Outlook into the future of front-line immune checkpoint inhibition in metastatic urothelial carcinoma.

Immune checkpoint inhibition has been approved for front-line treatment of metastatic bladder cancer in patients who are cisplatin-ineligible and demonstrate programmed death-ligand 1 (PD-L1) positivity. This approval followed the positive results of IMvigor210 and KEYNOTE-052 studies. Immunotherapy has also demonstrated efficacy as maintenance therapy patients for patients who initially respond to platinum-based chemotherapy. Other studies have investigated combinations of immunotherapy with chemotherapy, combinations between immunotherapies, and immunotherapy with novel agents. Although these combinations have demonstrated promise, further investigation is necessary to optimize the patients who would benefit from these approaches. Biomarkers beyond PD-L1 scoring can help predict response and resistance to immune checkpoint inhibition and will be integral to future studies.

Buschke-Lowenstein Tumors: A Review and Proposed Classification System.

ABSTRACT: Buschke-Lowenstein (B-L) tumors or giant condylomata are large fungating lesions that are caused by human papillomavirus (HPV) and develop in the anogenital region. Although uncommon, physicians and surgeons who treat sexually transmitted diseases or other diseases involving the anogenital area will encounter these patients. The purpose of this study is to review the current literature regarding these lesions. We evaluated every published study in PubMed and Embase from 1925 to 2020, concentrating on the clinical data included in each report, such as presentation and treatment. We also evaluated each work for any definition used and found that there is no accepted definition for these lesions. As such, we provide an inclusive, workable definition. In addition, there are many misconceptions about B-L that continue to be propogated as more case reports are published every year. After evaluating every published case, we refute the fact that these lesions have a high mortality or a high malignancy rate. Furthermore, we refute that these lesions are synonymous with verrucous carcinoma. In addition to a definition, we also propose a simple grading system that we hope can be used to assist in the study and management of these patients moving forward. Although the literature is very heterogenous regarding B-L, they are caused by HPV and are distinct from verrucous carcinoma. Because of the majority of information is based on case reports, the literature concentrates on treatment, but more work is clearly needed to delineate the association with specific HPV types and optimal management of this disease.

Impact of family history on prostate cancer mortality in white men undergoing prostate specific antigen based screening.

PURPOSE: We assessed whether prostate cancer screening would decrease prostate cancer mortality in white men with a family history of prostate cancer. MATERIALS AND METHODS: Data from the PLCO cancer screening trial were used to compare the screening and usual care arms in the subset of men with and without a family history of prostate cancer. Univariate and multivariate Cox regression analysis, and log rank analysis of Kaplan-Meier curves were done to examine the data for differences in prostate cancer specific survival. RESULTS: A total of 65,179 white subjects were included in the prostate specific antigen screening trial, of whom 7,314 (11.2%) were diagnosed with prostate cancer. Only 4,833 white men (7.4%) had a family history of prostate cancer. Those with a positive family history had a significantly higher incidence of prostate cancer (16.9% vs 10.8%) and higher prostate cancer specific mortality (0.56% vs 0.37%, each p <0.01). On multivariate analysis this trended toward significance (HR 1.47, 95% CI 0.98-2.21, p = 0.06). Screening in men with a positive family history also showed a trend toward decreased prostate cancer specific mortality (HR 0.49, 95% CI 0.22-1.1, p = 0.08) and decreased time to death from prostate cancer (log rank p = 0.05). CONCLUSIONS: White men with a family history of prostate cancer are at increased risk for being diagnosed with and subsequently dying of prostate cancer. Yearly digital rectal examination and prostate specific antigen testing may decrease prostate cancer death in these individuals.