739 results on '"Mark S. Soloway"'
Search Results
2. Challenging Cases in Urothelial Cancer: Case 27
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Mark S. Soloway and Neil A. Abrahams
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Oncology ,Urology - Published
- 2023
3. Challenging Cases in Urothelial Cancer: Case 26
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Mark S. Soloway
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Oncology ,Urology - Published
- 2022
4. Challenging Cases in Urothelial Cancer: Case 23
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Mark S. Soloway and Neil A. Abrahams
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Oncology ,Urology - Published
- 2022
5. Challenging Cases in Urothelial Cancer: Case 22
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Mark S. Soloway
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Oncology ,Urology - Published
- 2021
6. Challenging Cases in Urothelial Cancer: Case 21
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Mark S. Soloway
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Oncology ,Urology - Published
- 2021
7. Targeting hyaluronic acid synthase-3 (HAS3) for the treatment of advanced renal cell carcinoma
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Jiaojiao Wang, Andre R. Jordan, Huabin Zhu, Sarrah L. Hasanali, Eric Thomas, Soum D. Lokeshwar, Daley S. Morera, Sung Alexander, Joseph McDaniels, Anuj Sharma, Karina Aguilar, Semih Sarcan, Tianyi Zhu, Mark S. Soloway, Martha K. Terris, Muthusamy Thangaraju, Luis E. Lopez, and Vinata B. Lokeshwar
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Cancer Research ,Oncology ,Genetics - Abstract
Background Hyaluronic acid (HA) promotes cancer metastasis; however, the currently approved treatments do not target HA. Metastatic renal carcinoma (mRCC) is an incurable disease. Sorafenib (SF) is a modestly effective antiangiogenic drug for mRCC. Although only endothelial cells express known SF targets, SF is cytotoxic to RCC cells at concentrations higher than the pharmacological-dose (5-µM). Using patient cohorts, mRCC models, and SF combination with 4-methylumbelliferone (MU), we discovered an SF target in RCC cells and targeted it for treatment. Methods We analyzed HA-synthase (HAS1, HAS2, HAS3) expression in RCC cells and clinical (n = 129), TCGA-KIRC (n = 542), and TCGA-KIRP (n = 291) cohorts. We evaluated the efficacy of SF and SF plus MU combination in RCC cells, HAS3-transfectants, endothelial-RCC co-cultures, and xenografts. Results RCC cells showed increased HAS3 expression. In the clinical and TCGA-KIRC/TCGA-KIRP cohorts, higher HAS3 levels predicted metastasis and shorter survival. At > 10-µM dose, SF inhibited HAS3/HA-synthesis and RCC cell growth. However, at ≤ 5-µM dose SF in combination with MU inhibited HAS3/HA synthesis, growth of RCC cells and endothelial-RCC co-cultures, and induced apoptosis. The combination inhibited motility/invasion and an HA-signaling-related invasive-signature. We previously showed that MU inhibits SF inactivation in RCC cells. While HAS3-knockdown transfectants were sensitive to SF, ectopic-HAS3-expression induced resistance to the combination. In RCC models, the combination inhibited tumor growth and metastasis with little toxicity; however, ectopic-HAS3-expressing tumors were resistant. Conclusion HAS3 is the first known target of SF in RCC cells. In combination with MU (human equivalent-dose, 0.6–1.1-g/day), SF targets HAS3 and effectively abrogates mRCC.
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- 2022
8. Challenging Cases in Urothelial Cancer: Case 19
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Mark S. Soloway and Neil A. Abrahams
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Oncology ,Urology - Published
- 2021
9. Best Practices to Optimise Quality and Outcomes of Transurethral Resection of Bladder Tumours
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Ashish M. Kamat, Hugh Mostafid, James W.F. Catto, Siamak Daneshmand, Mark S. Soloway, Marko Babjuk, John A. Taylor, Joan Palou, and James M. McKiernan
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medicine.medical_specialty ,Urologists ,Urology ,media_common.quotation_subject ,Best practice ,Judgement ,030232 urology & nephrology ,MEDLINE ,Context (language use) ,Cystectomy ,03 medical and health sciences ,0302 clinical medicine ,Humans ,Medicine ,Radiology, Nuclear Medicine and imaging ,Quality (business) ,Retrospective Studies ,media_common ,Bladder cancer ,business.industry ,General surgery ,Guideline ,Evidence-based medicine ,medicine.disease ,Urinary Bladder Neoplasms ,Oncology ,030220 oncology & carcinogenesis ,Urologic Surgical Procedures ,Surgery ,business - Abstract
Context Transurethral resection of bladder tumour (TURBT) for bladder cancer (BC) is an underappreciated common urological procedure. TURBT outcomes are highly variable, and results are dependent on judgement and surgical skill. Objective To perform a narrative review and identify optimal best practice in TURBT including preparation, choice of equipment, procedural steps, surgical technique, and management of difficult scenarios and complications. Evidence acquisition Medline, Embase, and the Cochrane Central Register of Controlled Trials were searched. Important studies were identified and reviewed by an international panel of urologists representing major urological societies and guideline panels with a record of academic publication in this field. In areas where the group identified a lack of evidence or agreement, discussions took place until a consensus was reached. Evidence synthesis A total of 814 studies were identified and 43 were included. The majority were retrospective (level of evidence 3), with only two prospective randomised trials. Four broad themes were identified, which formed the basis for the review: (1) the role of TURBT within the overall management of BC, (2) TURBT techniques, (3) measurement of outcomes including quality control and checklists, and (4) postoperative management. Familiarity with all aspects of the procedure is necessary to minimise morbidity and improve oncological outcomes. Development of new instruments and techniques, and prospective audit of TURBT outcomes are important future goals. Conclusions TURBT is a common and challenging operation with known variable outcomes. To reduce these variations and optimise outcomes, best practice based on evidence and expert opinion is recommended. Patient summary Transurethral resection of bladder tumour (TURBT) is a common but deceptively difficult urological operation. Optimal outcomes depend on experience and surgical skill. An international group of experienced TURBT surgeons review critical aspects of the procedure and share best practice to stimulate further discussion.
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- 2021
10. Challenging Cases in Urothelial Cancer: Case 20
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Mark S. Soloway
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Oncology ,Urology - Published
- 2021
11. Risk‐adapted management of low‐grade bladder tumours: recommendations from the International Bladder Cancer Group (IBCG)
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Roger Buckley, Mark S. Soloway, Raj Persad, J. Alfred Witjes, Maurizio Brausi, Marc Colombel, Donald L. Lamm, Ashish M. Kamat, Andreas Boehle, Justin T. Matulay, and Joan Palou
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medicine.medical_specialty ,Urology ,Urinary system ,medicine.medical_treatment ,030232 urology & nephrology ,Disease ,Risk Assessment ,03 medical and health sciences ,0302 clinical medicine ,Urological cancers Radboud Institute for Molecular Life Sciences [Radboudumc 15] ,medicine ,Humans ,Chemotherapy ,Bladder cancer ,medicine.diagnostic_test ,Minimal risk ,Fulguration ,business.industry ,General surgery ,Cystoscopy ,medicine.disease ,Urinary Bladder Neoplasms ,Time to recurrence ,030220 oncology & carcinogenesis ,Neoplasm Grading ,business - Abstract
Contains fulltext : 220546.pdf (Publisher’s version ) (Closed access) OBJECTIVE: To provide a contemporary update and recommendations for the diagnosis and management of low-grade non-muscle-invasive bladder cancer (BCa) based on current literature and expert consensus of the International Bladder Cancer Group. METHODS: We reviewed published trials, guidelines, meta-analyses and reviews (up to March 2019) and provide recommendations on baseline evaluations, treatment, endpoints, study design and surveillance protocols. RESULTS: Low-grade Ta BCa poses minimal risk to patients in terms of progression and disease-specific survival. Thus, to minimize patient morbidity, this entity should be managed appropriately. After initial diagnosis of low-grade Ta tumour, subsequent stable, low-grade-appearing recurrences can be managed conservatively with office cystoscopy and fulguration or even followed using an active surveillance protocol. Intravesical therapy other than single-dose peri-operative chemotherapy instillation should be used judiciously, and only after assigning appropriate risk points. Routine use of urinary cytology - other than at initial risk stratification, or for patients on active surveillance without therapy - is not recommended; and surveillance cystoscopy may be discontinued after 5 years. Clinical studies in this group of patients should focus on recurrence rates, and time to recurrence, rather than progression events. CONCLUSIONS: The International Bladder Cancer Group has developed formal recommendations regarding the diagnosis, treatment and surveillance of low-grade non-muscle-invasive BCa to minimize morbidity and encourage uniformity among studies in this disease.
