvis, ureters, and urethra occur in approximately 4-10% of patients after radical removal of the bladder for bladder cancer. These patients' prognoses are reduced, likely due to delayed diagnosis. Therefore, routine surveillance might be important to detect tumors at an early stage.

11 Review Recent progress with next-generation biomarkers in muscle-invasive bladder cancer. 2017

Contreras-Sanz, Alberto / Roberts, Morgan E / Seiler, Roland / Black, Peter C. ·The Vancouver Prostate Centre and Department of Urological Sciences, University of British Columbia, Vancouver, British Columbia, Canada. ·Int J Urol · Pubmed #27597124.

ABSTRACT: Muscle-invasive bladder cancer is a heterogeneous disease with different clinical phenotypes. Histomorphological variants, variable mutation rates and aberrant protein expression, along with the recently identified molecular subtypes, have been linked to prognosis and response to therapy. Complete response to chemotherapy and outcome after radical cystectomy are difficult to predict. To date, no validated pathological or clinical test exists to predict response. Advances in high-throughput, next-generation, genomic techniques to study the molecular pathways that govern the disease have led to novel strategies for the identification of such biomarkers relevant to muscle-invasive bladder cancer. Progress has been made not only in tissue-based biomarkers, but also in the liquid biopsy field. Liquid biopsies represent an opportunity to obtain patient samples non-invasively at multiple time-points during their treatment course without the need for biopsy. Especially in the metastatic setting, this will allow monitoring of the molecular evolution of the tumor under treatment, which should inform subsequent therapeutic decisions.

12 Review Emerging role of checkpoint inhibition in localized bladder cancer. 2016

Singh, Parminder / Black, Peter. ·Division of Hematology and Oncology , Mayo clinic, Phoenix, AZ. Electronic address: drparminder.singh@me.com. · Department of Urologic Sciences, Vancouver Prostate Centre, University of British Columbia, Vancouver, BC, Canada. ·Urol Oncol · Pubmed #27776977.

ABSTRACT: OBJECTIVE: Checkpoint inhibitors have rapidly become a standard treatment option for metastatic urothelial carcinoma. A wave of enthusiasm for these drugs has pushed them also into the setting of localized bladder cancer, including both non-muscle-invasive bladder cancer (NMIBC) and muscle-invasive disease bladder cancer (MIBC). Here, we aimed to review the emerging role of checkpoint inhibition in localized bladder cancer. METHODS: We reviewed the current treatment landscape for both NMIBC and MIBC and established a significant unmet clinical need for novel therapies. We have compiled the evidence that supports the investigation of checkpoint blockade in localized bladder cancer and have reviewed the corresponding clinical trial׳s landscape. RESULTS: The success of checkpoint inhibitors in metastatic bladder cancer offers the most compelling rationale for testing checkpoint blockade in localized disease. The established benefit of intravesical Bacillus Calmette-Guérin provides precedent for immune therapy in bladder cancer. Immune dysfunction has been described in bladder cancer, and we know that checkpoint molecules are expressed in these tumors. Furthermore, the high neoantigen burden of bladder cancer and results from preclinical studies suggest that checkpoint blockade deserves testing in earlier stage disease. Multiple trials are either planned or underway in almost all bladder cancer disease states. CONCLUSION: Ongoing trials would determine in the next several years whether checkpoint inhibitors can have a similar effect in localized disease as they have had in metastatic bladder cancer. They would also determine if patients with earlier disease would tolerate the toxicity of systemic therapy. The future holds promise for predictive biomarkers to guide individualized use of these agents and for effective combination therapies to overcome resistances.

