Genitourinary Oncology Research Updates

Multicenter retrospective cohort of 1,032 patients with pathological NMIBC (pTis/pTa/pT1 N0 R0) who underwent radical cystectomy (2000–2015) without perioperative therapy. Lymphovascular invasion (present in 3.8%) was independently associated with shorter recurrence-free survival (HR 2.37, 95% CI 1.29–4.38) and worse cancer-specific survival (HR 2.59, 95% CI 1.31–5.10); LVI-positive patients had higher 10-year cancer-specific mortality (35.3% vs 13.7%, p=0.002). Pathological stage was not associated with RFS, age predicted overall survival, and model discrimination was modest (C-index 0.59); limitations included retrospective design and low LVI prevalence.

P-PSMA-101, a stem cell memory T cell–enriched PSMA-targeting CAR-T product, produced notable clinical activity in two patients but generally modest PSA50 responses across the studied cohort. Severe immune effector–related toxicities occurred in some patients, although a novel iCasp9 safety switch was largely effective at mitigating toxicity.

This systematic review of 61 studies evaluated plasma circulating tumor DNA (ctDNA) across urothelial carcinoma (UC) stages (NMIBC, MIBC, mUC, UTUC). ctDNA detection rates rose with disease stage (NMIBC ~53%, MIBC ~48%, mUC ~86%, UTUC ~51%), with TERT promoter and TP53 alterations most common, and studies reported ctDNA utility for risk stratification in NMIBC, guiding adjuvant decisions in MIBC (eg, IMvigor010/011 findings), and monitoring response and resistance in mUC and UTUC, with high sensitivity for postoperative recurrence and lead times of months. The authors conclude ctDNA is a promising precision-oncology tool with stage-tailored applications but emphasize need for prospective validation and standardization of assays.