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- 2020
12. Diffuse large B-cell lymphoma presenting as LUTS: Clinical practice points
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Syed N. Rahman, Mark S. Soloway, Soum D. Lokeshwar, Thomas F. Monaghan, Jamil Syed, and Benjamin Press
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medicine.medical_specialty ,Bladder cancer ,medicine.diagnostic_test ,Lymphoma ,business.industry ,Urology ,Cystoscopy ,medicine.disease ,Diseases of the genitourinary system. Urology ,Oncology ,Lower urinary tract symptoms ,Biopsy ,medicine ,EPOCH (chemotherapy) ,Radiology ,RC870-923 ,Stage (cooking) ,business ,Diffuse large B-cell lymphoma - Abstract
There is a paucity of management recommendations for patients with aggressive Diffuse large B cell lymphoma (DLBCL) of the bladder. A 57-year-old male patient presented with lower urinary tract symptoms underwent flexible cystoscopy and then bladder tumor biopsy. Through immediate staging CT scan, tumor and bone biopsies he was diagnosed with a 16 cm Stage IVa high-grade DLBCL. He was treated with DA EPOCH with only a partial response and was transitioned to R-ICE. For rarer presentations of bladder cancer during diagnostic cystoscopy there should be no delay in tumor imaging and involving medical oncology in early treatment decision making.
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- 2021
13. Challenging Cases in Urothelial Cancer: Case 181
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Mark S. Soloway
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Oncology ,Urology - Published
- 2020
14. Challenging Cases in Urothelial Cancer1
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Mark S. Soloway and Neil A. Abrahams
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Oncology ,Urology - Published
- 2020
15. Epidemiology, prevention, screening, diagnosis, and evaluation: update of the ICUD-SIU joint consultation on bladder cancer
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Rafael Sanchez-Salas, Ashish M. Kamat, H. Barton Grossman, Lambertus A. Kiemeney, Bernard Malavaud, Makarand Khochikar, Robert S. Svatek, Mark S. Soloway, Raghunandan Vikram, Peter E. Clark, Michael S. Cookson, Maurizio Brausi, Mario I. Fernández, and Alina Vrieling
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medicine.medical_specialty ,Urology ,medicine.medical_treatment ,Population Dynamics ,Population ,030232 urology & nephrology ,Disease ,Narrow Band Imaging ,03 medical and health sciences ,0302 clinical medicine ,All institutes and research themes of the Radboud University Medical Center ,Risk Factors ,Epidemiology ,Prevalence ,Tobacco Smoking ,medicine ,Humans ,Risk factor ,Intensive care medicine ,education ,Early Detection of Cancer ,Societies, Medical ,Neoplasm Staging ,Carcinoma, Transitional Cell ,education.field_of_study ,Bladder cancer ,business.industry ,Incidence ,Incidence (epidemiology) ,Cystoscopy ,Evidence-based medicine ,medicine.disease ,Magnetic Resonance Imaging ,Urinary Bladder Neoplasms ,030220 oncology & carcinogenesis ,Urological cancers Radboud Institute for Health Sciences [Radboudumc 15] ,Practice Guidelines as Topic ,Smoking cessation ,Smoking Cessation ,Tomography, X-Ray Computed ,business ,Algorithms - Abstract
To update current recommendations on prevention, screening, diagnosis, and evaluation of bladder cancer (BC) based on a thorough assessment of the most recent literature on these topics. A non-systematic review was performed, including articles until June 2017. A variety of original articles, reviews, and editorials were selected according to their epidemiologic, demographic, and clinical relevance. Assessment of the level of evidence and grade of recommendations was performed according to the International Consultation on Urological Diseases grading system. BC is the ninth most common cancer worldwide with 430,000 new cases in 2012. Currently, approximately 165,000 people die from the disease annually. Absolute incidence and prevalence of BC are expected to rise significantly during the next decades because of population ageing. Tobacco smoking is still the main risk factor, accounting for about 50% of cases. Smoking cessation is, therefore, the most relevant recommendation in terms of prevention, as the risk of developing BC drops almost 40% within 5 years of cessation. BC screening is not recommended for the general population. BC diagnosis remains mainly based on cystoscopy, but development of new endoscopic and imaging technologies may rapidly change the diagnosis algorithm. The same applies for local, regional, and distant staging modalities. A thorough understanding of epidemiology, risk factors, early detection strategies, diagnosis, and evaluation is essential for correct, evidence-based management of BC patients. Recent developments in endoscopic techniques and imaging raise the hope for providing better risk-adopted approaches and thereby improving clinical outcomes.
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- 2019
16. A Festschrift in Honor of Edward M. Messing, MD, FACS
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Mark S. Soloway, Paul Okunieff, Per-Anders Abrahamsson, Yves Fradet, Chunkit Fung, Ahmed Ghazi, Patrick J. Fultz, Kathy Rideout, Katia Noyes, Janet Baack Kukreja, Hani Rashid, Ganesh S. Palapattu, Yair Lotan, R.A. Brasacchio, Seth P. Lerner, Gerald Sufrin, Guan Wu, Seymour I. Schwartz, Chawnshang Chang, David J. McConkey, Edward M. Schwarz, Deepak M. Sahasrabudhe, Jean V. Joseph, Howard H. Bailey, Steven C. Campbell, Dan Theodorescu, Leonard G. Gomella, Yi-Fen Lee, Deborah J. Rubens, Eric A. Singer, Shuyuan Yeh, Michael J. Droller, Jay E. Reeder, Thomas Frye, Donald L. Trump, Supriya G. Mohile, Ithaar Derweesh, Khurshid A. Guru, G. Wilding, Dragan Golijanin, Kevin Bylund, Robert S. Svatek, James L. Mohler, and Gennady Bratslavsky
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Oncology ,business.industry ,Urology ,Honor ,Medicine ,Meeting Report ,business ,Classics - Published
- 2018
17. Molecular targeting of renal cell carcinoma by an oral combination
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Andre R. Jordan, Amar B. Singh, Martha K. Terris, Vinata B. Lokeshwar, Nagarajarao Shamaladevi, Travis Yates, Sarrah L. Hasanali, Soum D. Lokeshwar, Jiaojiao Wang, Charles S. Li, Muthusamy Thangaraju, Daley S. Morera, Mark S. Soloway, and Zachary Klaassen
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0301 basic medicine ,Sorafenib ,Cancer Research ,Choleretic ,Angiogenesis ,Cell ,urologic and male genital diseases ,lcsh:RC254-282 ,Article ,Metastasis ,03 medical and health sciences ,0302 clinical medicine ,Renal cell carcinoma ,Target identification ,medicine ,Molecular Biology ,business.industry ,medicine.disease ,lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,Primary tumor ,030104 developmental biology ,medicine.anatomical_structure ,030220 oncology & carcinogenesis ,Toxicity ,Cancer research ,business ,medicine.drug - Abstract
The 5-year survival rate of patients with metastatic renal cell carcinoma (mRCC) is
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- 2020
18. Molecular Characterization of Renal Cell Carcinoma: A Potential Three-MicroRNA Prognostic Signature
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Sarrah S. Lahorewala, Naureen N. Mullani, Michael Garcia-Roig, Mark S. Soloway, Asif Talukder, Soum D. Lokeshwar, Zachary Klaassen, Travis Yates, Murugesan Manoharan, Vinata B. Lokeshwar, Martin J.P. Hennig, and Bruce R. Kava
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Male ,0301 basic medicine ,Oncology ,medicine.medical_specialty ,Epidemiology ,Datasets as Topic ,Down-Regulation ,Kaplan-Meier Estimate ,Disease ,Metastasis ,03 medical and health sciences ,0302 clinical medicine ,Text mining ,Renal cell carcinoma ,Internal medicine ,microRNA ,Biomarkers, Tumor ,medicine ,Carcinoma ,Humans ,Carcinoma, Renal Cell ,Aged ,Oligonucleotide Array Sequence Analysis ,Regulation of gene expression ,Kidney ,business.industry ,Gene Expression Profiling ,Middle Aged ,Prognosis ,medicine.disease ,Kidney Neoplasms ,Gene Expression Regulation, Neoplastic ,MicroRNAs ,030104 developmental biology ,medicine.anatomical_structure ,030220 oncology & carcinogenesis ,Female ,business - Abstract
Background: Aberrantly expressed miRNAs promote renal cell carcinoma (RCC) growth and metastasis and are potentially useful biomarkers for metastatic disease. However, a consensus clinically significant miRNA signature has not been identified. To identify an miRNA signature for predicting clinical outcome in RCC patients, we used a four-pronged interconnected approach. Methods: Differentially expressed miRNAs were identified and analyzed in 113 specimens (normal kidney: 59; tumor: 54). miRNA profiling was performed in matched normal and tumor specimens from 8 patients and extended to 32 specimens. Seven aberrantly expressed miRNAs were analyzed by qPCR, and their levels were correlated with RCC subtypes and clinical outcome. miRNA signature was confirmed in The Cancer Genome Atlas RCC dataset (n = 241). Results: Discovery phase identified miR-21, miR-142-3p, miR-142-5p, miR-150, and miR-155 as significantly upregulated (2–4-fold) and miR-192 and miR-194 as downregulated (3–60-fold) in RCC; miR-155 distinguished small tumors ( Conclusions: The interconnected discovery–validation approach identified a three-miRNA signature as a potential predictor of disease outcome in RCC patients. Impact: With 10% survival at 5 years, metastatic disease presents poor prognosis for RCC patients. The three-miRNA signature discovered and validated may potentially at an early stage detect and predict metastasis, to allow early intervention for improving patient prognosis. Cancer Epidemiol Biomarkers Prev; 27(4); 464–72. ©2018 AACR.
