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  • Bar neurons and urination
    Nat. Rev. Urol. (IF 8.089) Pub Date : 2018-08-21
    Louise Stone

    Bar neurons and urination Bar neurons and urination, Published online: 21 August 2018; doi:10.1038/s41585-018-0078-x Bar neurons and urination

    更新日期:2018-08-21
  • Pembrolizumab: patient selection or immune intensification?
    Nat. Rev. Urol. (IF 8.089) Pub Date : 2018-08-21
    Ravi A. Madan, James L. Gulley

    Pembrolizumab: patient selection or immune intensification? Pembrolizumab: patient selection or immune intensification?, Published online: 21 August 2018; doi:10.1038/s41585-018-0076-z Immune checkpoint inhibitors targeting programmed cell death 1 (PD-1) or programmed cell death 1 ligand 1 (PD-L1) have had limited clinical impact in prostate cancer. To find a niche for immune checkpoint inhibition in this disease, future strategies might require improved biomarker-based patient selection or combination strategies to enhance in vivo immune activity.

    更新日期:2018-08-21
  • EMA and FDA prune the checkpoint inhibitor treatment landscape
    Nat. Rev. Urol. (IF 8.089) Pub Date : 2018-08-16
    Min Yuen Teo, Jonathan E. Rosenberg

    EMA and FDA prune the checkpoint inhibitor treatment landscapeEMA and FDA prune the checkpoint inhibitor treatment landscape, Published online: 16 August 2018; doi:10.1038/s41585-018-0074-1The European Medicines Agency (EMA) and FDA have recently restricted the indications for first-line pembrolizumab and atezolizumab to patients with programmed cell death 1 ligand 1 (PD-L1)-high advanced urothelial carcinoma, a decision made following interim analyses from the ongoing Keynote-361 and IMvigor130 phase III trials. Questions remain on the magnitude of inferior survival and standardized implementation of PD-L1 testing.

    更新日期:2018-08-17
  • Pelvic lymph node dissection during radical cystectomy for muscle-invasive bladder cancer
    Nat. Rev. Urol. (IF 8.089) Pub Date : 2018-08-13
    Marlon Perera, Shannon McGrath, Shomik Sengupta, Jack Crozier, Damien Bolton, Nathan Lawrentschuk

    Radical cystectomy is the gold-standard treatment option for muscle-invasive and metastatic bladder cancer. At the time of cystectomy, up to 25% of patients harbour metastatic lymph node deposits. These deposits most frequently occur in the obturator fossa, but can be as proximal as the interaortocaval region. Thus, the use of concurrent pelvic lymph node dissection (PLND) with cystectomy has been increasingly reported. Data from studies including many patients suggest substantial oncological benefit in PLND cohorts versus non-PLND cohorts, irrespective of pathological nodal status. Additionally, PLND provides useful prognostic information, including disease burden, lymph node density, and extracapsular extension of metastatic lymph nodes. Accordingly, the National Comprehensive Cancer Network guidelines advocate the use of PLND during radical cystectomy for muscle-invasive bladder cancer. Despite this recommendation, a lack of consensus exists regarding the optimal PLND template. Comparative series suggest that extended PLND provides improved recurrence-free survival and cancer-specific survival compared with more limited PLND templates. More extensive templates (such as super-extended PLND) provide no additional survival benefit at the potential cost of increased operative time and patient morbidity. In addition to extended PLND templates, increased nodal harvest confers an oncological benefit in patients with node-positive disease or in patients with node-negative disease. Accordingly, recommendations for a minimum nodal yield have been proposed. Despite the growing body of evidence, formal recommendations by oncological and urological authoritative bodies have been limited owing to the lack of randomized data and level I evidence.

    更新日期:2018-08-13
  • Genomic diversity in low-risk disease: present and future
    Nat. Rev. Urol. (IF 8.089) Pub Date : 2018-08-10
    Vidit Sharma, R. Jeffrey Karnes

    Genomic diversity in low-risk disease: present and future Genomic diversity in low-risk disease: present and future, Published online: 10 August 2018; doi:10.1038/s41585-018-0073-2 New data have confirmed the genomic diversity of low-risk prostate cancer. Improved understanding of the heterogeneity of this disease has implications for disease management and has the potential to change treatment for patients in the future.

    更新日期:2018-08-10
  • BCG enriches Treg cells
    Nat. Rev. Urol. (IF 8.089) Pub Date : 2018-08-09
    Annette Fenner

    BCG enriches Treg cells BCG enriches Treg cells, Published online: 09 August 2018; doi:10.1038/s41585-018-0075-0 BCG enriches Treg cells

    更新日期:2018-08-10
  • New nonsteroidal compound for treating CRPC
    Nat. Rev. Urol. (IF 8.089) Pub Date : 2018-08-01
    Louise Stone

    New nonsteroidal compound for treating CRPC New nonsteroidal compound for treating CRPC, Published online: 01 August 2018; doi:10.1038/s41585-018-0072-3 New nonsteroidal compound for treating CRPC

    更新日期:2018-08-02
  • Pembrolizumab effective in PD-L1-positive disease
    Nat. Rev. Urol. (IF 8.089) Pub Date : 2018-08-01
    Louise Stone

