Publications by authors named "Roger Li"
Oncologic Outcomes of Sequential Intravesical Gemcitabine and Docetaxel Compared with Bacillus Calmette-Guérin in Patients with Bacillus Calmette-Guérin-Unresponsive Non-Muscle Invasive Bladder Cancer.
Eur Urol Oncol
December 2024
Background And Objective: Non-muscle-invasive bladder cancer (NMIBC) patients treated with additional bacillus Calmette-Guérin (BCG) may become unresponsive to BCG. Recently, sequential intravesical gemcitabine and docetaxel (gem/doce) are being used for NMIBC. This study aims to compare oncologic outcomes between sequential intravesical gem/doce versus additional BCG in patients with BCG-unresponsive NMIBC.
View Article and Find Full Text PDFObjectives: To determine whether the area deprivation index (ADI), a surrogate for socioeconomic status (SES) associated with patient residence, affected UTUC staging, recurrence rates, and mortality.
Methods: Patients undergoing radical nephroureterectomy or ureterectomy for UTUC at a single institution between February 2010 to August 2021 were classified by ADI. A 50 percentile cut-off of ADI classified patients as "advantaged" or "disadvantaged.
Article Synopsis
- Immunotherapy has enhanced survival rates for patients with advanced clear cell renal cell carcinoma (ccRCC), but many patients still develop resistance to treatment.
- A study examined tumor samples from patients with both treatment-naïve and treatment-exposed ccRCC, revealing that tumors exposed to immunotherapy contained more immune cells (like CD8+ T cells and neutrophils) and showed significant changes in cellular markers.
- Key findings included increased expression of COL4A1 and ITGAV in the stroma of treated tumors, suggesting a need for further investigation into how these changes impact the tumor immune environment and potential new therapies.
Article Synopsis
- Advances in molecular diagnostics are transforming how prostate, renal, and urothelial cancers are assessed, offering more accurate detection methods for disease burden and minimal residual disease (MRD).
- A literature review from 1980-2024 highlights emerging radiographic and molecular tools aimed at improving disease quantification and monitoring through innovative technologies and biomarker-informed trials.
- New developments, like novel radiotracers and molecular detection methods (e.g., circulating tumor DNA), provide insights into disease mechanisms and have the potential to enhance clinical management, although full MRD application is still in progress.
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 PDFArticle Synopsis
- The study aimed to evaluate a genomic classifier (GC) to identify a subgroup of bladder cancer patients with a favorable prognosis based on long non-coding RNA (lncRNA) profiles following radical cystectomy (RC).
- Researchers analyzed tumor samples from 226 patients and classified them into subtypes, with a focus on overall survival and cancer-specific mortality as key outcomes.
- Results indicated that patients with the luminal favorable subtype had significantly better survival rates and lower risks of cancer progression compared to others, supporting the GC's effectiveness in assessing tumor aggressiveness.
Predicting Response to Intravesical BCG in High-Risk NMIBC Using an Artificial Intelligence-Powered Pathology Assay: Development and Validation in an International 12-Center Cohort.
J Urol
October 2024
Article Synopsis
- Researchers created AI-based histologic assays to predict the likelihood of recurrence and progression in patients with high-risk non-muscle invasive bladder cancer after treatment with intravesical BCG.
- They analyzed whole-slide images from bladder tumor resections and clinical data from multiple centers, successfully categorizing cases into high or low risk for various outcomes.
- The validation cohort showed that high-risk patients had significantly worse survival outcomes, indicating that these AI assays provide crucial predictive information beyond traditional clinical factors.
Background And Objective: The 2024 US Food and Drug Administration approval of erdafitinib for the treatment of metastatic urothelial carcinoma (mUC) with FGFR3 alterations ushered in the era of targeted therapy for bladder cancer. In this review, we summarize the effects of FGFR pathway alterations in oncogenesis, clinical data supporting FGFR inhibitors in the management of bladder cancer, and the challenges that remain.
Methods: Original articles relevant to FGFR inhibitors in urothelial cancer between 1995 and 2024 were systematically identified in the PubMed and MEDLINE databases using the search terms "FGFR" and "bladder cancer".