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- 2018
19. Hyaluronic acid family in bladder cancer: potential prognostic biomarkers and therapeutic targets
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Daley S. Morera, Luis E. Lopez, Jiaojiao Wang, Travis Yates, Mario W. Kramer, Nicolas Ortiz, Vinata B. Lokeshwar, Martha K. Terris, Georgios Kallifatidis, Andre R. Jordan, Martin S Hennig, Michael Garcia-Roig, Soum D. Lokeshwar, Murugesan Manoharan, Asif Talukder, Axel S. Merseburger, and Mark S. Soloway
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0301 basic medicine ,Cancer Research ,Epithelial-Mesenchymal Transition ,Mice, Nude ,Antineoplastic Agents ,Kaplan-Meier Estimate ,epithelial–mesenchymal transition ,Metastasis ,4-methylumbelliferone ,03 medical and health sciences ,chemistry.chemical_compound ,Mice ,0302 clinical medicine ,Hyaluronic acid ,hyaluronic acid ,Biomarkers, Tumor ,Medicine ,Animals ,Humans ,Epithelial–mesenchymal transition ,Protein kinase B ,Bladder cancer ,biology ,business.industry ,CD44 ,medicine.disease ,Prognosis ,3. Good health ,030104 developmental biology ,Oncology ,chemistry ,targeted treatment ,Urinary Bladder Neoplasms ,Apoptosis ,030220 oncology & carcinogenesis ,Cancer research ,biology.protein ,Biomarker (medicine) ,bladder cancer ,biomarker ,business ,Translational Therapeutics ,Hymecromone - Abstract
Background: Molecular markers of clinical outcome may aid in designing targeted treatments for bladder cancer. However, only a few bladder cancer biomarkers have been examined as therapeutic targets. Methods: Data from The Cancer Genome Atlas (TCGA) and bladder specimens were evaluated to determine the biomarker potential of the hyaluronic acid (HA) family of molecules – HA synthases, HA receptors and hyaluronidase. The therapeutic efficacy of 4-methylumbelliferone (4MU), a HA synthesis inhibitor, was evaluated in vitro and in xenograft models. Results: In clinical specimens and TCGA data sets, HA synthases and hyaluronidase-1 levels significantly predicted metastasis and poor survival. 4-Methylumbelliferone inhibited proliferation and motility/invasion and induced apoptosis in bladder cancer cells. Oral administration of 4MU both prevented and inhibited tumour growth, without dose-related toxicity. Effects of 4MU were mediated through the inhibition of CD44/RHAMM and phosphatidylinositol 3-kinase/AKT axis, and of epithelial–mesenchymal transition determinants. These were attenuated by HA, suggesting that 4MU targets oncogenic HA signalling. In tumour specimens and the TCGA data set, HA family expression correlated positively with β-catenin, Twist and Snail expression, but negatively with E-cadherin expression. Conclusions: This study demonstrates that the HA family can be exploited for developing a biomarker-driven, targeted treatment for bladder cancer, and 4MU, a non-toxic oral HA synthesis inhibitor, is one such candidate.
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- 2017
20. The Fallacy of 'Definitive Therapy' for Prostate Cancer
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Soum D. Lokeshwar and Mark S Soloway
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Male ,Fallacy ,medicine.medical_specialty ,business.industry ,Urology ,Definitive Therapy ,Misnomer ,MEDLINE ,Prostatic Neoplasms ,medicine.disease ,Primary therapy ,Prostate cancer ,Terminology as Topic ,Humans ,Medicine ,business ,Intensive care medicine - Abstract
The term "definitive therapy" for localized prostate cancer is a misnomer. Patients may be confused as to why "definitive therapy" sometimes requires further treatment after failure. This term should be replaced with "primary therapy".
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- 2020
21. European Association of Urology and American Urological Association/Society of Urologic Oncology Guidelines on Risk Categories for Non–muscle-invasive Bladder Cancer May Lead to Overtreatment for Low-grade Ta Bladder Tumors
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Zachary Klaassen and Mark S. Soloway
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medicine.medical_specialty ,Urology ,030232 urology & nephrology ,Urologic Oncology ,Medical Overuse ,Medical Oncology ,Risk Assessment ,Risk category ,03 medical and health sciences ,0302 clinical medicine ,medicine ,Humans ,Societies, Medical ,Bladder cancer ,business.industry ,medicine.disease ,United States ,Europe ,Urinary Bladder Neoplasms ,030220 oncology & carcinogenesis ,Practice Guidelines as Topic ,Neoplasm Grading ,Non muscle invasive ,business ,Risk assessment - Published
- 2017
22. BCG-unresponsive non-muscle-invasive bladder cancer: recommendations from the IBCG
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Mark S. Soloway, Donald L. Lamm, Ashish M. Kamat, Debasish Sundi, Andreas Boehle, J. Alfred Witjes, Maurizio Brausi, Joan Palou, Roger Buckley, Raj Persad, and Marc Colombel
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Oncology ,medicine.medical_specialty ,Internationality ,Urology ,medicine.medical_treatment ,030232 urology & nephrology ,Antineoplastic Agents ,Unmet needs ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,Urological cancers Radboud Institute for Molecular Life Sciences [Radboudumc 15] ,medicine ,Humans ,Neoplasm Invasiveness ,Treatment Failure ,Societies, Medical ,Chemotherapy ,Bladder cancer ,Invasive carcinoma ,business.industry ,Immunotherapy ,medicine.disease ,Optimal management ,Surgery ,Administration, Intravesical ,Urinary Bladder Neoplasms ,030220 oncology & carcinogenesis ,BCG Vaccine ,Intravesical chemotherapy ,Non muscle invasive ,business - Abstract
Item does not contain fulltext Intravesical immunotherapy with live attenuated BCG remains the standard of care for patients with high-risk and intermediate-risk non-muscle-invasive bladder cancer (NMIBC). Most patients initially respond, but recurrence is frequent and progression to invasive cancer is a concern. No established and effective intravesical therapies are available for patients whose tumours recur after BCG, representing a clinically important unmet need. Development and discovery of treatment options for BCG-unresponsive NMIBC is a high priority in order to decrease the morbidity, burden of health-care expenditures, and mortality related to bladder cancer. This Review of treatment options after BCG failure focuses on principles of optimal management emerging therapies, thus enabling a synthesis of recommendations for management for such patients.