13 Review Microhematuria assessment an IBCN consensus-Based upon a critical review of current guidelines. 2016

Schmitz-Dräger, Bernd J / Kuckuck, Eva C / Zuiverloon, Tahlita C M / Zwarthoff, Ellen C / Saltzman, Amanda / Srivastava, Abhishek / Hudson, M'Liss A / Seiler, Roland / Todenhöfer, Tilmann / Vlahou, Antonia / Grossman, H Barton / Schoenberg, Mark P / Sanchez-Carbayo, Marta / Brünn, Lenuta-A / van Rhijn, Bas W G / Goebell, Peter J / Kamat, Ashish M / Roupret, Morgan / Shariat, Sharokh F / Kiemeney, Lambertus A. ·Urologie 24/Urologie Schön Klinik Nürnberg Fürth, Europa-Allee 1, Fürth, Germany; Department of Urology, Friedrich-Alexander-Universität, Erlangen, Germany. Electronic address: bernd_sd@yahoo.de. · Urologie 24/Urologie Schön Klinik Nürnberg Fürth, Europa-Allee 1, Fürth, Germany. · Department of Urology, Erasmus MC Cancer Institute, Erasmus MC, Rotterdam, The Netherlands. · Department of Pathology, Erasmus MC Cancer Institute, Erasmus MC, Rotterdam, The Netherlands. · Department of Urology, Louisiana State University Health Sciences Center, New Orleans, LA. · Department of Urology, Montefiore Medical Center and Albert Einstein College of Medicine, New York, NY. · Department of Urology, Diagnostic Clinic of Longview, Longview, TX. · Department of Urology, Inselspital, University of Berne, Berne, Switzerland; Department of Urologic Sciences, University of British Columbia, Vancouver, BC, Canada. · Department of Urologic Sciences, University of British Columbia, Vancouver, BC, Canada; Department of Urology, Eberhard-Karl University, Tübingen, Germany. · Division of Biotechnology, Biomedical Research Foundation, Academy of Athens, Athens, Greece. · Department of Urology, University of Texas MD Anderson Cancer Center, Houston, TX. · Lucio Lascaray Research Center, University of the Basque Country, Vitoria-Gasteiz, Spain. · Urologische Klinik, St. Franziskus Hospital, Bielefeld, Germany. · Division of Surgical Oncology (Urology), Antoni van Leeuwenhoek Hospital, Netherlands Cancer Institute, Amsterdam, The Netherlands. · Department of Urology, Friedrich-Alexander-Universität, Erlangen, Germany. · Pitié Salpétrière Hospital, Assistance Publique- Hopitaux de Paris, University Paris 6, Paris, France. · Department of Urology, Medical University of Vienna, Vienna, Austria. ·Urol Oncol · Pubmed #27641313.

ABSTRACT: RATIONALE: Assessment of patients with asymptomatic microhematuria (aMh) has been a challenge to urologists for decades. The aMh is a condition with a high prevalence in the general population and also an established diagnostic indicator of bladder cancer. Acknowledging aMh needs to be assessed within a complex context, multiple guidelines have been developed to identify individuals at high risk of being diagnosed with bladder cancer. MATERIAL & METHODS: This structured review and consensus of the International Bladder Cancer Network (IBCN) identified and examined 9 major guidelines. These recommendations are partly based on findings from a long-term study on the effects of home dipstick testing, but also on the assumption that early detection of malignancy might be beneficial. RESULTS: Despite similar designs, these guidelines differ in a variety of parameters including definition of aMh, rating of risks, use of imaging modalities, and the role of urine cytology. In addition, recommendations for further follow-up after negative initial assessment are controversial. In this review, different aspects for aMh assessment are analyzed based upon the evidence currently available. DISCUSSION: We question whether adherence to the complicated algorithms as recommended by most guidelines is practical for routine use. Based upon a consensus, the authors postulate a need for better tools. New concepts for risk assessment permitting improved risk stratification and prepone cystoscopy before refined imaging procedures (computed tomography scan and magnetic resonance imaging) are suggested.

14 Review Using the neoadjuvant chemotherapy paradigm to develop precision therapy for muscle-invasive bladder cancer. 2016

Chedgy, Edmund C P / Douglas, James / Wright, Jonathan L / Seiler, Roland / van Rhijn, Bas W G / Boormans, Joost / Todenhöfer, Tilman / Dinney, Colin P / Collins, Colin C / Van der Heijden, Michiel S / Black, Peter C. ·Department of Urologic Sciences, University of British Columbia, Vancouver, British Columbia, Canada. · Department of Urologic Sciences, University of British Columbia, Vancouver, British Columbia, Canada; Department of Urology, University Hospital Southampton, UK. · Department of Urology, University of Washington School of Medicine, Seattle, WA. · Department of Urologic Sciences, University of British Columbia, Vancouver, British Columbia, Canada; Department of Urology, Inselspital, University of Bern, Bern, Switzerland. · Department of Surgical Oncology (Urology) The Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital Amsterdam, The Netherlands. · Department of Urology, Erasmus MC Cancer Institute, Rotterdam, The Netherlands. · Department of Urologic Sciences, University of British Columbia, Vancouver, British Columbia, Canada; Department of Urology, Eberhard Karls University, Tübingen, Germany. · Department of Urology, MD Anderson Cancer Center, Houston, TX. · Department of Medical Oncology, The Netherlands Cancer Institute, Amsterdam, The Netherlands. · Department of Urologic Sciences, University of British Columbia, Vancouver, British Columbia, Canada. Electronic address: pblack@mail.ubc.ca. ·Urol Oncol · Pubmed #27317490.

