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Vol. 42. Issue 8.
Pages 488-498 (October 2018)
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Vol. 42. Issue 8.
Pages 488-498 (October 2018)
Review article
Developments in urologic oncology “OncoForum”: The best of 2017
Avances en uro-oncología «OncoForum»: lo mejor del 2017
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F. Gómez-Veigaa,
Corresponding author
fgveiga@telefonica.net

Corresponding author.
, A. Alcaraz-Asensiob, J. Burgos-Revillac, J. Cózar-Olmod
a Servicio de Urología, Hospital Universitario de Salamanca, Grupo de Investigación Traslacional de Urología GITUR, Instituto de Investigación Biomédica de Salamanca IBSAL, Salamanca, Spain
b Servicio de Urología, Hospital Clínic Universitari, Barcelona, Spain
c Servicio de Urología, Hospital Universitario Ramón y Cajal, Madrid, Spain
d Servicio de Urología, Complejo Hospitalario Universitario de Granada, Granada, Spain
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Tables (5)
Table 1. Safety results of the S-TRAC study.
Table 2. Score of sexual, incontinence and intestinal domains of Expanded Prostate Cancer Index Composite (EPIC-26) not adjusted for treatment and time interval and adjusted differences of the EPIC-26 score between treatment groups.
Table 3. Results of the main variables according to treatment.
Table 4. Secondary efficacy and exploratory results of the LATITUDE study.
Table 5. Main results according to treatment.
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Abstract
Objective

To put forth new findings of urologic oncology with an impact on clinical practice presented during 2017 in the main annual meetings.

Methods

This document reviews abstracts on prostate, kidney and bladder cancer presented at the congresses of 2016 (EAU, AUA, ASCO, ESMO and ASTRO) and publications with the highest impact in this period valued with the highest scores by the OncoForum committee.

Results

Among patients at high risk of recurrent renal cell carcinoma after nephrectomy, adjuvant sunitinib compared to placebo showed a benefit in patients at higher risk of recurrence. In cisplatin-ineligible advanced urothelial cancer, pembrolizumab elicits clinically meaningful, durable responses. Among patients with localized prostate cancer, treatment for disease progression was less frequent (absolute difference, 26.2 percentage points) and adverse events were more frequent with surgery than with observation. Among patients with locally advanced or merastatic prostate cancer, androgen-deprivation therapy plus abiraterone and prednisolone resulted in fewer deaths and fewer treatment-failure events (P<0.001). Among patients with metastatic castration-resistant prostate cancer previously treated with abiraterone acetate, enzalutamide median radiographic progression-free survival was 8.1 months and enzalutamide median overall survival was not reached.

Conclusions

Among patients at high risk of recurrent renal cell carcinoma after nephrectomy, adjuvant sunitinib showed a benefit across subgroups including patients at higher risk of recurrence. Among patients with localized prostate cancer, surgery was not associated with significantly lower all-cause or prostate-cancer mortality than observation. Among patients with locally advanced or merastatic prostate cancer, androgen-deprivation therapy plus abiraterone and prednisolone was associated with significantly higher rates of overall and failure-free survival than androgen-deprivation therapy alone. In patients with metastatic castration-resistant prostate cancer previously treated with abiraterone enzalutamide remained active.

Keywords:
Prostate cancer
Bladder cancer
Kidney cancer
Resumen
Objetivo

Conocer las últimas evidencias sobre Urología oncológica de tumores de próstata, riñón y vejiga, analizando su impacto en la práctica clínica diaria, además de los esquemas futuros a medio y largo plazo.

Métodos

Se revisan los resúmenes sobre cáncer de próstata, renal y vejiga presentados en los congresos del año 2017 (EAU, AUA, ASCO, ESMO y ASTRO) y las publicaciones de mayor impacto en este periodo que recibieron mayor valoración por parte del comité del OncoForum.

Resultados

En pacientes con cáncer renal de alto riesgo de recurrencia tras nefrectomía, se observó beneficio de sunitinib adyuvante versus placebo en el subgrupo de mayor riesgo. En pacientes con cáncer uroterial avanzado inelegibles a cisplatino, pembrolizumab en primera línea dio lugar a respuestas duraderas clínicamente significativas. En pacientes con cáncer de próstata (CaP) localizado, el tratamiento por progresión de la enfermedad fue menos frecuente con prostatectomía radical (PR) que con observación (diferencia absoluta de 26,2%) y se asoció a mayor frecuencia de eventos adversos (EA). En pacientes con CaP M0, la adición de abiraterona más prednisona (ABI+P) a deprivación androgénica (TDA) supuso menos muertes y menos eventos por fallo de tratamiento (p<0,001). En pacientes con cáncer de próstata resistente a castración metastásico (CPRCm) tratados previamente con abiraterona, la mediana de supervivencia libre de progresión radiográfica (SLPr) con enzalutamida fue de 8,1 meses y la de supervivencia global (SG) no se alcanzó.

Conclusiones

En pacientes con cáncer renal de alto riesgo de recurrencia tras nefrectomía, sunitinib adyuvante otorgó beneficio en todos los subgrupos, incluidos aquellos de mayor riesgo. En pacientes con CaP localizado, la PR no se asoció significativamente con mortalidad por todas las causas o mortalidad cáncer específica en comparación con observación. En pacientes con CaP M0, TDA combinado con ABI+P se asoció significativamente con mayores tasas de SG y SLP que TDA solo. En pacientes con CPRCm tratados previamente con abiraterona en tratamiento con enzalutamida permaneció activo.

Palabras clave:
Cáncer de próstata
Cáncer de vejiga
Cáncer renal

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