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- 2017
23. Challenging Cases in Urothelial Cancer: Case 171
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Mark S. Soloway
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Oncology ,medicine.medical_specialty ,business.industry ,Urology ,Internal medicine ,medicine ,Urothelial cancer ,business - Published
- 2020
24. Transurethral Resection of Bladder Tumour: The Neglected Procedure in the Technology Race in Bladder Cancer
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Seth P. Lerner, Maurizio Brausi, James W.F. Catto, Gary D. Steinberg, Bernard Malavaud, Bas W.G. van Rhijn, Stephen B. Williams, Ashish M. Kamat, S.F. Shariat, Morgan Rouprêt, Siamak Daneshmand, Paolo Gontero, Maximilian Burger, Bernard H. Bochner, Richard Sylvester, Eva Comperat, Joan Palou, Marko Babjuk, Fred Witjes, Richard Zigeuner, Peter McL. Black, Mark S. Soloway, and Hugh Mostafid
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medicine.medical_specialty ,Bladder cancer ,business.industry ,Urology ,General surgery ,Bladder tumour ,Biomedical Technology ,030232 urology & nephrology ,MEDLINE ,Cystectomy ,urologic and male genital diseases ,medicine.disease ,female genital diseases and pregnancy complications ,Resection ,03 medical and health sciences ,0302 clinical medicine ,Urethra ,Urinary Bladder Neoplasms ,030220 oncology & carcinogenesis ,Urological cancers Radboud Institute for Molecular Life Sciences [Radboudumc 15] ,Humans ,Medicine ,business - Abstract
Contains fulltext : 220581.pdf (Publisher’s version ) (Closed access) Transurethral resection of bladder tumour is the initial, most critical step in the management of bladder cancer; as such, this is a call to arms for the urological community to it the due diligence it deserves regarding technology and training.
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- 2020
25. Challenging Cases in Urothelial Cancer1
- Author
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Mark S. Soloway
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Oncology ,Urology - Published
- 2020
26. Active Surveillance or Office Fulguration for Low Grade Ta Bladder Tumors: A Win-Win for Patients and Urologists
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Mark S. Soloway
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medicine.medical_specialty ,Urology ,medicine.medical_treatment ,Urinary Bladder ,030232 urology & nephrology ,MEDLINE ,03 medical and health sciences ,0302 clinical medicine ,Electrocoagulation ,Pathology ,medicine ,Carcinoma ,Humans ,Watchful Waiting ,Societies, Medical ,Carcinoma, Transitional Cell ,Neoplasm Grading ,medicine.diagnostic_test ,Fulguration ,business.industry ,Disease progression ,Cystoscopy ,medicine.disease ,Surgery ,Win-win game ,Urinary Bladder Neoplasms ,030220 oncology & carcinogenesis ,Practice Guidelines as Topic ,Disease Progression ,business ,Watchful waiting - Published
- 2018
27. A Case for Risk-adapted Management of Low-grade Bladder Tumors
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Justin T. Matulay, Mark S. Soloway, and Ashish M. Kamat
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medicine.medical_specialty ,Focus (computing) ,Bladder cancer ,business.industry ,Urology ,education ,030232 urology & nephrology ,medicine.disease ,humanities ,03 medical and health sciences ,0302 clinical medicine ,Oncology ,Urinary Bladder Neoplasms ,Risk Factors ,030220 oncology & carcinogenesis ,medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,Surgery ,Neoplasm Grading ,business ,Intensive care medicine - Abstract
Management of low-grade bladder cancer should focus on minimizing morbidity and costs given the excellent oncologic outcomes.
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- 2019
28. Clinical Parameters Outperform Molecular Subtypes for Predicting Outcome in Bladder Cancer: Results from Multiple Cohorts, Including TCGA
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Jiaojiao Wang, Mark S. Soloway, Vinata B. Lokeshwar, Zachary Klaassen, Daley S. Morera, Daniel Belew, Santu Ghosh, Arnulf Stenzl, Andre R. Jordan, Roni J. Bollag, Sarrah L. Hasanali, Martha K. Terris, and Axel S. Merseburger
- Subjects
Oncology ,Male ,medicine.medical_specialty ,Urology ,030232 urology & nephrology ,Kaplan-Meier Estimate ,Outcome (game theory) ,Risk Assessment ,Article ,03 medical and health sciences ,0302 clinical medicine ,Predictive Value of Tests ,Risk Factors ,Internal medicine ,medicine ,Biomarkers, Tumor ,Molecular diagnostic techniques ,Humans ,Neoplasm Invasiveness ,Neoplasm Metastasis ,Neoplasm Staging ,Neoplasm Grading ,Carcinoma, Transitional Cell ,Bladder cancer ,business.industry ,Muscle invasive ,medicine.disease ,Prognosis ,Subtyping ,Phenotype ,Urinary Bladder Neoplasms ,Female ,business ,Transcriptome - Abstract
Studies indicate that molecular subtypes in muscle invasive bladder cancer predict the clinical outcome. We evaluated whether subtyping by a simplified method and established classifications could predict the clinical outcome.We subtyped institutional cohort 1 of 52 patients, including 39 with muscle invasive bladder cancer, an Oncomine™ data set of 151 with muscle invasive bladder cancer and TCGA (The Cancer Genome Atlas) data set of 402 with muscle invasive bladder cancer. Subtyping was done using simplified panels (MCG-1 and MCG-Ext) which included only transcripts common in published studies and were analyzed for predicting metastasis, and cancer specific, overall and recurrence-free survival. TCGA data set was further analyzed using the Lund taxonomy, the Bladder Cancer Molecular Taxonomy Group Consensus and TCGA 2017 mRNA subtype classifications.Muscle invasive bladder cancer specimens from cohort 1 and the Oncomine data set showed intratumor heterogeneity for transcript and protein expression. MCG-1 subtypes did not predict the outcome on univariate or Kaplan-Meier analysis. On multivariate analysis N stage (p ≤0.007), T stage (p ≤0.04), M stage (p=0.007) and/or patient age (p=0.01) predicted metastasis, cancer specific and overall survival, and/or the cisplatin based adjuvant chemotherapy response. In TCGA data set publications showed that subtypes risk stratified patients for overall survival. Consistently the MCG-1 and MCG-Ext subtypes were associated with overall but not recurrence-free survival on univariate and Kaplan-Meier analyses. TCGA data set included 21 low grade specimens of the total of 402 and subtypes associated with tumor grade (p=0.005). However, less than 1% of muscle invasive bladder cancer cases are low grade. In only high grade specimens the MCG-1 and MCG-Ext subtypes could not predict overall survival. On univariate analysis subtypes according to the Bladder Cancer Molecular Taxonomy Group Consensus, TCGA 2017 and the Lund taxonomy were associated with tumor grade (p0.0001) and overall survival (p=0.01 to0.0001). Regardless of classification, subtypes had about 50% to 60% sensitivity and specificity to predict overall and recurrence-free survival. On multivariate analyses N stage and lymphovascular invasion consistently predicted recurrence-free and overall survival (p=0.039 and 0.003, respectively).Molecular subtypes reflect bladder tumor heterogeneity and are associated with tumor grade. In multiple cohorts and subtyping classifications the clinical parameters outperformed subtypes for predicting the outcome.
