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Article ; Online: Adjuvant and Neoadjuvant Therapy in Renal Cell Carcinoma.

Kuusk, Teele / Bex, Axel

Hematology/oncology clinics of North America

2023 Volume 37, Issue 5, Page(s) 907–920

Abstract: In locally advanced RCC, 6 phase 3 randomized controlled trials (RCTs) were designed in the perioperative setting with immune checkpoint inhibitor (ICI) monotherapy or combinations. Adjuvant trials with atezolizumab, pembrolizumab, and nivolumab with ... ...

Abstract	In locally advanced RCC, 6 phase 3 randomized controlled trials (RCTs) were designed in the perioperative setting with immune checkpoint inhibitor (ICI) monotherapy or combinations. Adjuvant trials with atezolizumab, pembrolizumab, and nivolumab with ipilimumab reported results, as did the only perioperative trial with nivolumab. Of these, only 1 year of adjuvant pembrolizumab improved disease-free survival (DFS) versus placebo, with the other trials showing no improvement in DFS. In the purely neoadjuvant setting, phase 1 b/2 ICI trials have demonstrated safety, efficacy, and dynamic changes of immune infiltrates, and provide a rationale for randomized trial concepts.
MeSH term(s)	Humans ; Carcinoma, Renal Cell/drug therapy ; Nivolumab/therapeutic use ; Neoadjuvant Therapy ; Ipilimumab/therapeutic use ; Kidney Neoplasms/drug therapy ; Kidney Neoplasms/pathology
Chemical Substances	Nivolumab (31YO63LBSN) ; Ipilimumab
Language	English
Publishing date	2023-06-25
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	93115-9
ISSN	1558-1977 ; 0889-8588
ISSN (online)	1558-1977
ISSN	0889-8588
DOI	10.1016/j.hoc.2023.05.020
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Article ; Online: Partial Nephrectomy for Metastatic Renal Cell Carcinoma: Con.

Kuusk, Teele / Bex, Axel

European urology open science

2022 Volume 44, Page(s) 81–83

Language	English
Publishing date	2022-08-30
Publishing country	Netherlands
Document type	Journal Article
ZDB-ID	3040546-4
ISSN	2666-1683 ; 2058-4881
ISSN (online)	2666-1683
ISSN	2058-4881
DOI	10.1016/j.euros.2022.07.011
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Article ; Online: Three-dimensional models-assisted minimally-invasive partial nephrectomy: looking forward to more evidence.

Bertolo, Riccardo / Kuusk, Teele / Mir, Maria C

Minerva urology and nephrology

2023 Volume 75, Issue 6, Page(s) 665–666

MeSH term(s)	Humans ; Nephrectomy/methods ; Kidney Neoplasms/surgery
Language	English
Publishing date	2023-09-06
Publishing country	Italy
Document type	Journal Article
ZDB-ID	3062840-4
ISSN	2724-6442
ISSN (online)	2724-6442
DOI	10.23736/S2724-6051.23.05446-0
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Article ; Online: Re: Adjuvant Chemotherapy in Upper Tract Urothelial Carcinoma (the POUT Trial): A Phase 3, Open-label, Randomised Controlled Trial.

Kuusk, Teele / Bex, Axel

European urology

2020 Volume 78, Issue 4, Page(s) 630–631

MeSH term(s)	Carcinoma, Transitional Cell/drug therapy ; Chemotherapy, Adjuvant ; Humans
Language	English
Publishing date	2020-05-22
Publishing country	Switzerland
Document type	Journal Article ; Comment
ZDB-ID	193790-x
ISSN	1873-7560 ; 1421-993X ; 0302-2838
ISSN (online)	1873-7560 ; 1421-993X
ISSN	0302-2838
DOI	10.1016/j.eururo.2020.04.021
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Zs.A 1247: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (1.OG) ab Jg. 2022: Lesesaal (EG)
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Article ; Online: Radiomics to better characterize small renal masses.

Kuusk, Teele / Neves, Joana B / Tran, Maxine / Bex, Axel

World journal of urology

2021 Volume 39, Issue 8, Page(s) 2861–2868

Abstract: Purpose: Radiomics is a specific field of medical research that uses programmable recognition tools to extract objective information from standard images to combine with clinical data, with the aim of improving diagnostic, prognostic, and predictive ... ...