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.
Article Synopsis
- - The study aimed to compare the cancer risks of bladder-sparing therapy (BST) versus radical cystectomy (RC) in patients with BCG-unresponsive non-muscle-invasive bladder cancer (NMIBC).
- - Data from 578 patients showed no significant differences in survival outcomes between the two treatment options, but the BST group had higher rates of high-grade recurrences and progressions to muscle-invasive bladder cancer (MIBC) over time.
- - The findings suggest that while BST and upfront RC provide similar survival rates in the intermediate term, patients receiving BST face increasing recurrence and progression risks, particularly with additional treatment attempts.
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.
Impact of Angiotensin Converting Enzyme Inhibitors on Pathologic Complete Response With Neoadjuvant Chemotherapy for Muscle Invasive Bladder Cancer.
Clin Genitourin Cancer
October 2024
Introduction: The renin-angiotensin system (RAS) has been demonstrated to modulate cell proliferation, desmoplasia, angiogenesis and immunosuppression. We examined the association of RAS inhibitors (RASi)-namely angiotensin converting enzyme inhibitors (ACEi) and angiotensin receptor blockers (ARB)-with neoadjuvant chemotherapy (NAC) for muscle-invasive bladder cancer (MIBC) preceding radical cystectomy (RC).
Patients And Methods: We retrospectively investigated concurrent RASi use with NAC prior to RC in 302 patients with MIBC from 3 academic institutions.
Cluster analysis of blood biomarkers to identify molecular patterns in pulmonary fibrosis: assessment of a multicentre, prospective, observational cohort with independent validation.
Lancet Respir Med
September 2024
Article Synopsis
- - The study investigates pulmonary fibrosis, a condition where lung tissue becomes damaged, by classifying patients based on blood biomarkers to identify different disease types, or endotypes.
- - Researchers used data from the PROFILE study, involving a group of UK patients, to perform cluster analysis and measure 13 specific blood biomarkers related to lung tissue health.
- - The analysis revealed three distinct patient clusters that correlate with different biomarker levels, providing insights into disease patterns and their associations with mortality and lung function decline.
Purpose Of Review: In contemporary urological practice, managing rare genitourinary (GU) malignancies presents significant challenges, necessitating a comprehensive understanding of their unique characteristics and tailored treatment approaches.
Recent Findings: Rare GU malignancies, whether per se, variants of common histologies, or common tumors in uncommon locations, often lack widely available clinical guidelines. Consequently, treatment decisions are frequently based on empirical evidence, risking suboptimal outcomes.
Cretostimogene grenadenorepvec is a serotype-5 oncolytic adenovirus designed to selectively replicate in cancer cells with retinoblastoma pathway alterations, previously tested as monotherapy in bacillus Calmette-Guérin (BCG)-experienced non-muscle-invasive bladder cancer. In this phase 2 study, we assessed the potential synergistic efficacy between intravesical cretostimogene and systemic pembrolizumab in patients with BCG-unresponsive non-muscle-invasive bladder cancer with carcinoma in situ (CIS). Thirty-five patients were treated with intravesical cretostimogene with systemic pembrolizumab.
View Article and Find Full Text PDFArticle Synopsis
- The review focuses on the emerging role of urinary tumor DNA (utDNA) in diagnosing, monitoring, and treating bladder cancer, emphasizing its potential for personalized care.
- Recent studies suggest that utDNA is a highly effective biomarker, particularly in the early stages of bladder cancer, offering better sensitivity and more detailed genetic insights compared to traditional methods like urine cytology.
- The promise of utDNA lies in its ability for non-invasive and real-time assessment of tumor biology, indicating that future clinical trials could transform how bladder cancer is managed and treated.
Playing two-dimensional video games has been shown to result in improvements in a range of visual and cognitive tasks, and these improvements appear to generalize widely. Here we report that young adults with healthy vision, surprisingly, showed a dramatic improvement in stereo vision after playing three-dimensional, but not two-dimensional, video games for a relatively short period of time. Intriguingly, neither group showed any significant improvement in binocular contrast sensitivity.
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