    Pembrolizumab effective in PD-L1-positive disease Pembrolizumab effective in PD-L1-positive disease, Published online: 01 August 2018; doi:10.1038/s41585-018-0070-5 Pembrolizumab effective in PD-L1-positive disease

    更新日期:2018-08-02
  • PEERfect scores for RCC
    Nat. Rev. Urol. (IF 8.089) Pub Date : 2018-08-01
    Louise Stone

    PEERfect scores for RCC PEERfect scores for RCC, Published online: 01 August 2018; doi:10.1038/s41585-018-0069-y PEERfect scores for RCC

    更新日期:2018-08-02
  • Germline mutations in RCC
    Nat. Rev. Urol. (IF 8.089) Pub Date : 2018-08-01
    Louise Stone

    Germline mutations in RCC Germline mutations in RCC, Published online: 01 August 2018; doi:10.1038/s41585-018-0071-4 Germline mutations in RCC

    更新日期:2018-08-02
  • Landmarks in prostate cancer
    Nat. Rev. Urol. (IF 8.089) Pub Date : 2018-07-31
    Niranjan J. Sathianathen, Badrinath R. Konety, Juanita Crook, Fred Saad, Nathan Lawrentschuk

    The field of prostate cancer has been the subject of extensive research that has resulted in important discoveries and shaped our appreciation of this disease and its management. Advances in our understanding of the epidemiology, natural history, anatomy, detection, diagnosis, grading, staging, imaging, and management of prostate cancer have changed clinical practice and influenced guideline recommendations. The development of the Gleason score and subsequent modifications enabled accurate prediction of prognosis. Increased anatomical understanding and improved surgical techniques resulted in the development of nerve-sparing surgery for radical prostatectomy. The advent of active surveillance has changed the management of low-risk disease, and chemotherapy and hormonal therapy have improved the outcomes of patients with distant disease. Ongoing research and clinical trials are expected to yield more practice-changing results in the near future.

    更新日期:2018-07-31
  • Unearthing roles for the gut microbiome
    Nat. Rev. Urol. (IF 8.089) Pub Date : 2018-07-31
    Annette Fenner

    Unearthing roles for the gut microbiomeUnearthing roles for the gut microbiome, Published online: 31 July 2018; doi:10.1038/s41585-018-0068-zUnearthing roles for the gut microbiome

    更新日期:2018-07-31
  • Cytoreductive nephrectomy: questions remain after CARMENA
    Nat. Rev. Urol. (IF 8.089) Pub Date : 2018-07-27
    Sumeet Bhanvadia, Sumanta K. Pal

    Cytoreductive nephrectomy: questions remain after CARMENA Cytoreductive nephrectomy: questions remain after CARMENA, Published online: 27 July 2018; doi:10.1038/s41585-018-0064-3 Cytoreductive nephrectomy, a standard approach for de novo metastatic renal cell carcinoma in the era of cytokine therapy, has been upheld during the age of targeted therapy on the basis of retrospective data. Now, the first level I prospective data from the CARMENA and SURTIME trials challenge this standard.

    更新日期:2018-07-27
  • Efficacy of a PSMA-targeted nanoparticle
    Nat. Rev. Urol. (IF 8.089) Pub Date : 2018-07-26
    Conor A. Bradley

    Efficacy of a PSMA-targeted nanoparticleEfficacy of a PSMA-targeted nanoparticle, Published online: 26 July 2018; doi:10.1038/s41585-018-0067-0Efficacy of a PSMA-targeted nanoparticle

    更新日期:2018-07-26
  • Chlamydia paralyses neutrophils via CPAF
    Nat. Rev. Urol. (IF 8.089) Pub Date : 2018-07-23
    Annette Fenner

    Chlamydia paralyses neutrophils via CPAF<i>Chlamydia</i> paralyses neutrophils via CPAF, Published online: 23 July 2018; doi:10.1038/s41585-018-0065-2Chlamydia paralyses neutrophils via CPAF

    更新日期:2018-07-24
  • Biomarker challenges for immune checkpoint inhibitors in urothelial carcinoma
    Nat. Rev. Urol. (IF 8.089) Pub Date : 2018-07-20
    Tom Powles, Laura Morrison

    Biomarker challenges for immune checkpoint inhibitors in urothelial carcinoma Biomarker challenges for immune checkpoint inhibitors in urothelial carcinoma, Published online: 20 July 2018; doi:10.1038/s41585-018-0056-3 Immune checkpoint inhibitors are associated with durable and well-tolerated responses in metastatic urothelial carcinoma. Predicting which patients respond to therapy has been challenging; however, progress has been made using programmed cell death 1 ligand 1 as a biomarker and a second generation of biomarkers, which are being assessed.

