Dysregulation of fibroblast growth factor (FGF)-receptor (FGFR) signaling, which is implicated in various oncogenic processes, including tumor proliferation, survival, migration, invasion, and angiogenesis, has been identified as a critical factor in urothelial bladder cancer (UBC) progression. This has led to the development of novel FGFR-targeted therapies. Erdafitinib is an oral selective pan-FGFR tyrosine kinase inhibitor approved for locally advanced or metastatic urothelial cancer in patients with FGFR3 alterations who progress on both platinum-based chemotherapy and immunotherapy. The approval of FGFR inhibitors (FGFRis), such as erdafitinib, and ongoing research into combination therapies with immune checkpoint inhibitors (ICIs) signify a promising shift in the treatment paradigm for advanced/metastatic UBC despite challenges such as the variable efficacy of FGFRis and treatment-related toxicity. In this study, we review the FGFR signaling pathway and the impact of altered FGFR signaling on UBC tumorigenesis, the clinical development of FGFRis, the rationale for FGFRi-ICI combinations, and future directions.

Prostate cancer (PC) is the most commonly diagnosed malignancy among males worldwide. In recent years, there has been a need to find alternative methods for the early diagnosis of PC. Evidence indicates that metabolic dysfunction is a characteristic feature of PC carcinogenesis, with various metabolites acting as biomarkers of tumor growth. Metabolomics is a new science that has emerged at the intersection of molecular biology, biochemistry, and genetics. The complete set of substrates and metabolic products is a metabolic profile, or metabolome. The PC metabolome comprises substances formed as a result of metabolic changes in response to the occurrence of a malignant process in the prostate gland. We have obtained unique data on metabolic changes that allow us to rethink the carcinogenesis of PC. Research on the metabolome opens up new opportunities for the early diagnosis and treatment of PC, with implications for its prognosis.

Inferior vena cava (IVC) thrombi are detected in 4%–10% of patients with renal cell carcinoma (RCC). The 5-year survival rates following radical nephrectomy (RN) with IVC thrombectomy for patients with nonmetastatic RCC range between 50%–65%. Despite robot-assisted RN (RARN) with IVC thrombectomy proving to be feasible and potentially lessening complication rates, it remains technically demanding, with significant associated morbidity and mortality risks. Thus, meticulous patient selection and careful surgical planning are of paramount importance. This review aims to encapsulate the latest advancements and outline the detailed surgical processes involved in RARN with IVC thrombectomy.

In patients with renal cell carcinoma (RCC), the use of immunotherapy (IO) and tyrosine kinase inhibitor (TKI) regimens has proven beneficial in treating metastatic disease. These advances have led to the evaluation of IO/IO and IO/TKI treatment combinations in the perioperative setting. Neoadjuvant systemic therapy can improve surgical outcomes for patients by shrinking the tumor and prior studies have shown that the use of TKI regimens reduced tumor size significantly, whereas IO monotherapy had less of an objective radiographic response. In a retrospective series, patients with locally advanced RCC treated with IO/TKI experienced a higher decrease in median tumor size than those treated with IO/IO. For patients with locally advanced bulky tumors or tumor thrombus involving renal vein or inferior vena cava, early systemic treatment may be beneficial (with several trials ongoing). Finally, pembrolizumab has also improved outcomes in the adjuvant RCC setting. These studies have opened the door to other perioperative studies. Using perioperative therapies can alter the course of RCC with neoadjuvant therapies (IO/TKI) facilitating surgical challenges and adjuvant therapy (IO) improving disease-free survival, but trials are in the process and will further evaluate the impact of these treatments. In the meantime, these systemic therapies can be discussed with patients for perioperative treatment of locally advanced and invasive RCCs.

The remarkable advances in our understanding of renal tumor pathogenesis, driven by the widespread application of molecular testing, are reflected in the latest 2022 World Health Organization classification. This updated classification categorizes renal cell carcinoma (RCC) into morphologically and molecularly defined RCCs. It includes updates to existing entities and introduces newly established and provisional entities. A standard macroscopic and microscopic evaluation is typically sufficient for diagnosing morphologically defined RCCs and serves as the initial step in the identification of molecularly defined entities. In cases where classification based solely on histologic examination is challenging, a limited panel of immunohistochemical stains can be employed to aid in the diagnosis, with molecular testing for validation if necessary. Therefore, this review explores the key clinical, pathological, and molecular features essential for classifying both the commonly encountered morphologically defined RCCs and the less common but clinically significant molecularly defined RCCs. The goal is to increase awareness of these RCC subtypes among clinicians and promote a deeper understanding of the pathological diagnostic process, ultimately improving patient care.