ABSTRACT: BACKGROUND: Bladder cancer is a leading cause of morbidity and mortality. Despite recent advances in understanding its molecular biology, the 5-year survival for muscle-invasive disease (muscle-invasive bladder cancer [MIBC]) remains approximately 50%. Although neoadjuvant chemotherapy (NAC) offers an established 5% absolute survival benefit at 5 years, only the 40% of patients with a major tumor response appear to benefit. There remains, therefore, a critical unmet need for predictive markers to determine which patients are best managed with NAC, as well as for novel targeted therapies to overcome resistance to NAC. METHODS: The NAC paradigm offers the optimal clinical context for developing precision therapy for MIBC. Abundant tissue is available for analysis before NAC in all patients and after NAC in patients with residual MIBC. Technologic advances have enabled next-generation sequencing and gene expression microarray analysis of routinely collected and even archived tissue specimens. These technologies provide a foundation for the identification of markers of chemoresistance and for the development of rational cotargeting strategies. RESULTS: Modern computational methods allow for some measure of target validation, which can be enhanced by the use of patient-derived primary xenografts (PDX). These PDX can be established at the time of radical cystectomy after NAC if there is residual MIBC. By the time a patient recurs clinically, candidate drugs targeting specific molecular changes in the patient tumor and corresponding PDX would have been tested in the PDX model, and only the most efficacious drug(s) would be administered to the patient. Liquid biopsies in the form of circulating tumor DNA and circulating tumor cells allow noninvasive longitudinal monitoring of the molecular landscape of an advanced tumor as it is being treated with successive courses of systemic therapy. CONCLUSIONS: These tools combined form the foundation of an evidence-based precision oncology strategy for MIBC.

15 Review Predicting occult lymph node-positive disease at the time of radical cystectomy: a systematic review. 2016

Zargar, Homayoun / Zargar-Shoshtari, Kamran / Dundee, Phil / Black, Peter C. ·Australian Prostate Cancer Research Centre, Melbourne, Australia - pblack@mail.ubc.ca. ·Minerva Urol Nefrol · Pubmed #26928572.

ABSTRACT: INTRODUCTION: The aim of this paper is to provide a systematic examination of the available evidence identifying factors that predict the detection of occult nodal metastatic disease at the time of radical cystectomy in patients with urothelial cancer of the bladder (BCa). EVIDENCE ACQUISITION: A systematic literature search of the PubMed database was performed in August 2015 using medical subject headings and free-text protocol. The search was conducted by applying keywords: bladder cancer, urothelial cancer, lymph node metastasis, node positive, micrometastasis and occult metastasis. EVIDENCE SYNTHESIS: High-quality evidence assessing clinical factors that predict the discovery of occult nodal disease at the time of radical cystectomy is sparse. Despite the large number of studies examining this topic, there is a vast heterogeneity across the publications in patient selection, extent of lymph node dissection, and pathological assessment. The majority of studies reporting clinical and molecular characteristics associated with positive nodal status are based on univariable analysis and not corrected for known markers of tumor biology (stage, grade, lymphovascular invasion). CONCLUSIONS: Identifying BCa with occult lymph node metastasis holds the promise of facilitating patient selection for neoadjuvant medical therapy and tailoring surgical interventions, potentially improving clinical outcomes for BCa patients. Molecular markers need to be externally validated in prospectively well-designed trials and need to prove clinical utility. Image-guided surgical technologies need further development before being adopted in routine practice.