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- 2019
29. Challenging Cases in Urothelial Cancer: Case 17
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Mark S. Soloway
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Oncology ,Urology - Published
- 2021
30. Challenging Cases in Urothelial Cancer
- Author
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Mark S. Soloway and Neil A. Abrahams
- Subjects
Oncology ,Urology - Published
- 2021
31. Challenging Cases in Urothelial Cancer: Case 18
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Mark S. Soloway
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Oncology ,Urology - Published
- 2021
32. Definitions, End Points, and Clinical Trial Designs for Non-Muscle-Invasive Bladder Cancer: Recommendations From the International Bladder Cancer Group
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Maurizio Brausi, Richard Sylvester, Marc Colombel, Donald L. Lamm, Ashish M. Kamat, Raj Persad, J. Alfred Witjes, Mark S. Soloway, Roger Buckley, Andreas Böhle, and Joan Palou
- Subjects
Research design ,Cancer Research ,Pathology ,medicine.medical_specialty ,Endpoint Determination ,Population ,030232 urology & nephrology ,Specific risk ,MEDLINE ,Review Article ,03 medical and health sciences ,0302 clinical medicine ,Urological cancers Radboud Institute for Molecular Life Sciences [Radboudumc 15] ,Medicine ,Humans ,education ,Intensive care medicine ,education.field_of_study ,Clinical Trials as Topic ,Bladder cancer ,business.industry ,Clinical study design ,medicine.disease ,Clinical trial ,Oncology ,Urinary Bladder Neoplasms ,Sample size determination ,Research Design ,030220 oncology & carcinogenesis ,Sample Size ,BCG Vaccine ,Neoplasm Recurrence, Local ,business - Abstract
Purpose To provide recommendations on appropriate clinical trial designs in non–muscle-invasive bladder cancer (NMIBC) based on current literature and expert consensus of the International Bladder Cancer Group. Methods We reviewed published trials, guidelines, meta-analyses, and reviews and provided recommendations on eligibility criteria, baseline evaluations, end points, study designs, comparators, clinically meaningful magnitude of effect, and sample size. Results NMIBC trials must be designed to provide the most clinically relevant data for the specific risk category of interest (low, intermediate, or high). Specific eligibility criteria and baseline evaluations depend on the risk category being studied. For the population of patients for whom bacillus Calmette-Guérin (BCG) has failed, the type of failure (BCG unresponsive, refractory, relapsing, or intolerant) should be clearly defined to make comparisons across trials feasible. Single-arm designs may be relevant for the BCG-unresponsive population. Here, a clinically meaningful initial complete response rate (for carcinoma in situ) or recurrence-free rate (for papillary tumors) of at least 50% at 6 months, 30% at 12 months, and 25% at 18 months is recommended. For other risk levels, randomized superiority trial designs are recommended; noninferiority trials are to be used sparingly given the large sample size required. Placebo control is considered unethical for all intermediate- and high-risk strata; therefore, control arms should comprise the current guideline-recommended standard of care for the respective risk level. In general, trials should use time to recurrence or recurrence-free survival as the primary end point and time to progression, toxicity, disease-specific survival, and overall survival as potential secondary end points. Realistic efficacy thresholds should be set to ensure that novel therapies receive due review by regulatory bodies. Conclusion The International Bladder Cancer Group has developed formal recommendations regarding definitions, end points, and clinical trial designs for NMIBC to encourage uniformity among studies in this disease.
- Published
- 2016
33. Postoperative intravesical chemotherapy has an important role in reducing subsequent bladder tumours - why is it not routine?
- Author
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Mark S. Soloway
- Subjects
medicine.medical_specialty ,business.industry ,Urology ,Mitomycin ,030232 urology & nephrology ,03 medical and health sciences ,0302 clinical medicine ,Text mining ,Administration, Intravesical ,Urinary Bladder Neoplasms ,030220 oncology & carcinogenesis ,Medicine ,Humans ,Postoperative Period ,Neoplasm Recurrence, Local ,business ,Intravesical chemotherapy - Published
- 2018
34. MP58-01 MOLECULAR SUBTYPES IN MUSCLE INVASIVE BLADDER CANCER: EVALUATION OF CLINICAL SIGNIFICANCE
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Andre R. Jordan, Daley S. Morera, Sarrah S. Lahorewala, Daniel Belew, Martha K. Terris, Vinata B. Lokeshwar, Mark S. Soloway, and Zachary Klaassen
- Subjects
Pathology ,medicine.medical_specialty ,Bladder cancer ,business.industry ,Urology ,Muscle invasive ,medicine ,Clinical significance ,business ,medicine.disease - Published
- 2018
35. Double-Blind, Randomized, Placebo-controlled Studies Evaluating Apaziquone (E09, Qapzola) Intravesical Instillation Post Transurethral Resection of Bladder Tumors for the Treatment of Low-risk Non-Muscle Invasive Bladder Cancer
- Author
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Lawrence Karsh, Szu-Yun Leu, Mark S. Soloway, Neal D. Shore, Guru Reddy, J. Alfred Witjes, and Gajanan Bhat
- Subjects
0301 basic medicine ,Research Report ,medicine.medical_specialty ,E09 ,Urology ,medicine.medical_treatment ,Subgroup analysis ,Placebo ,chemotherapy ,intravesical instillation ,03 medical and health sciences ,chemistry.chemical_compound ,0302 clinical medicine ,non-muscle invasive bladder cancer ,Statistical significance ,Intravesical instillation ,Urological cancers Radboud Institute for Molecular Life Sciences [Radboudumc 15] ,medicine ,Apaziquone ,bladder ,Chemotherapy ,Bladder cancer ,business.industry ,medicine.disease ,TURBT ,030104 developmental biology ,Oncology ,chemistry ,030220 oncology & carcinogenesis ,Toxicity ,bladder cancer ,business - Abstract
Contains fulltext : 195581.pdf (Publisher’s version ) (Open Access) Background: Guidelines recommend a single postoperative instillation of intravesical chemotherapy within 24 hours of transurethral resection of bladder tumors (TURBT) in patients with low- and intermediate-risk non-muscle invasive bladder cancer (NMIBC) to reduce recurrence risk. Objective: To evaluate the 2-year recurrence rate (2-YRR) of bladder cancer in randomized patients with Ta, G1-G2 histology who receive TURBT plus apaziquone versus TURBT plus placebo. Methods: Two nearly identical Phase 3, multinational, randomized, double-blind, placebo-controlled trials were conducted in patients with histologically confirmed Ta, G1-G2 NMIBC (Target Population) to evaluate the efficacy/safety of a single instillation of apaziquone post-TURBT. A single intravesical instillation of apaziquone (4 mg/40 mL) or placebo was administered within 6 hours post-TURBT. The primary and secondary efficacy endpoints were 2-YRR and time to recurrence (TTR) respectively. Results: Overall, 1614 patients were enrolled, including 1146 patients in the Target Population. Individually, the two studies did not meet statistical significance for 2-YRR (38.0% vs 44.6% ; 39.7% vs. 46.3%). Because apaziquone is rapidly metabolized in blood, a post hoc subgroup analysis was performed by time window of drug instillation post-TURBT. Patients who had drug instilled in the time window 60+/-30 minutes post-TURBT demonstrated 20.3% and 20.8% reduction in 2-YRR and 56% (HR = 0.44) and 45% (HR = 0.55) reduction in hazards for TTR in two studies respectively. Apaziquone was well tolerated with minimal toxicity. Conclusions: Two identical Phase 3 studies supported the safety of apaziquone (4 mg/40 mL) administered as a single intravesical instillation post-TURBT and identified efficacy when instilled within 60+/-30-minutes time interval which requires further study.
- Published
- 2018
36. Editorial Commentary
- Author
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Mark S. Soloway
- Subjects
Urology - Published
- 2019
37. Active Surveillance with Delayed Intervention for Recurrent Low Risk Bladder Cancer
- Author
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Mark S. Soloway and Michael A. Gorin
- Subjects
Oncology ,medicine.medical_specialty ,Bladder cancer ,business.industry ,Urology ,medicine.medical_treatment ,English language ,medicine.disease ,Management strategy ,Delayed intervention ,Internal medicine ,Health care ,medicine ,Stage (cooking) ,business ,Risk assessment ,Watchful waiting - Abstract
Introduction Active surveillance with delayed intervention aims to minimize the discomfort, potential complications and costs associated with immediate treatment of recurrent low grade Ta tumors of the bladder. We reviewed the data supporting this management strategy for low risk bladder cancer. Methods A PubMed® query was performed to identify relevant literature on the topic of active surveillance for low risk bladder cancer. English language publications were reviewed and select data presented. Results Available data suggest that only 5% to 10% of patients diagnosed with a low grade appearing papillary bladder tumor will have progression in stage or grade. Coupled with the discomfort and potential for complications associated with transurethral resection, this supports the role of active surveillance for patients with small, recurrent, low risk bladder cancer. In addition, this management strategy stands to benefit the health care system by reducing the costs associated with caring for patients with bladder cancer. Conclusions Active surveillance with delayed intervention represents a safe and cost-effective strategy for patients with recurrent low risk bladder cancer.
