43 results match your criteria: "the Legorreta Cancer Center at Brown University[Affiliation]"

Navigating Management of Localized Prostate Cancer in the Geriatric Population.

Crit Rev Oncol Hematol

December 2024

The Minimally Invasive Urology Institute, The Miriam Hospital, Warren Alpert Medical School of Brown University, Providence, RI, US; Warren Alpert Medical School of Brown University, Providence, RI, US. Electronic address:

Prostate cancer (PCa) is highly prevalent among aging men and a significant contributor to global mortality. Balancing early detection and treatment of "clinically significant" disease with avoiding over-detection and overtreatment of slow-growing tumors is challenging, especially for elderly patients with competing health risks and potentially aggressive disease phenotypes. This review emphasizes the importance of individualized approaches for diagnosing and treating PCa in geriatric patients.

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Article Synopsis
  • - The study aimed to assess how pathologists report tumor content in prostate cancer biopsies and evaluate consistency among them using 10 standardized cases.
  • - A survey of 304 pathologists revealed that most report tumor extent as a percentage, but there is significant variability in how they calculate these percentages.
  • - The findings indicate high interobserver variability, especially with percentage reporting, suggesting that using absolute measures of tumor content could provide more consistent results for patient prognosis.
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Chronic prostate inflammation in patients with benign prostate hyperplasia (BPH) correlates with the severity of symptoms. How inflammation contributes to prostate enlargement and/or BPH symptoms and the underlying mechanisms remain unclear. In this study, we utilize a unique transgenic mouse model that mimics chronic non-bacterial prostatitis in men and investigate the impact of inflammation on androgen receptor (AR) in basal prostate stem cells (bPSC) and their differentiation in vivo.

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Article Synopsis
  • Synovial sarcoma (SS) is a rare type of cancer, primarily found in genitourinary tissues, commonly linked to the SS18::SSX gene fusion, and its paratesticular occurrence is extremely uncommon, with only 4 documented cases prior to this study.
  • This research details the characteristics and genetic profile of the largest cohort of paratesticular SS patients, analyzing data from 14 individuals aged 15 to 47, all of whom underwent surgical removal of the tumors and some received chemotherapy.
  • The findings indicate a generally poor prognosis for paratesticular SS even after aggressive treatment, emphasizing the need for thorough diagnostic methods to differentiate it from similar conditions, and supporting the use of SS18-SS
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Background: 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.

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Mesenchymal stem cells (MSCs) in tumor microenvironment (TME) are crucial for the initiation, development, and metastasis of cancer. The impact and mechanism of MSCs on bladder cancer are uncertain. Here we analyzed 205 patient samples to explore the relationships between tumor-stroma ratio and clinicopathological features.

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Genomic Profiling and Immune Phenotyping of Neuroendocrine Bladder Cancer.

Clin Cancer Res

November 2024

State Key Laboratory of Systems Medicine for Cancer, Department of Radiation Oncology, Department of Urology, Ren Ji Hospital, Shanghai Cancer Institute, Shanghai Jiao Tong University School of Medicine, Shanghai, China.

Article Synopsis
  • Neuroendocrine bladder cancer (NEBC) is challenging to treat, and there's a growing interest in using immunotherapy, but its immunogenic profiles are not well-studied.
  • A comprehensive analysis of NEBC using various methods (genomic, transcriptomic, and single-cell RNA sequencing) revealed it generally has an inactive immune environment, despite high mutation rates; however, some mixed types show immune activity that could influence prognosis.
  • Findings suggest that while immune checkpoint inhibitors alone are not very effective for NEBC, combining immunotherapy with chemotherapy may improve treatment responses and offer new pathways for reducing mortality.
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Article Synopsis
  • This study investigates the characteristics of 10 rare primary renal perivascular epithelioid cell tumors (PEComas) that have a specific genetic alteration (Xp11.2 translocation), focusing on their presentation and outcomes.
  • The patient group included both genders aged 14-65, with positive outcomes for most after surgical treatment, and showed consistent expression of certain markers (TFE3 being the most significant) while lacking others typically seen in similar tumors.
  • The findings reveal the genetic variety among these tumors, with unique TFE3 fusion partners identified, and emphasize the importance of TFE3 immunohistochemistry for diagnosis and differentiation from other kidney cancers.
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Pathologists have closely collaborated with clinicians, mainly urologists, to update the Gleason grading system to reflect the current practice and approach in prostate cancer diagnosis, prognosis, and treatment. This has led to the development of what is called patient advocacy and patient information. Ten common questions asked by patients to pathologists concerning PCa grading and the answers given by the latter are reported.