16 Review Prognostic and Prediction Tools in Bladder Cancer: A Comprehensive Review of the Literature. 2015

Kluth, Luis A / Black, Peter C / Bochner, Bernard H / Catto, James / Lerner, Seth P / Stenzl, Arnulf / Sylvester, Richard / Vickers, Andrew J / Xylinas, Evanguelos / Shariat, Shahrokh F. ·Department of Urology, Weill Cornell Medical College, New York Presbyterian Hospital, New York, NY, USA; Department of Urology, University Medical-Center Hamburg-Eppendorf, Hamburg, Germany. · Department of Urologic Sciences, University of British Columbia, Vancouver, BC, Canada. · Department of Urology, Memorial Sloan-Kettering Cancer Center, Kimmel Center for Prostate and Urologic Tumors, New York, NY, USA. · Academic Urology Unit, University of Sheffield, Sheffield, UK. · Scott Department of Urology, Baylor College of Medicine, Houston, TX, USA. · Department of Urology, Eberhard-Karls University, Tuebingen, Germany. · EORTC Headquarters, Brussels, Belgium. · Department of Epidemiology and Biostatistics, Memorial Sloan-Kettering Cancer Center, New York, NY, USA. · Department of Urology, Weill Cornell Medical College, New York Presbyterian Hospital, New York, NY, USA; Department of Urology, Cochin Hospital, Assistance Publique-Hôpitaux de Paris, Paris Descartes University, Paris, France. · Department of Urology, Weill Cornell Medical College, New York Presbyterian Hospital, New York, NY, USA; Department of Urology, Medical University of Vienna, Vienna, Austria; Department of Urology, UT Southwestern, Dallas, TX, USA; Division of Medical Oncology, Weill Cornell Medical College, New York Presbyterian Hospital, New York, NY, USA. Electronic address: sfshariat@gmail.com. ·Eur Urol · Pubmed #25709027.

ABSTRACT: CONTEXT: This review focuses on risk assessment and prediction tools for bladder cancer (BCa). OBJECTIVE: To review the current knowledge on risk assessment and prediction tools to enhance clinical decision making and counseling of patients with BCa. EVIDENCE ACQUISITION: A literature search in English was performed using PubMed in July 2013. Relevant risk assessment and prediction tools for BCa were selected. More than 1600 publications were retrieved. Special attention was given to studies that investigated the clinical benefit of a prediction tool. EVIDENCE SYNTHESIS: Most prediction tools for BCa focus on the prediction of disease recurrence and progression in non-muscle-invasive bladder cancer or disease recurrence and survival after radical cystectomy. Although these tools are helpful, recent prediction tools aim to address a specific clinical problem, such as the prediction of organ-confined disease and lymph node metastasis to help identify patients who might benefit from neoadjuvant chemotherapy. Although a large number of prediction tools have been reported in recent years, many of them lack external validation. Few studies have investigated the clinical utility of any given model as measured by its ability to improve clinical decision making. There is a need for novel biomarkers to improve the accuracy and utility of prediction tools for BCa. CONCLUSIONS: Decision tools hold the promise of facilitating the shared decision process, potentially improving clinical outcomes for BCa patients. Prediction models need external validation and assessment of clinical utility before they can be incorporated into routine clinical care. PATIENT SUMMARY: We looked at models that aim to predict outcomes for patients with bladder cancer (BCa). We found a large number of prediction models that hold the promise of facilitating treatment decisions for patients with BCa. However, many models are missing confirmation in a different patient cohort, and only a few studies have tested the clinical utility of any given model as measured by its ability to improve clinical decision making.

17 Review Bladder cancer: a portal into men's health. 2015

Skeldon, Sean C / Larry Goldenberg, S. ·Division of Urology, Department of Surgery, University of Toronto, Toronto, Ontario, Canada; Department of Urologic Sciences, University of British Columbia, Vancouver, British Columbia, Canada. · Department of Urologic Sciences, University of British Columbia, Vancouver, British Columbia, Canada. Electronic address: l.gold@ubc.ca. ·Urol Oncol · Pubmed #24745663.

ABSTRACT: Bladder cancer is the fourth most common cancer among men in the United States, with a 3-fold higher incidence than women. Globally, tobacco smoking remains significantly more common in men, contributing to half of all cases of bladder cancer. To prevent bladder cancer, urologists should promote smoking cessation to patients presenting at earlier ages with concerns such as sexual dysfunction, infertility, pelvic pain, or vasectomy. Bladder cancer also provides an entry point for men into the healthcare system, at which time, urologists can discuss and coordinate attention to other male health issues such as cardiovascular illness, depression, or addiction. By assuming the role of men's health physicians, urologists can have a significant benefit on men's urologic and overall health by targeting risk factors and behaviors.