- Published
- 2015
38. BCG for high grade NMIBC - Lessons learned over 40 years
- Author
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Mark S, Soloway
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Administration, Intravesical ,Urinary Bladder Neoplasms ,BCG Vaccine ,Humans ,Immunotherapy - Published
- 2017
39. MP48-01 EXPRESSION AND FUNCTION OF A NOVEL CHONDROITINASE IN BLADDER CANCER
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Axel S. Merseburger, Mario W. Kramer, Daley Schimmelpfennig, Mark S. Soloway, Vinata B. Lokeshwar, Marie C. Hupe, Martin J.P. Hennig, and Soum D. Lokeshwar
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Bladder cancer ,Expression (architecture) ,business.industry ,Urology ,medicine ,Cancer research ,medicine.disease ,business ,Function (biology) - Published
- 2017
40. MP39-15 SDCT2 AS A FUNCTIONAL BIOMARKER OF RENAL CELL CARCINOMA
- Author
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Andre R. Jordan, Mark S. Soloway, Mario W. Kramer, Vinata B. Lokeshwar, Martin J.P. Hennig, Marie C. Hupe, and Axel S. Merseburger
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Renal cell carcinoma ,business.industry ,Urology ,medicine ,Cancer research ,Biomarker (medicine) ,medicine.disease ,business - Published
- 2017
41. Differential Expression of SDF-1 Isoforms in Bladder Cancer
- Author
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Travis Yates, Muthu K. Veerapen, Axel S. Merseburger, John Shields, Marie C. Hupe, Vinata B. Lokeshwar, Miguel Gosalbez, Mark S. Soloway, Soum D. Lokeshwar, and Charles J. Rosser
- Subjects
Adult ,Male ,Gene isoform ,Pathology ,medicine.medical_specialty ,Urology ,Biology ,Real-Time Polymerase Chain Reaction ,CXCR4 ,Article ,Chemokine receptor ,Biomarkers, Tumor ,medicine ,Humans ,Protein Isoforms ,RNA, Neoplasm ,Messenger RNA ,Bladder cancer ,Reverse Transcriptase Polymerase Chain Reaction ,Carcinoma in situ ,Cancer ,Middle Aged ,medicine.disease ,Chemokine CXCL12 ,Gene Expression Regulation, Neoplastic ,Real-time polymerase chain reaction ,Urinary Bladder Neoplasms ,Cancer research ,Female - Abstract
SDF-1 is a ligand of the chemokine receptors CXCR4 and 7. The 6 known SDF-1 isoforms are generated by alternative mRNA splicing. While SDF-1 expression has been detected in various malignancies, only few groups have reported differential expression of SDF-1 isoforms and its clinical significance. We evaluated the expression of 3 SDF-1 isoforms (α, β and γ) in bladder cancer.Using quantitative polymerase chain reaction we measured SDF-1α, β and γ mRNA levels in 25 normal and 44 bladder cancer tissues, and in 210 urine specimens (28 normal, 74 benign, 57 bladder cancer, 35 bladder cancer history, 8 other cancer history and 8 other cancer) from consecutive patients. Levels were correlated with clinical outcome.Of the SDF-1 isoforms only SDF-1β mRNA was significantly over expressed 2.5-fold to sixfold in bladder cancer compared to normal bladder tissues. SDF-1α was expressed in bladder tissues but SDF-1γ was undetectable. On multivariate analysis SDF-1β was an independent predictor of metastasis and disease specific mortality (p=0.017 and 0.043, respectively). In exfoliated urothelial cells only SDF-1β mRNA levels were differentially expressed with 91.2% sensitivity and 73.8% specificity for detecting bladder cancer. In patients with a bladder cancer history increased SDF-1β levels indicated a 4.3-fold increased risk of recurrence within 6 months (p=0.0001).SDF-1 isoforms are differentially expressed in bladder tissues and exfoliated urothelial cells. SDF-1β mRNA levels in bladder cancer tissues predict a poor prognosis. Furthermore, SDF-1β mRNA levels in exfoliated cells detect bladder cancer with high sensitivity and they are a potential predictor of future recurrence.
- Published
- 2014
42. Defining Progression in Nonmuscle Invasive Bladder Cancer: It is Time for a New, Standard Definition
- Author
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Maurizio Brausi, Roger Buckley, Mark S. Soloway, Raj Persad, Marc Colombel, Joan Palou, Andreas Böhle, Donald L. Lamm, Ashish M. Kamat, and J. Alfred Witjes
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Oncology ,medicine.medical_specialty ,End point ,Bladder cancer ,business.industry ,Urology ,Carcinoma in situ ,Disease progression ,Prognosis ,medicine.disease ,Clinical trial ,Urinary Bladder Neoplasms ,Standard definition ,Internal medicine ,Urological cancers Radboud Institute for Molecular Life Sciences [Radboudumc 15] ,Disease Progression ,Humans ,Medicine ,Neoplasm Invasiveness ,business ,Neoplasm Staging - Abstract
Item does not contain fulltext PURPOSE: Despite being one of the most important clinical outcomes in nonmuscle invasive bladder cancer, there is currently no standard definition of disease progression. Major clinical trials and meta-analyses have used varying definitions or have failed to define this end point altogether. A standard definition of nonmuscle invasive bladder cancer progression as determined by reproducible and reliable procedures is needed. We examine current definitions of nonmuscle invasive bladder cancer progression, and propose a new definition that will be more clinically useful in determining patient prognosis and comparing treatment options. MATERIALS AND METHODS: The IBCG (International Bladder Cancer Group) analyzed published clinical trials and meta-analyses that examined nonmuscle invasive bladder cancer progression as of December 2012. The limitations of the definitions of progression used in these trials were considered, as were additional parameters associated with the advancement of nonmuscle invasive bladder cancer. RESULTS: The most commonly used definition of nonmuscle invasive bladder cancer progression is an increase in stage from nonmuscle invasive to muscle invasive disease. Although this definition is clinically important, it fails to include other important parameters of advancing disease such as progression to lamina propria invasion and increase in grade. CONCLUSIONS: The IBCG proposes the definition of nonmuscle invasive bladder cancer progression as an increase in T stage from CIS or Ta to T1 (lamina propria invasion), development of T2 or greater or lymph node (N+) disease or distant metastasis (M1), or an increase in grade from low to high. Investigators should consider the use of this new definition to help standardize protocols and improve the reporting of progression.
