The Lynx Group

Genitourinary Cancers

Orlando, FL—The incidence of bladder cancer is on the rise, and bladder cancer is 4 to 5 times more expensive to treat than breast or prostate cancer. The cost of bladder cancer treatment can be reduced by adhering to the National Comprehensive Cancer Network or the American Urological Association treatment guidelines.
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Orlando, FL—Clinical trials involving immunotherapy have increased in the past few years, and the oncology community is eagerly awaiting the results. However, not so well-known is what happens to patients who receive immunotherapy outside of the clinical trial setting, including those who are not eligible for clinical trials.
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Orlando, FL—One cycle of the bleomycin, etoposide, and cisplatin (BEP) regimen had less toxicity and was as effective as 2 cycles in patients with high-risk, nonseminomatous or germ-cell tumors of the testis (NSGCTT), according to results of a large prospective trial called 111 presented at the 2017 Genitourinary Cancers Symposium. Using 1 cycle of BEP as standard of care would reduce exposure to toxicity, and most patients with testicular cancer are relatively young.
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In the United States, the standard of care for locally advanced bladder cancer after radical cystectomy is to “consider” adjuvant chemotherapy and ad­juvant radiation. Results of a 3-arm randomized clinical trial showed that adjuvant radiation therapy alone or combined with chemotherapy (ie, chemoradiotherapy) did not significantly improve disease-free survival compared with adjuvant chemotherapy alone. However, the findings hint at benefits for chemoradiotherapy that should be studied further. Brian Baumann, MD, a radiation oncology resident at the University of Pennsylvania, Philadelphia, presented the findings at the 2016 Genitourinary Cancers Symposium.
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High-risk patients with metastatic renal-cell carcinoma (RCC) and venous tumor thrombus derived no benefit from cytoreductive nephrectomy and should be evaluated for clinical trials of systemic therapy, suggested a retrospective multicenter review.
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Contemporary treatment has led to improvements in survival for all patients with metastatic testicular germ-cell tumors (GCTs), including poor-risk patients, although they still have worse survival. A new study shows that if poor-risk patients receive curative therapy and survive for at least 2 years, their survival approaches that of favorable-risk and intermediate-risk patients. The study supports no further routine scanning 2 years after diagnosis in surviving patients.
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Cabozantinib (Cabometyx) achieved superior progression-­free survival (PFS) versus standard treatment with everolimus in patients with previously treated advanced renal-cell carcinoma in an updated analysis of the phase 3 METEOR trial, the results of which were reported at the 2016 Genitourinary Cancers Symposium.
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Experience at a high-volume cancer center suggests that nonstereotactic body radiotherapy external beam reirradiation of the pelvis for cancer recurrence or for a second genitourinary malignancy is safe in patients with advanced cancer, and can achieve excellent and durable palliation of symptoms without severe radiation-induced morbidity.
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