18 Review Assessing the quality of studies on the diagnostic accuracy of tumor markers. 2014

Goebell, Peter J / Kamat, Ashish M / Sylvester, Richard J / Black, Peter / Droller, Michael / Godoy, Guilherme / Hudson, M'Liss A / Junker, Kerstin / Kassouf, Wassim / Knowles, Margaret A / Schulz, Wolfgang A / Seiler, Roland / Schmitz-Dräger, Bernd J. ·Urologische Klinik, Friedrich-Alexander-Universität, Erlangen, Germany. · Department of Urology, Division of Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX. · EORTC Headquarters, Brussels, Belgium. · Department of Urology, Division of Surgery, University of British Columbia, Vancouver, Canada. · Department of Urology, Mount Sinai Hospital, New York, NY. · Scott Department of Urology, Baylor College of Medicine, Houston, TX. · Ochsner Clinic Foundation, Tom and Gayle Benson Cancer Center, New Orleans, LA. · Urologische Klinik und Poliklinik, Universität des Saarlandes, Saarland, Germany. · Department of Surgery (Urology), McGill University, Montreal, Quebec, Canada. · Section of Experimental Oncology, Leeds Institute of Cancer and Pathology, St James's University Hospital, Leeds, UK. · Urologische Klinik und Poliklinik, Heinrich-Heine-Universität, Düsseldorf, Germany. · Department of Urology, University of Berne, Berne, Switzerland. · Schön Klinik Nürnberg Fürth, Fürth, Germany; Urologie 24, Nürnberg, Germany. Electronic address: bernd_sd@yahoo.de. ·Urol Oncol · Pubmed #25159014.

ABSTRACT: OBJECTIVES: With rapidly increasing numbers of publications, assessments of study quality, reporting quality, and classification of studies according to their level of evidence or developmental stage have become key issues in weighing the relevance of new information reported. Diagnostic marker studies are often criticized for yielding highly discrepant and even controversial results. Much of this discrepancy has been attributed to differences in study quality. So far, numerous tools for measuring study quality have been developed, but few of them have been used for systematic reviews and meta-analysis. This is owing to the fact that most tools are complicated and time consuming, suffer from poor reproducibility, and do not permit quantitative scoring. METHODS: The International Bladder Cancer Network (IBCN) has adopted this problem and has systematically identified the more commonly used tools developed since 2000. RESULTS: In this review, those tools addressing study quality (Quality Assessment of Studies of Diagnostic Accuracy and Newcastle-Ottawa Scale), reporting quality (Standards for Reporting of Diagnostic Accuracy), and developmental stage (IBCN phases) of studies on diagnostic markers in bladder cancer are introduced and critically analyzed. Based upon this, the IBCN has launched an initiative to assess and validate existing tools with emphasis on diagnostic bladder cancer studies. CONCLUSIONS: The development of simple and reproducible tools for quality assessment of diagnostic marker studies permitting quantitative scoring is suggested.

19 Review Optimizing intravesical mitomycin C therapy in non-muscle-invasive bladder cancer. 2014

Zargar, Homayoun / Aning, Jonathan / Ischia, Joseph / So, Alan / Black, Peter. ·Department of Urology, Center for Robotic and Laparoscopic Surgery, Glickman Urological and Kidney Institute, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH 44195, USA. · Department of Urology, Bristol Urological Institute, Southmead Hospital, Bristol BS10 5NB, UK. · Departments of Surgery and Urology, Austin Health, 145 Studley Road, Heidelberg, Melbourne, VIC 3084, Australia. · Department of Urological Sciences, Vancouver Prostate Centre, University of British Columbia, 2660 Oak Street, Vancouver, BC V6H 3Z6, Canada. ·Nat Rev Urol · Pubmed #24619373.

ABSTRACT: Nearly three-quarters of all newly diagnosed urothelial cancers are non-muscle-invasive bladder cancers (NMIBCs). Although bladder-preserving surgery can be used to treat NMIBC, the rate of recurrence remains high. Intravesical chemotherapy has been shown to reduce the rate of NMIBC recurrence, and mitomycin C (MMC) has become the most commonly used intravesical cytotoxic agent. Despite the popularity of this agent in the treatment of NMIBCs, many questions regarding the optimal approach to MMC therapy remain unanswered. Strategies to enhance delivery of MMC have been well studied and multiple measures are recommended for implementation in routine clinical practice. In addition, less widely investigated techniques, such as hyperthermia and electromotive drug administration, have been shown to increase the efficacy of MMC therapy. Nevertheless, even when the current 'optimal' approaches to MMC administration are used, a large proportion of NMIBCs recur. This apparent treatment resistance might be overcome by combination of MMC with other agents that have different mechanisms of action and are unlikely to have cross-resistance. Study of the mechanisms of resistance is, therefore, important to identify key pathways underlying this phenomenon, which could be rationally targeted using specific combinations of drugs. Knowledge of these mechanisms might also reveal markers of responsiveness to therapy that could be used for patient selection.