- Published
- 2014
43. Development and multi-institutional validation of an upgrading risk tool for Gleason 6 prostate cancer
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E. Jason Abel, Aria Razmaria, David F. Jarrard, Mark S. Soloway, Jon Slezak, Tracy M. Downs, Chee Paul Lin, Martins Sado, Scott E. Eggener, Viacheslav Iremashvili, Glen Leverson, and Matthew Truong
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Oncology ,Cancer Research ,medicine.medical_specialty ,Receiver operating characteristic ,business.industry ,Prostatectomy ,medicine.medical_treatment ,Odds ratio ,Nomogram ,Lower risk ,medicine.disease ,Gleason Score 6 ,Surgery ,Prostate-specific antigen ,Prostate cancer ,Internal medicine ,Medicine ,business - Abstract
BACKGROUND Many patients with low-risk prostate cancer (PC) who are diagnosed with Gleason score 6 at biopsy are ultimately found to harbor higher grade PC (Gleason ≥ 7) at radical prostatectomy. This finding increases risk of recurrence and cancer-specific mortality. Validated clinical tools that are available preoperatively are needed to improve the ability to recognize likelihood of upgrading in patients with low-risk PC. METHODS More than 30 clinicopathologic parameters were assessed in consecutive patients with Gleason 6 PC upon biopsy who underwent radical prostatectomy. A nomogram for predicting upgrading (Gleason ≥ 7) on final pathology was generated using multivariable logistic regression in a development cohort of 431 patients. External validation was performed in 2 separate cohorts consisting of 1151 patients and 392 patients. Nomogram performance was assessed using receiver operating characteristic curves, calibration, and decision analysis. RESULTS On multivariable analysis, variables predicting upgrading were prostate-specific antigen density using ultrasound (odds ratio [OR] = 229, P = .003), obesity (OR = 1.90, P = .05), number of positive cores (OR = 1.23, P = .01), and maximum core involvement (OR = 0.02, P = .01). On internal validation, the bootstrap-corrected predictive accuracy was 0.753. External validation revealed a predictive accuracy of 0.677 and 0.672. The nomogram demonstrated excellent calibration in all 3 cohorts and decision curves demonstrated high net benefit across a wide range of threshold probabilities. The nomogram demonstrated areas under the curve of 0.597 to 0.672 for predicting upgrading in subsets of men with very low-risk PC who meet active surveillance criteria (all P
- Published
- 2013
44. Prognostic Implications of Partial Sampling of Radical Prostatectomy Specimens: Comparison of 3 Methods
- Author
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Liset Pelaez, Merce Jorda, Soum D. Lokeshwar, Mark S. Soloway, and Viacheslav Iremashvili
- Subjects
Male ,Biochemical recurrence ,medicine.medical_specialty ,Urology ,medicine.medical_treatment ,Kaplan-Meier Estimate ,Risk Assessment ,Sensitivity and Specificity ,Disease-Free Survival ,Specimen Handling ,Cohort Studies ,Tissue Culture Techniques ,medicine ,Humans ,Neoplasm Invasiveness ,Survival analysis ,Aged ,Neoplasm Staging ,Proportional Hazards Models ,Retrospective Studies ,Aged, 80 and over ,Prostatectomy ,Tissue Embedding ,Proportional hazards model ,business.industry ,Prostatic Neoplasms ,Sampling (statistics) ,Middle Aged ,Prostate-Specific Antigen ,Prognosis ,Immunohistochemistry ,Survival Analysis ,Extraprostatic ,Surgery ,Prostate-specific antigen ,Multivariate Analysis ,Radiology ,Positive Surgical Margin ,business - Abstract
We analyzed the prognostic implications of positive margins and extraprostatic extension missed by different methods of partially sampling prostatectomy specimens.The study group consisted of 1,499 patients treated with radical prostatectomy. All specimens were processed uniformly and submitted entirely. For each patient with a positive margin or extraprostatic extension we determined whether these pathological characteristics would have been diagnosed had the specimen been examined by 3 partial sampling techniques. The Harrell concordance index was used to quantify the predictive performance of the Cox models based on the potential findings of the different sampling methods.Partial sampling methods 1 and 2, which included the examination of alternate slides, missed 13% to 21% of positive margins and 27% to 46% of extraprostatic extensions. The effect on biochemical recurrence-free survival of these undetected pathological features was similar to that of positive margins and extraprostatic extension that would have been diagnosed by corresponding techniques. Method 3, which sampled the entire posterior region, the mid anterior prostate and the rest of the ipsilateral anterior gland (if sizeable tumor was seen), detected 95% of positive margins and 94% of extraprostatic extensions. The extraprostatic extension missed by this method was not associated with a significant increase in the risk of biochemical recurrence. The Harrell concordance index of the multivariate models was 0.806, 0.797, 0.795 and 0.804 based on the results of complete sampling, and methods 1, 2 and 3, respectively.Examining alternate sections of prostatectomy specimen results in missing clinically important positive margins and extraprostatic extension. It decreases our ability to predict biochemical recurrence-free survival.
- Published
- 2013
45. Improving risk stratification in patients with prostate cancer managed by active surveillance: a nomogram predicting the risk of biopsy progression
- Author
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Viacheslav Iremashvili, Joshua Burdick-Will, and Mark S. Soloway
- Subjects
Oncology ,medicine.medical_specialty ,Multivariate statistics ,Prostate biopsy ,medicine.diagnostic_test ,business.industry ,Urology ,Regression analysis ,Nomogram ,medicine.disease ,Surgery ,Prostate cancer ,Internal medicine ,Biopsy ,Cohort ,medicine ,In patient ,business - Abstract
Objective To develop a clinical tool that integrates different risk factors and provides individual predictions of the risk of biopsy progression in patients with prostate cancer managed by active surveillance. Materials and Methods Our analysis included 205 patients on active surveillance, each of whom had had at least two surveillance biopsies. We used the Cox proportional hazard regression model to analyse the association between different risk factors and progression-free survival over successive biopsies. This multivariate model was then used to develop a nomogram. Discrimination and calibration of the nomogram were internally validated using 200 bootstrap resamplings. Results The median follow-up of patients free of progression was 4.6 years. A total of 58 (28%) patients experienced progression. Factors significantly associated with progression were: overall number of positive cores in the diagnostic and first surveillance biopsies, race and prostate-specific antigen density. The bootstrapping concordance index of the nomogram including these variables was 81%. The nomogram tended to underestimate the probability of progression but it identified fairly accurately the distinct groups of patients at low, intermediate and high risk of progression. Conclusions In the development cohort, the nomogram was able to separate patients with respect to their risk of biopsy progression. Since accurate risk stratification is essential to optimize patient care, this tool, if external validation confirms its performance, may prove useful for both the counselling and management of patients with low-volume, Gleason 6 prostate cancer.
- Published
- 2013
46. Partial Sampling of Radical Prostatectomy Specimens
- Author
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Murugesan Manoharan, Mark S. Soloway, Soum D. Lokeshwar, Saleem A. Umar, Merce Jorda, Viacheslav Iremashvili, and Liset Pelaez
- Subjects
Male ,medicine.medical_specialty ,medicine.medical_treatment ,Adenocarcinoma ,Specimen Handling ,Pathology and Forensic Medicine ,Prostate cancer ,Prostate ,medicine ,Positive Margins ,Humans ,Neoplasm Invasiveness ,In patient ,Extraprostatic extension ,Aged ,Prostatectomy ,Tissue Embedding ,Positive margin ,business.industry ,Prostatic Neoplasms ,Sampling (statistics) ,Organ Size ,Middle Aged ,medicine.disease ,Surgery ,medicine.anatomical_structure ,Radiology ,Anatomy ,business - Abstract
Currently there is no global agreement as to how ex- tensively a radical prostatectomy specimen should be sectioned and histologically examined. We analyzed the ability of different methods of partial sampling in detecting positive margin (PM) and extraprostatic extension (EPE)—2 pathologic features of prostate cancer that are most easily missed by partial sampling of the prostate. Radical prostatectomy specimens from 617 pa- tients treated with open radical prostatectomy between 1992 and 2011 were analyzed. Examination of the entirely submitted prostate detected only PM in 370 (60%), only EPE in 100 (16%), and both in 147 (24%) specimens. We determined whether these pathologic features would have been diagnosed had the examination of the specimen been limited only to al- ternate sections (method 1), alternate sections representing the posterior aspect of the gland in addition to one of the mid- anterior aspects (method 2), and every section representing the posterior aspect of the gland in addition to one of the mid- anterior aspects, supplemented by the remaining ipsilateral an- terior sections if a sizeable tumor is seen (method 3). Methods 1 and 2 missed 13% and 21% of PMs and 28% and 47% of EPEs, respectively. Method 3 demonstrated better results missing only 5% of PMs and 7% of EPEs. Partial sampling techniques missed slightly more PMs and EPEs in patients with low-risk to intermediate-risk prostate cancer, although even in high-risk cases none of the methods detected all of the studied aggressive pathologic features.
- Published
- 2013
47. ICUD-EAU International Consultation on Bladder Cancer 2012: Urothelial Carcinoma of the Prostate
- Author
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Bernard H. Bochner, Ofer Yossepowitch, Mark S. Soloway, Henk G. van der Poel, Hikmat Al-Ahmadie, David P. Wood, Juan Palou, and Lawrence C. Jenkins
- Subjects
Male ,medicine.medical_specialty ,Biopsy ,Urology ,medicine.medical_treatment ,Antineoplastic Agents ,Cystectomy ,Predictive Value of Tests ,Prostatic urethra ,Prostate ,medicine ,Carcinoma ,Humans ,Neoplasm Invasiveness ,Transurethral resection of the prostate ,Bladder cancer ,medicine.diagnostic_test ,business.industry ,Carcinoma in situ ,Transurethral Resection of Prostate ,Prostatic Neoplasms ,Endoscopy ,medicine.disease ,Transurethral biopsy ,Administration, Intravesical ,Treatment Outcome ,medicine.anatomical_structure ,Urinary Bladder Neoplasms ,Chemotherapy, Adjuvant ,BCG Vaccine ,Neoplasm Grading ,Urothelium ,business - Abstract
Context The Second International Consultation on Bladder Cancer recommendations on urothelial carcinoma (UC) of the prostate were presented at the 2011 European Association of Urology Congress in Vienna, Austria, on March 18, 2011. Objective Our aim is to summarize the Second International Consultation on Bladder Cancer recommendations on UC of the prostate to help clinicians assess the current evidence-based management. Evidence acquisition The committee performed a thorough review of new data and updated previous recommendations. Levels of evidence and grades of recommendation were assigned based on a systematic review of the literature that included a search of online databases and review articles. Evidence synthesis Once a non–muscle-invasive high-grade tumor or carcinoma in situ (CIS) of the bladder has been diagnosed, careful follow-up of the prostatic urethra is necessary. Noninvasive UC including CIS of the prostate should be treated with intravesical bacillus Calmette-Guerin (BCG) following endoscopic resection. A transurethral resection of the prostate may improve contact of BCG with the prostatic urethra, and it appears that response rates to BCG are increased (level of evidence: 3). Transurethral biopsy of the prostatic urethra is effective in identifying prostatic involvement but may not accurately reveal the extent of involvement, particularly with stromal invasion. Stromal invasion by UC of the prostate carries a poor prognosis. Radical cystoprostatectomy is the treatment of choice for locoregional control in patients with prostatic stromal invasion. Conclusions These recommendations contain updated information on the diagnosis and treatment of UC of the prostate. However, prospective trials are needed to further elucidate the best management of these patients.