Abstract	Purpose: Radiomics is a specific field of medical research that uses programmable recognition tools to extract objective information from standard images to combine with clinical data, with the aim of improving diagnostic, prognostic, and predictive accuracy beyond standard visual interpretation. We performed a narrative review of radiomic applications that may support improved characterization of small renal masses (SRM). The main focus of the review was to identify and discuss methods which may accurately differentiate benign from malignant renal masses, specifically between renal cell carcinoma (RCC) subtypes and from angiomyolipoma without visible fat (fat-poor AML) and oncocytoma. Furthermore, prediction of grade, sarcomatoid features, and gene mutations would be of importance in terms of potential clinical utility in prognostic stratification and selecting personalised patient management strategies. Methods: A detailed search of original articles was performed using the PubMed-MEDLINE database until 20 September 2020 to identify the English literature relevant to radiomics applications in renal tumour assessment. In total, 42 articles were included in the analysis in 3 main categories related to SRM: prediction of benign versus malignant SRM, subtypes, and nuclear grade, and other features of aggressiveness. Conclusion: Overall, studies reported the superiority of radiomics over expert radiological assessment, but were mainly of retrospective design and therefore of low-quality evidence. However, it is clear that radiomics is an attractive modality that has the potential to improve the non-invasive diagnostic accuracy of SRM imaging and prediction of its natural behaviour. Further prospective validation studies of radiomics are needed to augment management algorithms of SRM.
MeSH term(s)	Artificial Intelligence ; Decision Support Systems, Clinical ; Diagnosis, Differential ; Humans ; Kidney Neoplasms/diagnostic imaging ; Kidney Neoplasms/genetics ; Kidney Neoplasms/pathology ; Neoplasm Staging ; Precision Medicine ; Radiology/methods ; Radiology/trends ; Tumor Burden
Language	English
Publishing date	2021-01-26
Publishing country	Germany
Document type	Journal Article ; Review
ZDB-ID	380333-8
ISSN	1433-8726 ; 0724-4983
ISSN (online)	1433-8726
ISSN	0724-4983
DOI	10.1007/s00345-021-03602-y
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Article ; Online: Re: Detection of Micrometastases by Flow Cytometry in Sentinel Lymph Nodes from Patients with Renal Tumours.

Kuusk, Teele / Bex, Axel

European urology

2017 Volume 71, Issue 4, Page(s) 691–692

Language	English
Publishing date	2017-04
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	193790-x
ISSN	1873-7560 ; 1421-993X ; 0302-2838
ISSN (online)	1873-7560 ; 1421-993X
ISSN	0302-2838
DOI	10.1016/j.eururo.2017.01.002
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Zs.A 1247: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (1.OG) ab Jg. 2022: Lesesaal (EG)
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Article ; Online: Nurse-led one stop hematuria clinic: Outcomes from 2,714 patients.

Madaan, Anika / Kuusk, Teele / Hamdoon, Musaab / Elliott, Angela / Pearce, Dianne / Madaan, Sanjeev

BJUI compass

2021 Volume 2, Issue 6, Page(s) 385–394

Abstract: Objectives: Objective of this study is to report the results of nurse led hematuria clinic service outcome of 2,714 patients.: Subjects and methods: We conducted a retrospective, single center review of 2714 patients with visible and nonvisible ... ...

Abstract	Objectives: Objective of this study is to report the results of nurse led hematuria clinic service outcome of 2,714 patients. Subjects and methods: We conducted a retrospective, single center review of 2714 patients with visible and nonvisible hematuria managed by a well-trained nurse specialist in a rapid access clinic (RAC) between 2014 and 2020. All patients received a full review, flexible cystoscopy performed by a nurse, and ultrasound of urinary tracts. After investigations, patients were reassured and discharged or referred for rigid cystoscopy, TURBT, and CT urography. Results: In total, 2714 patients attended the RAC between October 2014 and March 2020. Of these, 1684 (62%) were males and 1030 (38%) females. The median age of patients was 68.3 (IQR 58-79). Of the 1030 females, 500 (48.5%) presented with nonvisible hematuria (NVH), and 530 (51.5%) presented with visible hematuria (VH). The median age was 66 (IQR 56-76). The number of females diagnosed with any form of malignancy was 72 (7% of all females). Of the 1684 males, 288 (17.1%) presented with NVH, and 1396 (82.9%) presented with VH. The median age was 72 (IQR 59-81). The number of males diagnosed with some form of malignancy was 258 (15.3% of all males). Overall, 1926 patients presented with VH and 788 patients presented with NVH. After investigations, 290 patients (15.1%) with VH and 40 (5.1%) patients with NVH had some form of malignancy. The highest number of malignancies found in VH was bladder cancer (n = 222, 11.5%), followed by prostate (n = 28, 1%), renal (n = 23, 0.8%), UT urothelial (n = 17, 0.6%), gynaecological (n = 7, 0.3%), and gastrointestinal (n = 5, 0.2%) cancer. The highest number of pathologies found in NVH was infection (n = 44, 5.6%). Cancer detection rate for symptomatic NVH was more than double that of asymptomatic NVH, 6.5% versus 3.1%, respectively. Conclusion: Overall, 15.1% with VH and 5.1% with NVH present with malignancy. Nurse-led rapid access hematuria clinic and flexible cystoscopy investigation by trained nurse is safe and feasible.
Language	English
Publishing date	2021-06-12
Publishing country	United States
Document type	Journal Article
ISSN	2688-4526
ISSN (online)	2688-4526
DOI	10.1002/bco2.100
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Article ; Online: Perioperative therapy in renal cancer in the era of immune checkpoint inhibitor therapy.