20 Review Urological complications of illicit drug use. 2014

Skeldon, Sean C / Goldenberg, S Larry. ·Department of Urologic Sciences, University of British Columbia, Level 6, 2775 Laurel Street, Vancouver, BC V5Z 1M9, Canada. ·Nat Rev Urol · Pubmed #24535583.

ABSTRACT: Illicit drug use is prevalent worldwide; over 24 million people are estimated to have used recreational drugs during the past month in the UK and USA alone. Illicit drug use can result in a wide spectrum of potential medical complications that include many urological manifestations. To ensure optimal care and treatment, urologists need to be cognizant of these complications in their patients, particularly among youths. Ketamine uropathy is thought to affect over one-quarter of ketamine users and can lead to severe lower urinary tract symptoms, as well as upper tract obstruction. Cannabis use has been associated with an increased risk of bladder cancer, prostate cancer and nonseminomatous germ cell tumours in case-control studies. Fournier's gangrene has been reported following injection of heroin and cocaine into the penis. Excessive use of cough medicines can lead to the development of radiolucent stones composed of ephedrine, pseudoephedrine and guaifenesin. As the current evidence is mostly limited to case reports and case series, future epidemiological studies are needed to fully address this issue.

21 Review The role of heat shock proteins in bladder cancer. 2013

Ischia, Joseph / So, Alan I. ·Department of Urologic Sciences, Vancouver Prostate Centre, University of British Columbia, 2660 Oak Street, Vancouver, BC V6H 3Z6, Canada. ·Nat Rev Urol · Pubmed #23670183.

ABSTRACT: Heat shock proteins (HSPs) and clusterin (another chaperone protein with HSP-like properties) are present in normal cells and are upregulated by cellular stressors such as hyperthermia, hypoxia, and cytotoxic agents. HSPs are overexpressed in a wide range of cancers. Cancer cells are in a constant state of proteotoxic stress and exploit the HSPs to protect themselves against the toxic effects of aberrant oncoproteins, genomic instability, hypoxia, and acidosis. In many patients with cancer, high levels of HSPs are associated with poor prognosis and treatment resistance as these proteins protect tumour cells from therapeutic stressors such as androgen or oestrogen withdrawal, radiation, and cytotoxic chemotherapy. Differences in the expression levels of HSPs in bladder cancers compared with normal urothelium have led to HSPs being investigated as diagnostic and prognostic biomarkers. Evidence suggests that HSPs are important modulators of the immune system and have a role in BCG-stimulated regression of urothelial cancers. New bladder cancer treatment strategies that target HSPs are being investigated and could have a synergistic role with modern radiotherapy and chemotherapy regimens. A combination of OGX-427 (an antisense oligonucleotide that targets HSP27), gemcitabine, and cisplatin is currently being investigated in a phase II trial of patients with advanced bladder cancer.

22 Review Molecular signaling and the role of targeted therapies in bladder cancer. 2012

Black, P C. ·Department of Urologic Sciences, University of British Columbia, Vancouver, BC, USA. peter.black@ubc.ca ·Minerva Urol Nefrol · Pubmed #22402314.

ABSTRACT: Through our growing understanding of the molecular mechanisms that drive urothelial transformation and the growth, invasion and metastasis of bladder cancer, we are able to identify an increasingly broad spectrum of molecules and pathways that are suitable for novel targeted therapies. At the same time we are armed with an increasing number of agents designed to disrupt these signaling pathways, and, as these enter the clinical arena in other cancers, the barriers to use in bladder cancer patients decline. Targeted therapy for bladder cancer, however, remains in its infancy, and no major breakthroughs have been achieved. Here we review some of the molecular targets that have been best characterized in bladder cancer, as well as some of the newer targets that appear most promising. We will review the experience up to this point in testing targeted agents against these pathways, and describe some novel agents that have yet to be tested in clinical trials but have shown significant potential in pre-clinical models.

23 Review Genitourinary cancers. 2008

Krueger, Hans / McLean, David / Williams, Dan. ·Cancer Prevention Programs, BC Cancer Agency, Vancouver, BC, Canada. ·Prog Exp Tumor Res · Pubmed #18802392.

