Volume 23, Number 3Bladder CancerImmune Checkpoint Inhibitors for the Treatment of Non–Muscle-Invasive Bladder Cancer: An Overview of Ongoing Clinical TrialsNeal D ShoreTreatment of non–muscle-invasive bladder cancer (NMIBC) is evolving, seeking new treatments to overcome the limitations of bacille Calmette-Guérin therapy and alternatives to radical cystectomy. Studies are currently evaluating the safety and efficacy of immune checkpoint inhibitors in combination with bacille Calmette-Guérin vs bacille Calmette-Guérin monotherapy for patients with high-risk NMIBC that is bacille Calmette-Guérin naive or recurrent after bacille Calmette-Guérin induction. We briefly summarize 4 studies that are evaluating intravenous immune checkpoint inhibitors (atezolizumab, durvalumab, and pembrolizumab) and 1 subcutaneous immune checkpoint inhibitor (sasanlimab). These studies may substantially change standard-of-care treatment for patients with high-risk NMIBC.immune checkpoint inhibitorsMonoclonal antibodiesClinical trialsnon-muscle invasive bladder neoplasms
Volume 23, Number 1Reviews in UrologyAn interview with Shailendra Sharma, CEO, Specialty NetworksNeal D ShoreThe LUGPA board, in partnership with Specialty Networks, was thrilled to announce the return of Reviews in Urology in 2024, and no one more so than Specialty Networks’ CEO, Shailendra Sharma. “We are honored for our Reviews in Urology publication to be designated as the official journal of LUGPA and to further strengthen our partnership and commitment to LUGPA’s mission of preserving and advancing the independent practice of urology,” he said. Reviews in Urology first launched in 1999 as a PubMed-indexed, quarterly journal featuring peer-reviewed research, case studies, thought leader interviews, and insights on emerging trends and research shaping the field of urology. Mr Sharma says that Specialty Networks now plans to build on the journal’s long-standing focus on cutting-edge urology advances while offering expanded coverage of a broad range of urologic conditions and specialty care concerns. Mr Sharma sat down to talk with Neal Shore, MD, editor in chief of Reviews in Urology, to discuss the journal’s history and his hopes for the future of the journal and the profession.
Volume 12, Number 1Review ArticlesIntermittent Androgen Deprivation Therapy: Redefining the Standard of Care?Management UpdateE David CrawfordNeal D ShoreAs a clinical strategy, intermittent androgen deprivation therapy (IADT) has the potential to minimize adverse events associated with continuous androgen deprivation therapy while providing comparable efficacy for patients with advanced prostate cancer. Because most studies supporting IADT to date have been somewhat small and underpowered, additional large, randomized, controlled trials are needed before this strategy becomes the standard of care.However, the potential advantages of IADT, which include improved quality of life, the theoretical possibility of delaying hormone resistance, and possible reduction in expenses to the patient and health care payers, suggest it is a strategy worth further exploration.[Rev Urol. 2010;12(1):1-11 doi: 10.3909/riu0490]Prostate cancerAndrogen deprivation therapyProstate-specific antigenTestosteroneHormonal therapy
Volume 14, Number 1Review ArticlesLHRH Agonists for the Treatment of Prostate Cancer: 2012Management ReviewHerbert LeporNeal D ShoreThe most recent guidelines on prostate cancer screening from the American Urological Association (2009), the National Comprehensive Cancer Network (2011), and the European Association of Urology (2011), as well as treatment and advances in disease monitoring, have increased the androgen deprivation therapy (ADT) population and the duration of ADT usage as the first-line treatment for metastatic prostate cancer. According to the European Association of Urology, gonadotropin-releasing hormone (GnRH) agonists have become the leading therapeutic option for ADT because they avoid the physical and psychological discomforts associated with orchiectomy. However, GnRH agonists display several shortcomings, including testosterone (T) surge (“clinical flare”) and microsurges. T surge delays the intended serologic endpoint of T suppression and may exacerbate clinical symptoms. Furthermore, ADT manifests an adverse-event spectrum that can impact quality of life with its attendant well-documented morbidities. Strategies to improve ADT tolerability include a holistic management approach, improved diet and exercise, and more specific monitoring to detect and prevent T depletion toxicities. Intermittent ADT, which allows hormonal recovery between treatment periods, has become increasingly utilized as a methodology for improving quality of life while not diminishing chronic ADT efficacy, and may also provide healthcare cost savings. This review assesses the present and potential future role of GnRH agonists in prostate cancer and explores strategies to minimize the adverse-event profile for patients receiving ADT. [ Rev Urol. 2012;14(1/2):1-12 doi:10.3909/riu0547 ] © 2012 MedReviews®, LLCWilms’ tumorRenal massOpen radical nephrectomyMultimodal therapy