    更新日期:2018-07-21
  • Epigenetic modifiers: activities in renal cell carcinoma
    Nat. Rev. Urol. (IF 8.089) Pub Date : 2018-07-20
    Aguirre A. de Cubas, W. Kimryn Rathmell

    Renal cell carcinomas (RCCs) are a diverse set of malignancies that have recently been shown to harbour mutations in a number of chromatin modifier genes — including PBRM1, SETD2, BAP1, KDM5C, KDM6A, and MLL2 — through high-throughput sequencing efforts. Current research focuses on understanding the biological activities that chromatin modifiers employ to suppress tumorigenesis and on developing clinical approaches that take advantage of this knowledge. Unsurprisingly, several common themes unify the functions of these epigenetic modifiers, particularly regulation of histone post-translational modifications and nucleosome organization. Furthermore, chromatin modifiers also govern processes crucial for DNA repair and maintenance of genomic integrity as well as the regulation of splicing and other key processes. Many chromatin modifiers have additional non-canonical roles in cytoskeletal regulation, which further contribute to genomic stability, expanding the repertoire of functions that might be essential in tumorigenesis. Our understanding of how mutations in chromatin modifiers contribute to tumorigenesis in RCC is improving but remains an area of intense investigation. Importantly, elucidating the activities of chromatin modifiers offers intriguing opportunities for the development of new therapeutic interventions in RCC.

    更新日期:2018-07-21
  • IL-6 mediates high-fat diet-induced tumour growth
    Nat. Rev. Urol. (IF 8.089) Pub Date : 2018-07-17
    Conor A. Bradley

    IL-6 mediates high-fat diet-induced tumour growth IL-6 mediates high-fat diet-induced tumour growth, Published online: 17 July 2018; doi:10.1038/s41585-018-0063-4 IL-6 mediates high-fat diet-induced tumour growth

    更新日期:2018-07-18
  • The USPSTF screening recommendation: a swinging pendulum
    Nat. Rev. Urol. (IF 8.089) Pub Date : 2018-07-16
    Katherine Fleshner, Sigrid V. Carlsson

    The USPSTF screening recommendation: a swinging pendulum The USPSTF screening recommendation: a swinging pendulum, Published online: 16 July 2018; doi:10.1038/s41585-018-0062-5 A recent study reports widespread decreases in PSA screening, prostate cancer diagnoses, and use of active treatment modalities since the 2011–2012 United States Preventive Services Task Force (USPSTF) recommendation against PSA screening. The updated 2017 USPSTF guideline, which embraces individualized decision-making, suggests the pendulum swung too far, but must not prompt a return to indiscriminate screening.

    更新日期:2018-07-18
  • Visualizing hypoxia
    Nat. Rev. Urol. (IF 8.089) Pub Date : 2018-07-13
    Louise Stone

    Visualizing hypoxiaVisualizing hypoxia, Published online: 13 July 2018; doi:10.1038/s41585-018-0061-6Visualizing hypoxia

    更新日期:2018-07-14
  • Myeloid-derived IL-23 drives CRPC
    Nat. Rev. Urol. (IF 8.089) Pub Date : 2018-07-10
    Conor A. Bradley

    Myeloid-derived IL-23 drives CRPC Myeloid-derived IL-23 drives CRPC, Published online: 10 July 2018; doi:10.1038/s41585-018-0059-0 Myeloid-derived IL-23 drives CRPC

    更新日期:2018-07-12
  • Mechanisms of BCG immunotherapy and its outlook for bladder cancer
    Nat. Rev. Urol. (IF 8.089) Pub Date : 2018-07-10
    Caroline Pettenati, Molly A. Ingersoll

    BCG immunotherapy is the gold-standard treatment for non-muscle-invasive bladder cancer at high risk of recurrence or progression. Preclinical and clinical studies have revealed that a robust inflammatory response to BCG involves several steps: attachment of BCG; internalization of BCG into resident immune cells, normal cells, and tumour urothelial cells; BCG-mediated induction of innate immunity, which is orchestrated by a cellular and cytokine milieu; and BCG-mediated initiation of tumour-specific immunity. As an added layer of complexity, variation between clinical BCG strains might influence development of tumour immunity. However, more than 40 years after the first use of BCG for bladder cancer, many questions regarding its mechanism of action remain unanswered. Clearly, a better understanding of the mechanisms underlying BCG-mediated tumour immunity could lead to improved efficacy, increased tolerance of treatment, and identification of novel immune-based therapies. Indeed, enthusiasm for bladder cancer immunotherapy, and the possibility of combining BCG with other therapies, is increasing owing to the availability of targeted immunotherapies, including checkpoint inhibitors. Understanding of the mechanism of action of BCG immunotherapy has advanced greatly, but many questions remain, and further basic and clinical research efforts are needed to develop new treatment strategies for patients with bladder cancer.