ABSTRACT: -- No abstract --

24 Clinical Trial Ramucirumab plus docetaxel versus placebo plus docetaxel in patients with locally advanced or metastatic urothelial carcinoma after platinum-based therapy (RANGE): a randomised, double-blind, phase 3 trial. 2017

Petrylak, Daniel P / de Wit, Ronald / Chi, Kim N / Drakaki, Alexandra / Sternberg, Cora N / Nishiyama, Hiroyuki / Castellano, Daniel / Hussain, Syed / Fléchon, Aude / Bamias, Aristotelis / Yu, Evan Y / van der Heijden, Michiel S / Matsubara, Nobuaki / Alekseev, Boris / Necchi, Andrea / Géczi, Lajos / Ou, Yen-Chuan / Coskun, Hasan Senol / Su, Wen-Pin / Hegemann, Miriam / Percent, Ivor J / Lee, Jae-Lyun / Tucci, Marcello / Semenov, Andrey / Laestadius, Fredrik / Peer, Avivit / Tortora, Giampaolo / Safina, Sufia / Del Muro, Xavier Garcia / Rodriguez-Vida, Alejo / Cicin, Irfan / Harputluoglu, Hakan / Widau, Ryan C / Liepa, Astra M / Walgren, Richard A / Hamid, Oday / Zimmermann, Annamaria H / Bell-McGuinn, Katherine M / Powles, Thomas / Anonymous1141202. ·Yale University School of Medicine, New Haven, CT, USA. Electronic address: daniel.petrylak@yale.edu. · Erasmus MC Cancer Institute, Rotterdam, Netherlands. · British Columbia Cancer Agency, Vancouver, BC, Canada. · David Geffen School of Medicine, UCLA, Los Angeles, CA, USA. · San Camillo and Forlanini Hospitals, Rome, Italy. · University of Tsukuba, Tsukuba, Ibaraki, Japan. · Hospital Universitario 12 de Octubre (CiberOnc), Madrid, Spain. · Plymouth University Peninsula Schools of Medicine and Dentistry, Plymouth, UK. · Centre Léon Bérard, Lyon, France. · National and Kapodistrian University of Athens, Athens, Greece. · University of Washington, Seattle, WA, USA. · Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam, Netherlands. · National Cancer Centre Hospital East, Chiba, Japan. · PA Herzen Moscow Oncological Research Institute, Moscow, Russia. · Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy. · National Institute of Oncology, Budapest, Hungary. · Taichung Veterans General Hospital, Taichung, Taiwan. · Akdeniz University School of Medicine, Antalya, Turkey. · Institute of Clinical Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, Tainan, Taiwan. · University Hospital, Tübingen, Germany. · Florida Cancer Specialists, Port Charlotte, FL, USA. · Asan Medical Centre, University of Ulsan College of Medicine, Seoul, Korea. · Division of Medical Oncology, Department of Oncology, University of Turin, San Luigi Gonzaga Hospital, Orbassano, Turin, Italy. · RBHI Ivanovo Regional Oncology Dispensary, Ivanovo, Russia. · Centre Oscar Lambret, Lille, France. · Rambam Health Care Campus, Haifa, Israel. · University of Verona and Azienda Ospedaliera Universitaria Integrata, Verona, Italy. · Tatarstan Regional Cancer Centre, Kazan, Russia. · Institut Català d'Oncologia L'Hospitalet, IDIBELL, University of Barcelona, Barcelona, Spain. · Hospital del Mar, Barcelona, Spain. · Trakya University, Edirne, Turkey. · Inonu University, Malatya, Turkey. · Eli Lilly and Company, Indianapolis, IN, USA. · Barts Cancer Institute, Queen Mary University of London, London, UK. ·Lancet · Pubmed #28916371.