Volume 16, Number 3Review ArticlesThe Rationale for Optimal Combination Therapy With Sipuleucel-T for Patients With Castration-resistant Prostate CancerTreatment ReviewMark EmbertonRobert B SimsNeil MariadosVladimir MouravievChristopher M PieczonkaRaoul S ConcepcionNeal D ShoreImmunotherapy encourages the recipient’s own immune response to destroy cancer cells, and current evidence suggests that immunotherapies may be most beneficial in early metastatic castration-resistant prostate cancer (mCRPC). Sipuleucel-T is the first therapeutic cancer vaccine to be approved by both the US Food and Drug Administration and European Medicines Agency for the treatment of asymptomatic or minimally symptomatic mCRPC. Combining immunotherapy with other treatments may have potent anticancer effects; cytoreductive therapies can release tumor antigens and promote a proinflammatory environment that could augment immunotherapies. However, some cytoreductive agents or coadministered drugs may be immunosuppressive. Understanding these interactions between different mCRPC treatment modalities may offer further potential to improve patient outcomes. [Rev Urol. 2014;16(3):122-130 doi: 10.3909/riu0637] © 2014 MedReviews®, LLCProstate cancerSipuleucel-TCombination therapy
Volume 17, Number 2LUGPA NewsLUGPA Welcomes Membership of Smaller PracticesNeal D Shore[Rev Urol. 2015;17(2):86-87 doi: 10.3909/riu0672] © 2015 MedReviews®, LLC
Volume 17, Number 1LUGPA NewsThriving in the Independent Setting: Highlights From the 2014 LUGPA Annual MeetingNeal D Shore[Rev Urol. 2015;17(1):31-32 doi: 10.3909/riu0667] © 2015 MedReviews®, LLC
Volume 18, Number 3Review ArticlesUrology Group Compensation and Ancillary Service Models in an Era of Value-based CareHealth Care EconomicsDana JacobyNeal D ShoreChanges involving the health care economic landscape have affected physicians’ workflow, productivity, compensation structures, and culture. Ongoing Federal legislation regarding regulatory documentation and imminent payment-changing methodologies have encouraged physician consolidation into larger practices, creating affiliations with hospitals, multidisciplinary medical specialties, and integrated delivery networks. As subspecialization and evolution of care models have accelerated, independent medical groups have broadened ancillary service lines by investing in enterprises that compete with hospital-based (academic and nonacademic) entities, as well as non–physician-owned multispecialty enterprises, for both outpatient and inpatient services. The looming and dramatic shift from volume- to value-based health care compensation will assuredly affect urology group compensation arrangements and productivity formulae. For groups that can implement change rapidly, efficiently, and harmoniously, there will be opportunities to achieve the Triple Aim goals of the Patient Protection and Affordable Care Act, while maintaining a successful medical-financial practice. In summary, implementing new payment algorithms alongside comprehensive care coordination will assist urology groups in addressing the health economic cost and quality challenges that have been historically encountered with fee-for-service systems. Urology group leadership and stakeholders will need to adjust internal processes, methods of care coordination, cultural dependency, and organizational structures in order to create better systems of care and management. In response, ancillary services and patient throughput will need to evolve in order to adequately align quality measurement and reporting systems across provider footprints and patient populations. [Rev Urol. 2016;18(3):143-150 doi: 10.3909/riu0726] © 2016 MedReviews®, LLCIndependent practiceCollaborationValue-based careSpecializationCompensation
Volume 18, Number 4LUGPA NewsLooking Ahead to 2017Neal D Shore[Rev Urol. 2016;18(4):225 doi: 10.3909/riu0736] © 2016 MedReviews®, LLC
Volume 18, Number 4Practice ProfileAdvanced Prostate Cancer in Large Group PracticesNeal D ShoreGary M KirshDavid M. Albala[Rev Urol. 2016;18(4):226-230 doi:10.3909/riu0737] © 2016 MedReviews®, LLC