    更新日期:2018-07-12
  • FGF2 causes genomic instability
    Nat. Rev. Urol. (IF 8.089) Pub Date : 2018-07-05
    Louise Stone

    FGF2 causes genomic instabilityFGF2 causes genomic instability, Published online: 05 July 2018; doi:10.1038/s41585-018-0058-1FGF2 causes genomic instability

    更新日期:2018-07-08
  • New genomic drivers identified
    Nat. Rev. Urol. (IF 8.089) Pub Date : 2018-07-05
    Conor A. Bradley

    New genomic drivers identifiedNew genomic drivers identified, Published online: 05 July 2018; doi:10.1038/s41585-018-0057-2New genomic drivers identified

    更新日期:2018-07-08
  • Intracytoplasmic sperm injection for male infertility and consequences for offspring
    Nat. Rev. Urol. (IF 8.089) Pub Date : 2018-07-02
    Sandro C. Esteves, Matheus Roque, Giuliano Bedoschi, Thor Haahr, Peter Humaidan

    Intracytoplasmic sperm injection (ICSI) has become the most commonly used method of fertilization in assisted reproductive technology. The primary reasons for its popularity stem from its effectiveness, the standardization of the procedure, which means that it can easily be incorporated into the routine practice of fertility centres worldwide, and the fact that it can be used to treat virtually all forms of infertility. ICSI is the clear method of choice for overcoming untreatable severe male factor infertility, but its (over)use in other male and non-male factor infertility scenarios is not evidence-based. Despite all efforts to increase ICSI efficacy and safety through the application of advanced sperm retrieval and cryopreservation techniques, as well as methods for selecting sperm with better chromatin integrity, the overall pregnancy rates from infertile men remain suboptimal. Treating the underlying male infertility factor before ICSI seems to be a promising way to improve ICSI outcomes, but data remain limited. Information regarding the health of ICSI offspring has accumulated over the past 25 years, and there are reasons for concern as risks of congenital malformations, epigenetic disorders, chromosomal abnormalities, subfertility, cancer, delayed psychological and neurological development, and impaired cardiometabolic profile have been observed to be greater in infants born as a result of ICSI than in naturally conceived children. However, as subfertility probably influences the risk estimates, it remains to be determined to what extent the observed adverse outcomes are related to parental factors or associated with ICSI.

    更新日期:2018-07-03
  • The case for nonsurgical therapy of nonmetastatic penile cancer
    Nat. Rev. Urol. (IF 8.089) Pub Date : 2018-06-27
    Jonathan Tward

    Invasive squamous cell carcinoma (SCC) of the penis is almost always treated with surgical therapy at the primary site. However, almost all other SCC primary sites, such as anal, vulvar, uterine cervix, head and neck, and oesophagus, and their involved nodal basins, can be successfully treated with radiotherapy or combined chemotherapy and radiation, reserving surgery as a salvage option. Review of the penile cancer literature and examination of data from more common SCC primary sites make a case for complete organ preservation of the penis using definitive combined chemotherapy and radiation, reserving surgical therapies as salvage options.

    更新日期:2018-06-28
  • DKK3 loss induces opposing effects
    Nat. Rev. Urol. (IF 8.089) Pub Date : 2018-06-27
    Louise Stone

    DKK3 loss induces opposing effectsDKK3 loss induces opposing effects, Published online: 27 June 2018; doi:10.1038/s41585-018-0054-5DKK3 loss induces opposing effects

    更新日期:2018-06-28
  • FGFR1 reprogrammes cell metabolism
    Nat. Rev. Urol. (IF 8.089) Pub Date : 2018-06-26
    Conor A. Bradley

    FGFR1 reprogrammes cell metabolismFGFR1 reprogrammes cell metabolism, Published online: 26 June 2018; doi:10.1038/s41585-018-0053-6FGFR1 reprogrammes cell metabolism

    更新日期:2018-06-27
  • A new role for ERG
    Nat. Rev. Urol. (IF 8.089) Pub Date : 2018-06-25
    Louise Stone

    A new role for ERGA new role for ERG, Published online: 25 June 2018; doi:10.1038/s41585-018-0044-7A new role for ERG

    更新日期:2018-06-27
  • SBRT suitable for early-stage disease
    Nat. Rev. Urol. (IF 8.089) Pub Date : 2018-06-21
    Conor A. Bradley

    SBRT suitable for early-stage disease SBRT suitable for early-stage disease, Published online: 21 June 2018; doi:10.1038/s41585-018-0050-9 SBRT suitable for early-stage disease

    更新日期:2018-06-22
  • PRECISION delivers on the PROMIS of mpMRI in early detection
    Nat. Rev. Urol. (IF 8.089) Pub Date : 2018-06-21
    Tatenda Nzenza, Declan G. Murphy

    PRECISION delivers on the PROMIS of mpMRI in early detection PRECISION delivers on the PROMIS of mpMRI in early detection, Published online: 21 June 2018; doi:10.1038/s41585-018-0046-5 Use of multiparametric MRI for detection of prostate cancer has been increasing and two recent studies have provided high-quality evidence advocating its integration into the diagnostic protocol. A new paradigm for detection of prostate cancer in the era of PROMIS and PRECISION should be adopted globally.