ABSTRACT: BACKGROUND: Few treatments with a distinct mechanism of action are available for patients with platinum-refractory advanced or metastatic urothelial carcinoma. We assessed the efficacy and safety of treatment with docetaxel plus either ramucirumab-a human IgG1 VEGFR-2 antagonist-or placebo in this patient population. METHODS: We did a randomised, double-blind, phase 3 trial in patients with advanced or metastatic urothelial carcinoma who progressed during or after platinum-based chemotherapy. Patients were enrolled from 124 sites in 23 countries. Previous treatment with one immune-checkpoint inhibitor was permitted. Patients were randomised (1:1) using an interactive web response system to receive intravenous docetaxel 75 mg/m FINDINGS: Between July, 2015, and April, 2017, 530 patients were randomly allocated either ramucirumab plus docetaxel (n=263) or placebo plus docetaxel (n=267). Progression-free survival was prolonged significantly in patients allocated ramucirumab plus docetaxel versus placebo plus docetaxel (median 4·07 months [95% CI 2·96-4·47] vs 2·76 months [2·60-2·96]; hazard ratio [HR] 0·757, 95% CI 0·607-0·943; p=0·0118). A blinded independent central analysis was consistent with these results. An objective response was achieved by 53 (24·5%, 95% CI 18·8-30·3) of 216 patients allocated ramucirumab and 31 (14·0%, 9·4-18·6) of 221 assigned placebo. The most frequently reported treatment-emergent adverse events, regardless of causality, in either treatment group (any grade) were fatigue, alopecia, diarrhoea, decreased appetite, and nausea. These events occurred predominantly at grade 1-2 severity. The frequency of grade 3 or worse adverse events was similar for patients allocated ramucirumab and placebo (156 [60%] of 258 vs 163 [62%] of 265 had an adverse event), with no unexpected toxic effects. 63 (24%) of 258 patients allocated ramucirumab and 54 (20%) of 265 assigned placebo had a serious adverse event that was judged by the investigator to be related to treatment. 38 (15%) of 258 patients allocated ramucirumab and 43 (16%) of 265 assigned placebo died on treatment or within 30 days of discontinuation, of which eight (3%) and five (2%) deaths were deemed related to treatment by the investigator. Sepsis was the most common adverse event leading to death on treatment (four [2%] vs none [0%]). One fatal event of neutropenic sepsis was reported in a patient allocated ramucirumab. INTERPRETATION: To the best of our knowledge, ramucirumab plus docetaxel is the first regimen in a phase 3 study to show superior progression-free survival over chemotherapy in patients with platinum-refractory advanced urothelial carcinoma. These data validate inhibition of VEGFR-2 signalling as a potential new therapeutic treatment option for patients with urothelial carcinoma. FUNDING: Eli Lilly and Company.

25 Clinical Trial Intravesical chemotherapy of high-grade bladder cancer with HTI-286, a synthetic analogue of the marine sponge product hemiasterlin. 2008

Hadaschik, Boris A / Adomat, Hans / Fazli, Ladan / Fradet, Yves / Andersen, Raymond J / Gleave, Martin E / So, Alan I. ·The Prostate Centre at Vancouver General Hospital, University of British Columbia, Vancouver, British Columbia, Canada. ·Clin Cancer Res · Pubmed #18316576.

ABSTRACT: PURPOSE: HTI-286 is a fully synthetic analogue of the natural tripeptide hemiasterlin that inhibits tubulin polymerization and has strong cytotoxic potential. In this study, we evaluate the inhibitory effects of HTI-286 on human bladder cancer growth, both in vitro and as an intravesical agent in an orthotopic murine model. EXPERIMENTAL DESIGN: Various bladder cancer cell lines were treated with HTI-286 and mitomycin C (MMC) in vitro. Human KU-7 bladder tumor cells that stably express firefly luciferase were inoculated in female nude mice by intravesical instillation and quantified using bioluminescence imaging. Mice with established KU-7-luc tumors were given HTI-286 or MMC intravesically twice a week for 2 h. Pharmacokinetic data was obtained using high-performance liquid chromatography-mass spectrometry analyses. RESULTS: In vitro, HTI-286 was a potent inhibitor of proliferation in all tested cell lines and induced marked increases in apoptosis of KU-7-luc cells even after brief exposure. In vivo, HTI-286 significantly delayed cancer growth of bladder tumors in a dose-dependent fashion. HTI-286, at a concentration of 0.2 mg/mL, had comparable strong cytotoxicity as 2.0 mg/mL of MMC. The estimated systemic bioavailability of intravesically given HTI-286 was 1.5% to 2.1% of the initial dose. CONCLUSIONS: Intravesical HTI-286 instillation therapy showed promising antitumor activity and minimal toxicity in an orthotopic mouse model of high-grade bladder cancer. These findings provide preclinical proof-of-principle for HTI-286 as an intravesical therapy for nonmuscle-invasive bladder cancer and warrant further evaluation of efficacy and safety in early-phase clinical trials.

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