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Advancing the molecular understanding of renal tumorigenesis: Acquired cystic disease-associated renal cell carcinoma (ACD-RCC) as a model system.

Ann Diagn Pathol

December 2024

Department of Pathology and Laboratory Medicine, Department of Surgery (Urology), Brown University Warren Alpert Medical School, the Legorreta Cancer Center at Brown University, Brown University Health, Providence, RI, United States of America. Electronic address:

In summary, the study's investigation of KMT2C and TSC2 variants in ACD-RCC marks a significant advancement in comprehending this distinct kidney tumor. By illuminating the molecular landscape of ACD-RCC, the research sets the stage for future studies aimed at revealing the complex mechanisms driving tumor development and progression. This understanding could eventually lead to more effective management and treatment strategies for renal cancer patients.

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[Several key and difficult issues related to the grading of urothelial carcinoma of urinary bladder].

Zhonghua Bing Li Xue Za Zhi

August 2024

Department of Pathology and Laboratory Medicine, Department of Surgery (Urology), Brown University Warren Alpert Medical School, the Legorreta Cancer Center at Brown University, Providence, RI 02903, U S A.

Grading and staging are the most important prognostic factors for both non-invasive and invasive urothelial carcinomas, and are also one of the most common difficulties encountered by pathologists in the daily diagnostic practice of urothelial carcinoma. Recently, the International Society of Urological Pathology organized a survey and questionnaire conference on various issues related to the diagnosis, grading, and staging of urothelial carcinoma, and ultimately formed a series of consensus opinions. This article briefly summarizes the consensus opinions of this series, and combines them with the current pathological diagnosis status of urothelial carcinoma in China.

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Giant cell carcinoma of the urinary bladder : Clinicopathologic analysis and oncological outcomes.

Virchows Arch

September 2024

Department of Pathology and Laboratory Medicine, Department of Surgery/Urology, Warren Alpert Medical School of Brown University, Lifespan Health, and The Legorreta Cancer Center at Brown University, Providence, RI, USA.

Article Synopsis
  • The study analyzes 23 cases of giant cell urothelial carcinoma, a rare type of bladder cancer noted for its distinctive features classified by the World Health Organization.
  • Histologically, the tumors displayed a range of structures, often containing a significant giant cell component, alongside other types of differentiated cancers.
  • Patients diagnosed with this subtype had a higher incidence of advanced disease and showed differing survival rates compared to conventional urothelial carcinoma, suggesting a poorer prognosis overall.
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Comprehensive Characterization of Intraductal Oncocytic Papillary Neoplasm of the Pancreas: A Systematic and Critical Review.

Mod Pathol

September 2024

Section of Pathology, Department of Diagnostics and Public Health, University of Verona, Verona, Italy; ARC-Net Research Center, University of Verona, Verona, Italy. Electronic address:

Intraductal oncocytic papillary neoplasm (IOPN) of the pancreas is a recently recognized pancreatic tumor. Here, we aimed to determine its most essential features with the systematic review tool. PubMed, Scopus, and Embase were searched for studies reporting data on pancreatic IOPN.

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Applications of Artificial Intelligence in Prostate Cancer Care: A Path to Enhanced Efficiency and Outcomes.

Am Soc Clin Oncol Educ Book

June 2024

Department of Pathology and Laboratory Medicine, Department of Surgery (Urology), Brown University Warren Alpert Medical School, Lifespan Health, and the Legorreta Cancer Center at Brown University, Providence, RI.

The landscape of prostate cancer care has rapidly evolved. We have transitioned from the use of conventional imaging, radical surgeries, and single-agent androgen deprivation therapy to an era of advanced imaging, precision diagnostics, genomics, and targeted treatment options. Concurrently, the emergence of large language models (LLMs) has dramatically transformed the paradigm for artificial intelligence (AI).