    更新日期:2018-06-22
  • Mirabegron and solifenacin for OAB
    Nat. Rev. Urol. (IF 8.089) Pub Date : 2018-06-21
    Conor A. Bradley

    Mirabegron and solifenacin for OAB Mirabegron and solifenacin for OAB, Published online: 21 June 2018; doi:10.1038/s41585-018-0049-2 Mirabegron and solifenacin for OAB

    更新日期:2018-06-22
  • Pazopanib exposure associated with outcomes
    Nat. Rev. Urol. (IF 8.089) Pub Date : 2018-06-21
    Conor A. Bradley

    Pazopanib exposure associated with outcomes Pazopanib exposure associated with outcomes, Published online: 21 June 2018; doi:10.1038/s41585-018-0047-4 Pazopanib exposure associated with outcomes

    更新日期:2018-06-22
  • TRPV4 targeting improves function in DUA rat model
    Nat. Rev. Urol. (IF 8.089) Pub Date : 2018-06-21
    Annette Fenner

    TRPV4 targeting improves function in DUA rat model TRPV4 targeting improves function in DUA rat model, Published online: 21 June 2018; doi:10.1038/s41585-018-0045-6 TRPV4 targeting improves function in DUA rat model

    更新日期:2018-06-22
  • Efficacy of a PARP inhibitor combination
    Nat. Rev. Urol. (IF 8.089) Pub Date : 2018-06-21
    Conor A. Bradley

    Efficacy of a PARP inhibitor combination Efficacy of a PARP inhibitor combination, Published online: 21 June 2018; doi:10.1038/s41585-018-0048-3 Efficacy of a PARP inhibitor combination

    更新日期:2018-06-22
  • Checkpoint inhibitor combination sets the wheels IMmotion
    Nat. Rev. Urol. (IF 8.089) Pub Date : 2018-06-19
    Conor A. Bradley

    Checkpoint inhibitor combination sets the wheels IMmotion Checkpoint inhibitor combination sets the wheels IMmotion, Published online: 19 June 2018; doi:10.1038/s41585-018-0043-8 Checkpoint inhibitor combination sets the wheels IMmotion

    更新日期:2018-06-20
  • Dusting technique for lithotripsy: what does it mean?
    Nat. Rev. Urol. (IF 8.089) Pub Date : 2018-06-19
    Steeve Doizi, Etienne Xavier Keller, Vincent De Coninck, Olivier Traxer

    Dusting technique for lithotripsy: what does it mean? Dusting technique for lithotripsy: what does it mean?, Published online: 19 June 2018; doi:10.1038/s41585-018-0042-9 Kidney stones are currently managed using laser lithotripsy and the most recent generation of laser generators have enabled the possibility of the dusting technique. Dusting avoids the use of a basket, as stone fragments are spontaneously evacuated; however, no consensus on the definition of dust currently exists.

    更新日期:2018-06-19
  • Underfunded and fragmented — a storm is brewing for sexual and reproductive health services
    Nat. Rev. Urol. (IF 8.089) Pub Date : 2018-06-18
    Neha Pathak, Shema Tariq

    Underfunded and fragmented — a storm is brewing for sexual and reproductive health services Underfunded and fragmented — a storm is brewing for sexual and reproductive health services, Published online: 18 June 2018; doi:10.1038/s41585-018-0038-5 The Guttmacher–Lancet Commission’s report on Sexual and Reproductive Health and Rights for All coincides with raised awareness of this topic as a result of global movements such as #metoo. However, weak political leadership, increasing fragmentation of services, and sustained underfunding pose a threat to sexual and reproductive health globally.

    更新日期:2018-06-19
  • An interdisciplinary consensus on the management of bone metastases from renal cell carcinoma
    Nat. Rev. Urol. (IF 8.089) Pub Date : 2018-06-14
    Viktor Grünwald, Berit Eberhardt, Axel Bex, Anne Flörcken, Thomas Gauler, Thorsten Derlin, Martin Panzica, Hans Roland Dürr, Knut Achim Grötz, Rachel H. Giles, Christian von Falck, Anno Graser, Alexander Muacevic, Michael Staehler

    Bone is a major site of haematogenous tumour cell spread in renal cell carcinoma (RCC), and most patients with RCC will develop painful and functionally disabling bone metastases at advanced disease stages. The prognosis of these patients is generally poor and the treatment is, therefore, aimed at palliation. However, RCC-associated bone metastases can be curable in select patients. Current data support a multimodal management strategy that includes wide resection of lesions, radiotherapy, systemic therapy, and other local treatment options, which can improve quality of life and survival. Nevertheless, the optimal approach for metastatic bone disease in RCC has not yet been defined and practical recommendations are rare. To improve the management and outcomes of patients with RCC and bone metastases, the International Kidney Cancer Coalition and the interdisciplinary working group on renal tumours of the German Cancer Society convened a meeting of experts with a global perspective to perform an unstructured review and elaborate on current treatment strategies on the basis of published data and expertise. The panel formulated recommendations for the diagnosis and treatment of patients with RCC and metastasis to the bone. Furthermore, the experts summarized current challenges and unmet patient needs that should be addressed in the future.

    更新日期:2018-06-15
  • Towards gender diversity in urological leadership
    Nat. Rev. Urol. (IF 8.089) Pub Date : 2018-06-14
    Jiasian Teh, Tatenda C. Nzenza, Stephanie op’t Hoog, Nathan Lawrentschuk

    Towards gender diversity in urological leadership Towards gender diversity in urological leadership, Published online: 14 June 2018; doi:10.1038/s41585-018-0039-4 Is gender parity in urology possible? Although the number of female urologists is increasing, a disparity remains in the gender composition of the editorial boards of the top urology journals and in urological societies.

