Antibody-Drug Conjugates in Uro-Oncology.

Currently available treatment options for patients with refractory metastatic prostate, bladder, or kidney cancers are limited with the prognosis remaining poor. Advances in the pathobiology of tumors has led to the discovery of cancer antigens that may be used as the target for cancer treatment. Antibody-drug conjugates (ADCs) are a relatively new concept in cancer treatment that broaden therapeutic landscape. ADCs are examples of a 'drug delivery into the tumor' system composed of an antigen-directed antibody linked to a cytotoxic drug that may release cytotoxic components after binding to the antigen located on the surface of tumor cells. The clinical properties of drugs are influenced by every component of ADCs. Regarding uro-oncology, enfortumab vedotin (EV) and sacituzumab govitecan (SG) are currently registered for patients with locally advanced or metastatic urothelial cancer following previous treatment with an immune checkpoint inhibitor (iCPI; programmed death receptor-1 [PD-1] or programmed death-ligand 1 [PD-L1]) inhibitor) and platinum-containing chemotherapy. The EV-301 trial showed that EV significantly prolonged the overall survival compared with classic chemotherapy. The TROPHY-U-01 trial conducted to evaluate SG demonstrated promising results as regards the objective response rate and duration of response. The safety and efficacy of ADCs in monotherapy and polytherapy (mainly with iCPIs) for different cancer stages and tumor types are assessed in numerous ongoing clinical trials. The aim of this review is to present new molecular biomarkers, specific mechanisms of action, and ongoing clinical trials of ADCs in genitourinary cancers. In the expert discussion, we assess the place of ADCs in uro-oncology and discuss their clinical value.

Prophphylactic bilateral salpingngectomy: why is it worthwhile?

Malignant tumors of the ovary are characterized by late detection which is the chief factor responsible for their poor prognosis. Almost 70% of ovarian cancers are diagnosed at clinical stage III or IV. At present, effective methods for early detection of ovarian cancer are lacking. One accepted approach to reduce the risk of ovarian cancer is bilateral salpingo-oophorectomy. However, it is increasingly widely believed that even a more limited surgery of bilateral salpingectomy may be also used prophylactically as an effective means to reduce cancer risk. The procedure is based on extensive anatomopathological research on the origins of malignant cells in ovarian cancer. There is already ample scientific evidence that in a high proportion of cases the primary site of neoplastic transformation is the distal segment of the fallopian tube, from which malignant cells migrate to the ovary. However, long-term studies demonstrating the effectiveness of prophylactic salpingectomy for ovarian cancer are required. This article summarizes the benefits and disadvantages of the procedure based on currently available literature.

HER-3 expression in HER-2-amplified breast carcinoma.

AIM OF THE STUDY: To determine whether the expression of HER-3 influences the survival of HER-2 positive patients with breast cancer (BC). MATERIAL AND METHODS: In the present work, the expression of HER-3 in a group of 35 HER-2 positive patients with BC was studied by performing immunohistochemistry (IHC) in formalin-fixed paraffin embedded tissues. RESULTS: Higher HER-3 status if estimated by IHC correlated significantly with older age of the patients. HER-3 expression did not correlate with estrogen or progesterone receptor status, pT or pN. There was also no significant difference in disease-free or overall survival (DFS and OS) between groups with different HER-3 expression, although some tendencies were seen as HER-3 expression in over 50% of cells was a factor of worse 5- and 10-year survival. CONCLUSIONS: Further studies should be performed on a larger group of patients to confirm the prognostic role of HER-3 status determined by IHC in BC.