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Harnessing artificial intelligence for prostate cancer management.

Cell Rep Med

April 2024

Department of Urology, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200127, China. Electronic address:

Prostate cancer (PCa) is a common malignancy in males. The pathology review of PCa is crucial for clinical decision-making, but traditional pathology review is labor intensive and subjective to some extent. Digital pathology and whole-slide imaging enable the application of artificial intelligence (AI) in pathology.

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Multimodal Approach in the Diagnosis of Urologic Malignancies: Critical Assessment of ChatGPT-4V's Image-Reading Capabilities.

JCO Clin Cancer Inform

April 2024

Lingxuan Zhu, MD, Department of Urology, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China, Department of Etiology and Carcinogenesis, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Changping Laboratory, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China; Yancheng Lai, MD, The First Clinical Medical School, Southern Medical University, Guangdong, China; Na Ta, MD, Department of Pathology, Shanghai Changhai Hospital, Naval Medical University, Shanghai, China; Liang Cheng, MD, Department of Pathology and Laboratory Medicine, Department of Surgery (Urology), Brown University Warren Alpert Medical School, Lifespan Health, and the Legorreta Cancer Center at Brown University, Providence, RI; and Rui Chen, MD, Department of Urology, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.

ChatGPT-4V model with image interpretation tested for distinguishing kidney & prostate tumors from normal tissue.

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Assessing programmed death ligand 1 (PD-L1) expression on tumor cells (TCs) using Food and Drug Administration-approved, validated immunoassays can guide the use of immune checkpoint inhibitor (ICI) therapy in cancer treatment. However, substantial interobserver variability has been reported using these immunoassays. Artificial intelligence (AI) has the potential to accurately measure biomarker expression in tissue samples, but its reliability and comparability to standard manual scoring remain to be evaluated.

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Ductal, intraductal, and cribriform carcinoma of the prostate: Molecular characteristics and clinical management.

Urol Oncol

May 2024

Department of Pathology and Laboratory Medicine, Department of Surgery (Urology), Brown University Warren Alpert Medical School, Lifespan Health, and the Legorreta Cancer Center at Brown University, Providence, RI, USA. Electronic address:

Prostatic acinar adenocarcinoma accounts for approximately 95% of prostate cancer (CaP) cases. The remaining 5% of histologic subtypes of CaP are known to be more aggressive and have recently garnered substantial attention. These histologic subtypes - namely, prostatic ductal adenocarcinoma (PDA), intraductal carcinoma of the prostate (IDC-P), and cribriform carcinoma of the prostate (CC-P) - typically exhibit distinct growth characteristics, genomic features, and unique oncologic outcomes.

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TROP-2, NECTIN-4 and predictive biomarkers in sarcomatoid and rhabdoid bladder urothelial carcinoma.

Pathologica

February 2024

Medical and Translational Oncology, Department of Oncology, Azienda Ospedaliera S. Maria, Terni, Italy.

Article Synopsis
  • This study investigates the expression of TROP-2 and NECTIN-4 in undifferentiated bladder urothelial carcinoma (BUC), specifically focusing on sarcomatoid and rhabdoid subtypes, which are less understood compared to common forms of BUC.
  • Out of 35 undifferentiated BUC cases, TROP-2 was expressed in 20% and NECTIN-4 in 29%, with various other biomarkers such as HER-2 and PD-L1 also evaluated, showing diverse expression rates across cases.
  • The findings suggest that while TROP-2 and NECTIN-4 can be present in some sarcomato
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Characterizing the Genomic Landscape of the Micropapillary Subtype of Urothelial Carcinoma of the Bladder Harboring Activating Extracellular Mutations of ERBB2.