    更新日期:2018-06-14
  • Ensuring a bright present and future for sexual medicine
    Nat. Rev. Urol. (IF 8.089) Pub Date : 2018-06-13
    Yacov Reisman, Selcuk Sarikaya

    Ensuring a bright present and future for sexual medicine Ensuring a bright present and future for sexual medicine, Published online: 13 June 2018; doi:10.1038/s41585-018-0041-x Although sexual disorders have been widespread for millennia, sexual medicine has historically been an unofficial specialty with no standards of training or recognition. Initiatives from the European Society for Sexual Medicine have sought to cement its role in modern medicine and to encourage and support early-career physicians and sexologists in their chosen specialty.

    更新日期:2018-06-13
  • Advances in laser technology and fibre-optic delivery systems in lithotripsy
    Nat. Rev. Urol. (IF 8.089) Pub Date : 2018-06-08
    Nathaniel M. Fried, Pierce B. Irby

    The flashlamp-pumped, solid-state holmium:yttrium–aluminium–garnet (YAG) laser has been the laser of choice for use in ureteroscopic lithotripsy for the past 20 years. However, although the holmium laser works well on all stone compositions and is cost-effective, this technology still has several fundamental limitations. Newer laser technologies, including the frequency-doubled, double-pulse YAG (FREDDY), erbium:YAG, femtosecond, and thulium fibre lasers, have all been explored as potential alternatives to the holmium:YAG laser for lithotripsy. Each of these laser technologies is associated with technical advantages and disadvantages, and the search continues for the next generation of laser lithotripsy systems that can provide rapid, safe, and efficient stone ablation. New fibre-optic approaches for safer and more efficient delivery of the laser energy inside the urinary tract include the use of smaller-core fibres and fibres that are tapered, spherical, detachable or hollow steel, or have muzzle brake distal fibre-optic tips. These specialty fibres might provide advantages, including improved flexibility for maximal ureteroscope deflection, reduced cross section for increased saline irrigation rates through the working channel of the ureteroscope, reduced stone retropulsion for improved stone ablation efficiency, and reduced fibre degradation and burnback for longer fibre life.

    更新日期:2018-06-08
  • BLUE LIGHT IMPROVES DETECTION
    Nat. Rev. Urol. (IF 8.089) Pub Date : 2018-06-06
    Louise Stone

    BLUE LIGHT IMPROVES DETECTION BLUE LIGHT IMPROVES DETECTION, Published online: 06 June 2018; doi:10.1038/s41585-018-0037-6 BLUE LIGHT IMPROVES DETECTION

    更新日期:2018-06-06
  • Diagnostic microfluidic immunoassays — go with the flow
    Nat. Rev. Urol. (IF 8.089) Pub Date : 2018-06-05
    Conor A. Bradley

    Diagnostic microfluidic immunoassays — go with the flow Diagnostic microfluidic immunoassays — go with the flow, Published online: 05 June 2018; doi:10.1038/s41585-018-0036-7 Diagnostic microfluidic immunoassays — go with the flow

    更新日期:2018-06-06
  • Epigenetics in renal cell cancer: mechanisms and clinical applications
    Nat. Rev. Urol. (IF 8.089) Pub Date : 2018-06-04
    Sophie C. Joosten, Kim M. Smits, Maureen J. Aarts, Veerle Melotte, Alexander Koch, Vivianne C. Tjan-Heijnen, Manon van Engeland

    Renal cell carcinoma (RCC) is characterized by an infrequent number of somatic mutations. By contrast, epigenetic aberrations are commonly found in RCC, indicating that epigenetic reprogramming is an important event in RCC development. Epigenetic alterations comprise several different aberrations, such as changes in histone modifications, DNA methylation, and microRNA levels, and occur in the most important signalling pathways in RCC, such as the von Hippel–Lindau disease tumour suppressor (VHL)–hypoxia-inducible factor (HIF) pathway, the WNT–β-catenin pathway, and pathways involved in epithelial–mesenchymal transition. Owing to their involvement in these pathways and frequent occurrence in RCC, epigenetic alterations are regarded as potential biomarkers for the early detection of disease and for prediction of prognosis and treatment response. In addition, most of these alterations are potentially reversible, so they also provide new targets for therapy. At the moment, epigenetic biomarkers for RCC are not being used in clinical practice, but targeted epigenetic therapies are under investigation. Understanding the extent of epigenetic changes occurring in RCC and the mechanisms by which they influence disease progression and treatment response, as well as knowledge of current research on biomarkers and treatments, is crucial to successful clinical translation of epigenetics in RCC.

    更新日期:2018-06-04
  • Gemcitabine reduces recurrence
    Nat. Rev. Urol. (IF 8.089) Pub Date : 2018-05-30
    Louise Stone

    Gemcitabine reduces recurrence Gemcitabine reduces recurrence, Published online: 30 May 2018; doi:10.1038/s41585-018-0033-x Gemcitabine reduces recurrence

    更新日期:2018-05-31
  • What are bacteria doing in the bladder?
    Nat. Rev. Urol. (IF 8.089) Pub Date : 2018-05-29
    Gregor Reid

    What are bacteria doing in the bladder? What are bacteria doing in the bladder?, Published online: 29 May 2018; doi:10.1038/s41585-018-0032-y The detection of 78 bacterial species in the urinary tracts of 77 catheterized female patients further emphasizes that the urinary tract is not sterile. However, many questions arise from these findings, not the least of which is what these organisms are doing in the urinary tract.

