Publications by authors named "Philippe Spiess"
Renal cell carcinoma (RCC) is a heterogeneous disease that represents the most common type of kidney cancer. The classification of RCC is primarily based on distinct morphological and molecular characteristics, with two broad categories: clear cell RCC (ccRCC) and non-clear cell RCC (nccRCC). Clear cell RCC is the predominant subtype, representing about 70-80% of all RCC cases, while non-clear cell subtypes collectively make up the remaining 20-30%.
View Article and Find Full Text PDFObjectives: To evaluate the benefit of neoadjuvant chemotherapy (NAC) for patients with high-risk upper tract urothelial carcinoma (UTUC) using a large, well-curated multi-institutional database.
Patients And Methods: This study was a multi-institutional retrospective analysis conducted by the UTUC Collaborative Network (UCAN), combining data from 2276 patients with UTUC who underwent radical nephroureterectomy at seven high-volume tertiary care centres in the United States. The UCAN data were analysed to evaluate the impact of response to NAC on survival outcomes in patients with UTUC.
Background: HPV infection is implicated in approximately half of global penile squamous cell carcinoma (PSCC) cases. Previous studies on HPV DNA and p16INK4a status in PSCC have yielded inconclusive prognostic findings. This meta-analysis aims to elucidate the prognostic role of HPV in PSCC by pooling data on disease-free survival (DFS), disease-specific survival (DSS), and overall survival (OS).
View Article and Find Full Text PDFIntroduction: Utilization of neoadjuvant systemic therapy (NAT) prior to radical nephroureterectomy (RNU) for upper tract urothelial carcinoma (UTUC) is inconsistent, and optimal patient selection for NAT is unclear. The purpose of this study was to evaluate the clinical benefit of NAT in high grade UTUC undergoing RNU.
Materials And Methods: The UTUC Collaborative Network (UCAN) identified patients who underwent RNU for high grade UTUC between 2000 and 2022.
Background: The purpose of this study was to evaluate the efficacy and safety of PD-1 blockade combined with cisplatin and paclitaxel (TP)-based chemotherapy as first-line treatment for advanced penile squamous cell carcinoma (PSCC).
Patients And Methods: A retrospective review was performed of 32 eligible patients with high-risk stage IV (cN3M0-1) PSCC who received first-line PD-1 blockade combined with TP-based chemotherapy at 5 medical centers (2019-2023). Clinical responses were assessed using RECIST version 1.
Article Synopsis
- The study aimed to explore the impact of socioeconomic status (SES) on the progression and outcomes of upper tract urothelial carcinoma (UTUC) in patients.
- The research involved classifying 432 patients undergoing surgery for UTUC into "advantaged" and "disadvantaged" groups based on their area deprivation index (ADI), with comparisons made on treatment and survival outcomes.
- Findings indicated no significant differences in tumor characteristics, recurrence-free survival (RFS), or overall survival (OS) between SES groups, suggesting improved healthcare access and management strategies may benefit disadvantaged patients.
Article Synopsis
- - The study investigates the expression of nectin-4 (N4) in various genitourinary (GU) cancers, particularly focusing on its relevance as a potential target for antibody-drug conjugates, given its aberrant expression in malignancies like urothelial carcinoma of the bladder (UBC).
- - A systematic review analyzed 25 studies on N4 positivity across different GU tumors, finding that N4 positivity is generally higher in bladder cancers, especially in metastatic and non-muscle-invasive stages, compared to other types like upper tract urothelial carcinoma and non-urothelial cancers.
- - The findings suggest that non-urothelial malignancies have lower rates of N4 positivity compared to bladder cancer,
Article Synopsis
- - Testicular germ cell tumors (TGCTs) are rare but their incidence is rising globally, with varying rates across different regions and ethnicities. This review examines the changing patterns and identifies risk factors associated with TGCT.
- - The research included a systematic review of 53 reports, revealing that genetic predisposition accounts for about 44% of TGCT heritability, as well as various risk factors like in utero chemical exposure and behavioral issues such as marijuana use.
- - Conclusions suggest that the increase in TGCT cases may be linked to socioeconomic changes and migration, necessitating further research and better screening programs to address the rising incidence.
Purpose Of Review: The purpose of this review is to summarize the most recent evidence on surgical management, strategies to reduce tumor recurrence, and surveillance regimens in patients diagnosed with upper tract urothelial carcinoma (UTUC) and elected for radical treatment.
Recent Findings: Minimally invasive surgery is gaining momentum in the surgical management of UTUC. Chemoprophylaxis is still the gold standard to reduce intravesical recurrence after radical nephroureterectomy (RNU).
There is a critical unmet need for safe and efficacious neoadjuvant treatment for cisplatin-ineligible patients with muscle-invasive bladder cancer. Here we launched a phase 1b study using the combination of intravesical cretostimogene grenadenorepvec (oncolytic serotype 5 adenovirus encoding granulocyte-macrophage colony-stimulating factor) with systemic nivolumab in cisplatin-ineligible patients with cT2-4aN0-1M0 muscle-invasive bladder cancer. The primary objective was to measure safety, and the secondary objective was to assess the anti-tumor efficacy as measured by pathologic complete response along with 1-year recurrence-free survival.
View Article and Find Full Text PDFBackground: Tumors harboring two or more PIK3CA short variant (SV) ("multi-hit") mutations have been linked to improved outcomes with anti-PIK3CA-targeted therapies in breast cancer. The landscape and clinical implications of multi-hit PIK3CA alterations in clinically advanced prostate cancer (CAPC) remains elusive.
Objective: To evaluate the genomic landscape of single-hit and multi-hit PIK3CA genomic alterations in CAPC.