Mod Pathol

March 2024

Department of Pathology and Laboratory Medicine, The Warren Albert Medical School of Brown University, Lifespan Academic Medical Center, and the Legorreta Cancer Center at Brown University, Providence, Rhode Island. Electronic address:

Article Synopsis
  • The micropapillary subtype of urothelial carcinoma (MPUC) is a highly aggressive form of bladder cancer, often linked to specific mutations in the ERBB2 gene, particularly in the extracellular domain (ECD).
  • In a study analyzing 5,485 bladder cancer cases, researchers found that 63 out of 219 ERBB2 ECD-mutated cases were MPUC, with notable co-alterations in genes like TERT, TP53, and ARID1A.
  • Key differences in MPUC included lower KMT2D and higher RB1 mutation rates, which may help in developing prognostic and predictive biomarkers for treatment response and tumor behavior.
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Predictive and prognostic biomarkers in urological tumours.

Pathology

March 2024

The Legorreta Cancer Center at Brown University, Department of Pathology and Laboratory Medicine, Warren Alpert Medical School of Brown University, Lifespan Academic Medical Center, Providence, RI, USA. Electronic address:

Advancements in cutting-edge molecular profiling techniques, such as next-generation sequencing and bioinformatic analytic tools, have allowed researchers to examine tumour biology in detail and stratify patients based on factors linked with clinical outcome and response to therapy. This manuscript highlights the most relevant prognostic and predictive biomarkers in kidney, bladder, prostate and testicular cancers with recognised impact in clinical practice. In bladder and prostate cancer, new genetic acquisitions concerning the biology of tumours have modified the therapeutic scenario and led to the approval of target directed therapies, increasing the quality of patient care.

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Primary mucinous adenocarcinoma of the urethra: A clinicopathological analysis of 35 cases.

Histopathology

April 2024

Department of Pathology and Laboratory Medicine, Brown University Warren Alpert Medical School, Lifespan Academic Medical Center and the Legorreta Cancer Center at Brown University, Providence, RI, USA.

Aim: Primary mucinous adenocarcinoma of the urethra represents an extremely rare entity. We sought to characterise further these tumours' clinicopathological, immunohistochemical and molecular features.

Methods And Results: Thirty-five cases were identified, occurring in 18 males and 17 females.

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"Shared decision-making" for prostate cancer screening: Is it a marker of quality preventative healthcare?

Cancer Epidemiol

February 2024

The Minimally Invasive Urology Institute at The Miriam Hospital, Division of Urology, Lifespan Academic Medical Center, the Legorreta Cancer Center at Brown University, Warren Alpert Medical School of Brown University, Providence, RI 02906, United States.

Background: "Shared decision-making" (SDM) is a cornerstone of prostate cancer (PCa) screening guidelines due to tradeoffs between clinical benefits and concerns for over-diagnosis and over-treatment. SDM requires effort by primary-care-providers (PCP) in an often busy clinical setting to understand patient preferences with the backdrop of patient risk factors. We hypothesized that SDM for PCa screening, given its prominence in guidelines and practical challenges, may be associated with quality preventative healthcare in terms of other appropriate cancer screening and encouragement of other preventative health behaviors.

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Evolution of the HIF targeted therapy in clear cell renal cell carcinoma.

Cancer Treat Rev

December 2023

Lifespan Cancer Institute, Department of Hematology and Oncology, The Miriam Hospital, Lifespan Academic Medical Center, The Legorreta Cancer Center at Brown University, Warren Alpert Medical School of Brown University, Providence, RI 02906, United States.

Clear cell renal cell carcinoma (ccRCC) is the most common type of kidney cancer, affecting hundreds of thousands of people worldwide and can affect people of any age. The pathogenesis of ccRCC is most commonly due to biallelic loss of the tumor suppressor gene VHL. VHL is the recognition subunit of an E3-ubiquitin-ligase-complex essential for degradation of the hypoxia-inducible factors (HIF) 1α and 2α.

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Article Synopsis
  • Advanced bladder squamous cell carcinoma (aBSCC) is a rare type of bladder cancer, and researchers studied its genomic alterations (GAs) in relation to human papilloma virus (HPV) status.
  • Out of 171 aBSCC samples analyzed, 11 (6.4%) were HPV-positive, predominantly affecting younger women, with significant differences in genomic alterations between HPV+ and HPV- tumors, particularly in mutations related to tumor suppressor genes.
  • Notably, markers associated with immunotherapy did not show significant differences between the two groups, and the absence of MTAP loss in HPV+ cases indicates a potential divergence in treatment options.
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