    更新日期:2018-05-29
  • Stress less: targeting the stress response in advanced disease
    Nat. Rev. Urol. (IF 8.089) Pub Date : 2018-05-25
    Louise Stone

    Stress less: targeting the stress response in advanced disease Stress less: targeting the stress response in advanced disease, Published online: 25 May 2018; doi:10.1038/s41585-018-0031-z Stress less: targeting the stress response in advanced disease

    更新日期:2018-05-25
  • Yes or no to local therapy for oligometastatic prostate cancer?
    Nat. Rev. Urol. (IF 8.089) Pub Date : 2018-05-23
    Judd W. Moul

    Yes or no to local therapy for oligometastatic prostate cancer? Yes or no to local therapy for oligometastatic prostate cancer?, Published online: 23 May 2018; doi:10.1038/s41585-018-0028-7 Metastatic prostate cancer has traditionally been treated with systemic therapy alone, but the issue of oligometastatic disease raises the question of whether local therapy — radical prostatectomy or prostate radiotherapy — should be performed. A number of phase III trials should improve our understanding of metastatic disease and lead to better care of our patients.

    更新日期:2018-05-23
  • Signal of GV1001 efficacy
    Nat. Rev. Urol. (IF 8.089) Pub Date : 2018-05-23
    Clemens Thoma

    Signal of GV1001 efficacy Signal of GV1001 efficacy, Published online: 23 May 2018; doi:10.1038/s41585-018-0030-0 Signal of GV1001 efficacy

    更新日期:2018-05-23
  • [177Lu]PSMA-617 radionuclide therapy shows promise
    Nat. Rev. Urol. (IF 8.089) Pub Date : 2018-05-22
    Conor A. Bradley

    [177Lu]PSMA-617 radionuclide therapy shows promise [177Lu]PSMA-617 radionuclide therapy shows promise, Published online: 22 May 2018; doi:10.1038/s41585-018-0029-6 [177Lu]PSMA-617 radionuclide therapy shows promise

    更新日期:2018-05-22
  • Hypoxia-related gene panel is prognostic
    Nat. Rev. Urol. (IF 8.089) Pub Date : 2018-05-17
    Louise Stone

    Hypoxia-related gene panel is prognostic Hypoxia-related gene panel is prognostic, Published online: 17 May 2018; doi:10.1038/s41585-018-0025-x Hypoxia-related gene panel is prognostic

    更新日期:2018-05-18
  • Surfaceome profiling for NEPC target antigens
    Nat. Rev. Urol. (IF 8.089) Pub Date : 2018-05-17
    Annette Fenner

    Surfaceome profiling for NEPC target antigens Surfaceome profiling for NEPC target antigens, Published online: 17 May 2018; doi:10.1038/s41585-018-0026-9 Surfaceome profiling for NEPC target antigens

    更新日期:2018-05-17
  • Translational models of prostate cancer bone metastasis
    Nat. Rev. Urol. (IF 8.089) Pub Date : 2018-05-16
    Richard B. Berish, Aymon N. Ali, Patrick G. Telmer, John A. Ronald, Hon S. Leong

    Metastatic disease is the principal cause of prostate-cancer-related mortality. Our ability to accurately recapitulate the spread of prostate cancer to bone — the most common site of metastasis — is critical to the development of novel metastasis-directed therapies. Several translational models of prostate cancer bone metastasis have been developed, including animal models, cell line injection models, 3D in vitro models, bone implant models, and patient-derived xenograft models. The use of these models has led to numerous advances in elucidating the molecular mechanisms of metastasis and innovations in targeted therapy. Despite this progress, current models are limited by a failure to holistically reproduce each individual element of the metastatic cascade in prostate cancer bone metastasis. In addition, factors such as accurate recapitulation of immunobiological events and improvements in tumour heterogeneity require further consideration. Knowledge gained from historical and currently used models will improve the development of next-generation models. An introspective appraisal of current preclinical models demonstrating bone metastases is warranted to narrow research focus, improve future translational modelling, and expedite the delivery of urgently needed metastasis-directed treatments.

    更新日期:2018-05-17
  • Aptamer effective in vivo
    Nat. Rev. Urol. (IF 8.089) Pub Date : 2018-05-16
    Clemens Thoma

    Aptamer effective in vivo Aptamer effective in vivo, Published online: 16 May 2018; doi:10.1038/s41585-018-0027-8 Aptamer effective in vivo

    更新日期:2018-05-16
  • Systemic treatments for high-risk localized prostate cancer
    Nat. Rev. Urol. (IF 8.089) Pub Date : 2018-05-15
    Géraldine Pignot, Denis Maillet, Emmanuel Gross, Philippe Barthelemy, Jean-Baptiste Beauval, Friederike Constans-Schlurmann, Yohann Loriot, Guillaume Ploussard, Paul Sargos, Marc-Olivier Timsit, Sébastien Vincendeau, Gilles Pasticier, Delphine Borchiellini