- Published
- 2013
48. ICUD-EAU International Consultation on Bladder Cancer 2012: Radical Cystectomy and Bladder Preservation for Muscle-Invasive Urothelial Carcinoma of the Bladder
- Author
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Jason A. Efstathiou, Kirk A. Keegan, Arthur I. Sagaloswky, Michael S. Cookson, Axel Heidenreich, Khurshid A. Guru, William U. Shipley, Mark S. Soloway, Georgios Gakis, Mark P. Schoenberg, Arnulf Stenzl, and Seth P. Lerner
- Subjects
Male ,Laparoscopic surgery ,medicine.medical_specialty ,Urology ,medicine.medical_treatment ,Context (language use) ,Cystectomy ,Humans ,Medicine ,Neoplasm Invasiveness ,Bladder cancer ,business.industry ,Standard treatment ,Carcinoma ,Chemoradiotherapy ,Perioperative ,medicine.disease ,Surgery ,Treatment Outcome ,Urethra ,medicine.anatomical_structure ,Urinary Bladder Neoplasms ,Disease Progression ,Lymph Node Excision ,Female ,Laparoscopy ,Lymphadenectomy ,Neoplasm Recurrence, Local ,Urothelium ,business ,Organ Sparing Treatments - Abstract
Context New guidelines of the International Consultation on Urological Diseases for the treatment of muscle-invasive bladder cancer (MIBC) have recently been published. Objective To provide a comprehensive overview of the current role of radical cystectomy (RC) in MIBC. Evidence acquisition A detailed Medline analysis was performed for original articles addressing the role of RC with regard to indication, timing, surgical extent, perioperative morbidity, oncologic outcome, and follow-up. The analysis also included radiation-based bladder-preserving strategies. Evidence synthesis The major findings are presented in an evidence-based fashion and are based on large retrospective unicenter and multicenter series with some prospective data. Conclusions Open RC is the standard treatment for locoregional control of MIBC. Delay of RC is associated with reduced cancer-specific survival. In males, standard RC includes the removal of the bladder, prostate, seminal vesicles, and distal ureters; in females, RC includes an anterior pelvic exenteration including the bladder, entire urethra and adjacent vagina, uterus, and distal ureters. A procedure sparing the urethra and the urethra-supplying autonomous nerves can be performed in case of a planned orthotopic neobladder. Further technical variations (ie, seminal-sparing or vaginal-sparing techniques) aimed at improving functional outcomes must be weighed against the risk of a positive margin. Laparoscopic surgery is promising, but long-term data are required prior to accepting it as an option equivalent to the open procedure. Lymphadenectomy should remove all lymphatic tissue around the common iliac, external iliac, internal iliac, and obturator region bilaterally. Complications after RC should be reported according to the modified Clavien grading system. In selected patients with MIBC, bladder-preserving therapy with cystectomy reserved for tumor recurrence represents a safe and effective alternative to immediate RC.
- Published
- 2013
49. ICUD-EAU International Consultation on Bladder Cancer 2012: Non–Muscle-Invasive Urothelial Carcinoma of the Bladder
- Author
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Christopher Cheng, Maurizio Brausi, Paul Sved, Colin P.N. Dinney, Marko Babjuk, Joachim Thürof, Raj S. Pruthi, Mark S. Soloway, J. Alfred Witjes, Sam S. Chang, Wolfgang Otto, Sigurdur Gudjonsson, Jay B. Shah, Badrinath R. Konety, Eduardo Solsona, Eva Comperat, Willem Oosterlinck, and Maximilian Burger
- Subjects
medicine.medical_specialty ,Urology ,medicine.medical_treatment ,MEDLINE ,Antineoplastic Agents ,Context (language use) ,Aetiology, screening and detection [ONCOL 5] ,Cystectomy ,Quality of Care [ONCOL 4] ,Molecular epidemiology [NCEBP 1] ,Translational research [ONCOL 3] ,medicine ,Humans ,Neoplasm Invasiveness ,Prospective cohort study ,Neoplasm Staging ,Bladder cancer ,medicine.diagnostic_test ,business.industry ,General surgery ,Carcinoma in situ ,Cystoscopy ,medicine.disease ,Administration, Intravesical ,Treatment Outcome ,Urinary Bladder Neoplasms ,BCG Vaccine ,Disease Progression ,Neoplasm Grading ,Neoplasm Recurrence, Local ,Urothelium ,business ,Intravesical chemotherapy ,Carcinoma in Situ - Abstract
Item does not contain fulltext CONTEXT: Our aim was to present a summary of the Second International Consultation on Bladder Cancer recommendations on the diagnosis and treatment options for non-muscle-invasive urothelial cancer of the bladder (NMIBC) using an evidence-based approach. OBJECTIVE: To critically review the recent data on the management of NMIBC to arrive at a general consensus. EVIDENCE ACQUISITION: A detailed Medline analysis was performed for original articles addressing the treatment of NMIBC with regard to diagnosis, surgery, intravesical chemotherapy, and follow-up. Proceedings from the last 5 yr of major conferences were also searched. EVIDENCE SYNTHESIS: The major findings are presented in an evidence-based fashion. We analyzed large retrospective and prospective studies. CONCLUSIONS: Urothelial cancer of the bladder staged Ta, T1, and carcinoma in situ (CIS), also indicated as NMIBC, poses greatly varying but uniformly demanding challenges to urologic care. On the one hand, the high recurrence rate and low progression rate with Ta low-grade demand risk-adapted treatment and surveillance to provide thorough care while minimizing treatment-related burden. On the other hand, the propensity of Ta high-grade, T1, and CIS to progress demands intense care and timely consideration of radical cystectomy.
- Published
- 2013
50. ICUD-EAU International Consultation on Bladder Cancer 2012: Pathology
- Author
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Mahul B. Amin, Mark S. Soloway, Gladell P. Paner, David J. Grignon, Merce Jorda, Rodolfo Montironi, Donna E. Hansel, Jonathan I. Epstein, Oscar Lin, Victor E. Reuter, Jesse K. McKenney, and Lawrence C. Jenkins
- Subjects
Pathology ,medicine.medical_specialty ,Biopsy ,Urology ,MEDLINE ,Prospective data ,Context (language use) ,urologic and male genital diseases ,Predictive Value of Tests ,Biomarkers, Tumor ,medicine ,Carcinoma ,Humans ,Interdisciplinary communication ,Cooperative Behavior ,Pathology, Molecular ,Neoplasm Staging ,Urothelial carcinoma ,Pathology, Clinical ,Bladder cancer ,business.industry ,Prognosis ,medicine.disease ,Immunohistochemistry ,female genital diseases and pregnancy complications ,Urinary Bladder Neoplasms ,Interdisciplinary Communication ,Urothelium ,business ,Evidence synthesis - Abstract
Context To present a summary of the 2nd International Consultation on Bladder Cancer recommendations on the pathology of bladder cancer using an evidence-based strategy. Objective To standardize descriptions of the diagnosis and reporting of urothelial carcinoma of the bladder and help optimize uniformity between individual pathology practices and institutions. Evidence acquisition A detailed Medline analysis was performed for original articles addressing bladder cancer with regard to pathology. Proceedings from the last 5 yr of major conferences were also searched. Evidence synthesis The major findings are presented in an evidence-based fashion. Large retrospective and prospective data were analyzed. Conclusions Providing the best management for patients with bladder neoplasia relies on close cooperation and teamwork among urologists, oncologists, radiologists, and pathologists.
- Published
- 2013
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