Purpose: The objective of this large retrospective cohort study is to better understand the relationship of bladder cancer and depression incidence, specifically relating to the incorporation of neoadjuvant chemotherapy (NCT) in treatment plans. Materials and Methods: This is a large retrospective cohort study utilizing a formulated dataset from the TriNetX Research Network Database. ICD-10 (International Statistical Classification of Diseases, 10th revision) codes related to bladder cancer and depression diagnoses and treatments were implemented to identify patients of interest. Propensity score matching was implemented for various demographic factors and comorbidities. The patient population was limited to stage T2 bladder cancer, and NCT was defined as receival within 90 days prior to cystectomy (CYS). The primary outcome was denoted as depressive episode diagnosis within 3 months of CYS. Secondary outcomes of hospitalizations, mortality, and suicide attempts within 3 months of CYS were analyzed. Results: In total, 4,630 patients were included after propensity score matching, yielding 2,315 patients per group. All patients had T2 disease and underwent CYS. In the NCT cohort, 243 patients (10.5%) acquired a diagnosis of depression within 3 months from CYS compared to 144 patients (6.2%) who received no NCT (95% confidence interval [CI], 0.027– 0.059; p<0.001). Odds ratio was 1.768 (95% CI, 1.426–2.192) when comparing cohorts with and without NCT. There was no statistical difference in mortality (95% CI, -0.012 to 0.014; p=0.844) or inpatient hospitalizations (95% CI, -0.046 to 0.009; p=0.191) within 3 months. There was a statistically significant increase in suicide attempts in the NCT group within 3 months (95% CI, 0.002–0.007; p=0.002). Conclusions Bladder cancer can induce significant patient morbidity with ensuing depression. Our retrospective cohort study demonstrates NCT correlates to increased incidence of depression as well as suicidal attempts. Assiduous attention needs to be directed towards mental health counseling and treatment for oncologic patients.

Purpose: We prospectively compared the diagnostic accuracy of kidney dynamic computed tomography (KDCT), magnetic resonance imaging (MRI), and contrast-enhanced ultrasonography (CEUS) for the assessment of small renal mass (SRM) (≤4 cm). Materials and Methods: Seventy-six patients with SRM (mean age, 58.4±13.1 years) who underwent renal biopsy (n=11) or nephrectomy (partial or radical) (n=65) were enrolled. All patients underwent KDCT, MRI, and CEUS before renal biopsy or nephrectomy. Results: The mean maximal tumor size was 21.0±9.8 mm. The mean R.E.N.A.L nephrometry score was 7.0±1.7. Fifty-six patients had renal cell carcinoma (RCC) (clear cell, 42; papillary, 7; chromophobe, 5; succinate dehydrogenase deficient, 1; unspecified RCC, 1). Twenty patients had a benign tumor (angiomyolipoma, 11; oncocytoma, 3; others, 6). Clinicopathologic variables were comparable in RCC and benign groups. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of KDCT were 89.3%, 10.0%, 73.5%, and 25.0%, respectively. The sensitivity, specificity, PPV, and NPV of MRI were 89.3%, 10.0%, 73.5%, and 25.0%, respectively. The sensitivity, specificity, PPV, and NPV of CEUS were 85.7%, 50.0%, 82.8%, and 55.6%, respectively. The diagnostic accuracy of KDCT, MRI, and CEUS were 68.4%, 68.4%, and 76.3%, respectively. In a subgroup analysis based on clinical tumor size of 10 mm and 20 mm, CEUS also showed the highest diagnostic accuracy. Conclusions CEUS had the highest specificity, PPV, and NPV and may help improve the assessment of SRM.

Prostate cancer shows significant racial disparity, with men of African ancestry disproportionately impacted. While prostate cancer health disparity studies focus on elucidating the contributing socioeconomic, lifestyle, environmental, biological and underlying genetic factors, genome sequencing is helping to reduce the burden through disease stratification and treatment. Sub-Saharan Africa has, till now, been excluded from these benefits. The new Prostate Cancer Precision Health Africa1K Health Equity Research Outcomes and Improvement Consortium has been tasked with addressing this gap. Initiating efforts in Southern Africa, with the highest globally recorded regional mortality rates, in this review we discuss our earliest observations, with the objective to share knowledge, encourage further inclusivity across Sub-Saharan Africa, while considering challenges and benefits. Most notably, and in contrast to regions of current scientific efforts, African nations not only represent extreme disparities in rural-urban transition, but our early data also suggests that this transition has direct impact on both genetic and nongenetic health determinants, with further translation into tumour genome disparities. Ultimately, we propose from this first-of-its-kind resource, that rural communities provide an unmet opportunity to control for cultural practices, regional movement, genetic ancestry, and environmental exposures to enhance African inclusion in prostate cancer health disparity studies.