    The majority of patients with prostate cancer who later develop lethal metastatic disease have high-risk localized disease at presentation, emphasizing the importance of effective treatment strategies at this stage. Multimodal treatment approaches that combine systemic and local therapies offer a promising strategy for improving the clinical outcomes of patients with high-risk localized prostate cancer. Combinations of neoadjuvant and adjuvant chemotherapy, hormonal therapy, or chemohormonal therapy are considered to be the standard of care in most solid tumours and should be investigated in the future for the treatment of prostate cancer to improve patient outcomes. However, although the combination of androgen deprivation therapy and radiotherapy is a standard of care in high-risk localized or locally advanced prostate cancer, the benefit of chemotherapy or chemohormonal therapy has yet to be demonstrated outside of the metastatic setting. Moreover, the benefit of neoadjuvant and/or adjuvant systemic therapies in combination with radical prostatectomy has not been proved. The development of next-generation hormonal agents, which have been approved for the treatment of castration-resistant prostate cancer, offers further therapeutic possibilities that are being assessed in early-phase clinical trials.

    更新日期:2018-05-16
  • Optimizing radiotherapy for intermediate-risk localized disease
    Nat. Rev. Urol. (IF 8.089) Pub Date : 2018-05-15
    Pirus Ghadjar, Thomas Wiegel

    Optimizing radiotherapy for intermediate-risk localized disease Optimizing radiotherapy for intermediate-risk localized disease, Published online: 15 May 2018; doi:10.1038/s41585-018-0024-y Dose-intensified radiotherapy is widely used in prostate cancer treatment but its effect on distant metastasis and overall survival is unclear. A large randomized clinical trial to evaluate the role of external-beam-based dose intensification without androgen deprivation therapy in intermediate-risk disease shows that dose escalation can reduce distant metastases.

    更新日期:2018-05-15
  • Do dietary calcium and vitamin D matter in men with prostate cancer?
    Nat. Rev. Urol. (IF 8.089) Pub Date : 2018-05-15
    Thierry Capiod, Nicolas Barry Delongchamps, Natascha Pigat, Jean-Claude Souberbielle, Vincent Goffin

    Active surveillance (AS) is an attractive alternative to immediate treatment for men with low-risk prostate cancer. Thus, the identification of environmental factors that promote the progression of indolent disease towards aggressive stages is critical to optimize clinical management. Epidemiological studies suggest that calcium-rich diets contribute to an increased risk of developing prostate cancer and that vitamin D reduces this risk. However, the potential effect of these nutrients on the progression of early-stage prostate tumours is uncertain, as studies in this setting are scarce and have not provided unambiguous conclusions. By contrast, the results of a preclinical study from our own group demonstrate that a diet high in calcium dose-dependently accelerated the progression of early-stage prostate tumours and that dietary vitamin D prevented this effect. The extent to which the conclusions of preclinical and epidemiological studies support a role for calcium and vitamin D and the relevance of monitoring and adjustment of calcium and/or vitamin D intake in patients on AS require further investigation.

    更新日期:2018-05-15
  • Personalization of prostate cancer therapy through phosphoproteomics
    Nat. Rev. Urol. (IF 8.089) Pub Date : 2018-05-11
    Wei Yang, Michael R. Freeman, Natasha Kyprianou

    Castration-resistant prostate cancer (CRPC) remains incurable despite the approval of several new treatments. Identification of new biomarkers and therapeutic targets to enable personalization of CRPC therapy, with the aim of maximizing therapeutic responses and minimizing toxicity in patients, is urgently needed. Prostate cancer progression and therapeutic resistance are frequently driven by aberrantly activated kinase signalling pathways that are amenable to pharmacological inhibition. Personalized phosphoproteomics, which enables the analysis of signalling networks in individual tumours, is a promising approach to advance personalized therapy by discovering biomarkers of pathway activity and clinically actionable targets. Several technologies for global and targeted phosphoproteomic analysis exist, each with its own strengths and shortcomings. Global discovery phosphoproteomics is predominantly conducted using liquid chromatography–tandem mass spectrometry coupled with data-dependent or data-independent acquisition technologies. Multiplexed targeted phosphoproteomics can be divided into platforms based on mass spectrometry or antibodies, including selected or parallel reaction monitoring and triggered by offset, multiplexed, accurate mass, high-resolution, absolute quantification (known as TOMAHAQ) or forward-phase or reverse-phase protein arrays, respectively. Several obstacles still need to be overcome before the full potential of phosphoproteomics can be realized in routine clinical practice, but a future phosphoproteomics-centric trans-omic profiling approach should enable optimized personalized CRPC management through improved biomarkers and targeted treatments.

    更新日期:2018-05-11
  • Controlling mutational chaos
    Nat. Rev. Urol. (IF 8.089) Pub Date : 2018-05-09
    Clemens Thoma

    Controlling mutational chaos Controlling mutational chaos, Published online: 09 May 2018; doi:10.1038/s41585-018-0021-1 Controlling mutational chaos

    更新日期:2018-05-09
Some contents have been Reproduced with permission of the American Chemical Society.
Some contents have been Reproduced by permission of The Royal Society of Chemistry.
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