Article Synopsis
- Neuroendocrine carcinoma of the bladder (NEC-bladder) is a rare and aggressive cancer, and the study focused on patients treated between 2001-2021 to assess treatment outcomes.
- The research found that most patients received neoadjuvant chemotherapy (NAC), and higher rates of pathologic complete response (pCR) and downstaging were associated with improved progression-free and overall survival (PFS and OS).
- Key findings indicated that achieving ypN0 status (negative nodes post-treatment) correlated with better long-term survival, while the presence of nodal involvement (pN+) was linked to poorer outcomes.
Penile cancer (PC) is a rare malignancy predominantly of squamous cell origin. Approximately 40% of penile tumors are associated with human papillomavirus (HPV) infection. Diagnosing PC remains challenging due to its rarity and variety of clinical presentations.
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- The diagnosis of occult inguinal lymph node metastasis in invasive penile squamous cell carcinoma (PSCC) is difficult and has high surgical complications.
- Recent advances in dynamic sentinel lymph node biopsy (DSLNB) show better diagnostic accuracy and fewer complications than traditional methods, but its use is still limited.
- Laparoscopic and robotic-assisted inguinal lymph node dissection (ILND) offer alternative approaches that reduce infection and pain, yet variations in treatment remain due to the rarity of PSCC and lack of large-scale studies.
Molecular characterization of metastatic penile squamous cell carcinoma in developing countries and its impact on clinical outcomes: LACOG 2018 translational study.
Oncologist
September 2024
Article Synopsis
- Penile squamous cell carcinoma (PSCC) is a rare cancer, more prevalent in developing countries, and understanding its molecular changes can help in finding better treatments.
- A study of 23 Brazilian mPSCC patients revealed that most had clinically significant genomic alterations, with high PD-L1 expression in 63.6% of cases and specific mutations linked to worse survival rates.
- The findings indicate similar molecular characteristics between developing and developed countries, highlighting potential for targeted therapies, despite the lack of predictive biomarkers for immunotherapy like TMB high or MSI.
Article Synopsis
- There has been an increase in agents for treating bacillus Calmette-Guérin-unresponsive (BCG-U) non-muscle-invasive bladder cancer (NMIBC), and there is a pressing need for patient and therapy selection guidelines due to a lack of randomized trials.
- A global expert committee developed recommendations through literature reviews and a voting process, refining these guidelines during a live meeting in August 2023, achieving over 75% agreement on the final recommendations.
- No single optimal treatment exists for BCG-U patients; personalized treatment based on individual preferences, tumor characteristics, and available agent data is essential, with specific options recommended for carcinoma in situ and papillary-only tumors, and clinical trial participation encouraged.
Purpose: Although both urachal (U) and nonurachal (NU) bladder adenocarcinomas (adenoCas) share several histologic similarities, they differ in location and sometimes in therapeutic options. We analyzed the differences in genomic alterations (GAs) between these tumor entities, with the aim of identifying potential therapeutic targets for clinical trials.
Materials And Methods: Overall, 133 U and 328 NU adenoCas were analyzed.
Article Synopsis
- There is limited data on how often testicular germ cell tumors (TGCT) occur alongside venous tumor thrombus (VTT), and the study aims to provide insights on this rare condition and its management.
- Researchers analyzed records from the IBM Marketscan database, identifying a small prevalence of TGCT with VTT and gathered expert insights from surgeons on the patient management practices at multiple centers.
- Findings showed that approximately 0.3% to 3.1% of TGCT cases involved VTT, with surgical options being the primary treatment, emphasizing the complexity of managing this combination and the need for a multidisciplinary approach.
Urologic cancers are among the leading causes of morbidity and mortality in the world, representing more than 10% of the total number of new cancer cases worldwide. These complex diseases are linked to several issues related to their diagnosis, management, monitoring, and treatment - issues that require multidisciplinary solutions that encompass and manage patients as complex entities. In response to this, the so-called cancer centers of excellence (CCEs) emerged, defined as multidisciplinary institutions specialized in the diagnosis, management, monitoring, and treatment of specific diseases, including cancer.
View Article and Find Full Text PDFFeasibility of a Smartphone Application for Education and Symptom Management of Patients With Renal Cell Carcinoma on Combined Tyrosine Kinase and Immune Checkpoint Inhibitors.
JCO Clin Cancer Inform
July 2024
Purpose: Patients with advanced renal cell carcinoma (RCC) face significant challenges, stemming both from the complexities of the disease itself and the adverse effects of treatments. This study evaluated the feasibility and acceptability of a mobile health (mHealth) application tailored for education and symptom management of patients with advanced RCC receiving combined immune checkpoint inhibitor and tyrosine kinase inhibitor (ICI-TKI) therapy.
Methods: The primary end points were acceptability and feasibility.
Article Synopsis
- This review discusses the role of radiotherapy as a treatment option for squamous cell carcinoma of the penis, emphasizing its effectiveness in preserving organs while managing tumors.
- Research indicates that radiotherapy can achieve tumor control rates similar to those of radical surgery, with specific techniques like brachytherapy showing high long-term survival rates, especially for smaller tumors.
- The findings suggest that brachytherapy is generally the preferred approach, but it comes with some risks of side effects; thus, close collaboration among healthcare professionals is crucial for patient management and outcomes.
Background: Inguinal lymph node dissection plays an important role in the management of melanoma, penile and vulval cancer. Inguinal lymph node dissection is associated with various intraoperative and postoperative complications with significant heterogeneity in classification and reporting. This lack of standardization challenges efforts to study and report inguinal lymph node dissection outcomes.
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