Kuusk, Teele / Abu-Ghanem, Yasmin / Mumtaz, Faiz / Powles, Thomas / Bex, Axel

Current opinion in urology

2021 Volume 31, Issue 3, Page(s) 262–269

Abstract: Purpose of review: Immune checkpoint inhibitor (ICI) combination therapy has revolutionized therapy of metastatic renal cancer. The success of immunotherapy has renewed an interest to study these agents in adjuvant and neoadjuvant settings and prior to ... ...

Abstract	Purpose of review: Immune checkpoint inhibitor (ICI) combination therapy has revolutionized therapy of metastatic renal cancer. The success of immunotherapy has renewed an interest to study these agents in adjuvant and neoadjuvant settings and prior to cytoreductive nephrectomy. This narrative review will give an overview of ongoing trials and early translational research outcomes. Recent findings: In nonmetastatic renal cell carcinoma (RCC), five phase 3 adjuvant and neoadjuvant trials with ICI monotherapy or combinations are ongoing with atezolizumab (IMmotion 010; NCT03024996), pembrolizumab (KEYNOTE-564; NCT03142334), nivolumab (PROSPER; NCT03055013), nivolumab with or without ipilimumab (CheckMate 914; NCT03138512) and durvalumab with or without tremelimumab (RAMPART; NCT03288532). Phase 1b/2 neoadjuvant trials demonstrate safety, efficacy and dynamic changes of immune infiltrates and provide rationales for neoadjuvant trial concepts as well as prediction of response to therapy. In primary metastatic RCC, two phase 3 trials investigate the role of deferred cytoreductive nephrectomy following pretreatment with ICI combination (NORDICSUN; NCT03977571 and PROBE; NCT04510597). Summary: The outcomes of the major phase 3 trials are awaited as early as 2023. Meanwhile, translational data from phase 1b/2 studies enhance our understanding of the tumour immune microenvironment and its dynamic changes.
MeSH term(s)	Carcinoma, Renal Cell/drug therapy ; Clinical Trials, Phase I as Topic ; Clinical Trials, Phase II as Topic ; Humans ; Immune Checkpoint Inhibitors ; Kidney Neoplasms/drug therapy ; Nephrectomy ; Nivolumab/adverse effects ; Tumor Microenvironment
Chemical Substances	Immune Checkpoint Inhibitors ; Nivolumab (31YO63LBSN)
Language	English
Publishing date	2021-04-07
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	1091792-5
ISSN	1473-6586 ; 0963-0643
ISSN (online)	1473-6586
ISSN	0963-0643
DOI	10.1097/MOU.0000000000000868
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Zs.A 3345: Show issues

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ab Jg. 2022: Lesesaal (EG)

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Article ; Online: Follow-up after curative treatment of localised renal cell carcinoma.

Dabestani, Saeed / Marconi, Lorenzo / Kuusk, Teele / Bex, Axel

World journal of urology

2018 Volume 36, Issue 12, Page(s) 1953–1959

Abstract: Purpose: Patients with localised renal cell carcinoma (RCC) receiving curative surgery, either radical or partial nephrectomy, have been shown in contemporary studies to develop recurrence within 5 years in 20-30% of case. Therefore, post-operative ... ...

Abstract	Purpose: Patients with localised renal cell carcinoma (RCC) receiving curative surgery, either radical or partial nephrectomy, have been shown in contemporary studies to develop recurrence within 5 years in 20-30% of case. Therefore, post-operative follow-up (FU) imaging plays a crucial role in detecting recurrent or metastatic disease. A number of prognostic scores have been developed to predict risk of recurrence. This review summarises the current knowledge on established FU protocols and their limitations. Methods: A non-systematic literature search was conducted using Medline. Furthermore, major guidelines [European Association of Urology (EAU), American Urological Association (AUA) and National Comprehensive Cancer Network (NCCN)] were reviewed and assessed. Results: The EAU, AUA and NCCN post-operative follow-up guidelines differ in the frequency and type of imaging modalities recommended. The optimal duration of follow-up remains to be elucidated as does the impact of follow-up protocols on patient outcomes and quality of life. Established follow-up protocols do not take non-RCC-related factors, such as patient age and performance status into account. However, in the future individualised duration of FU based on competing risks of cancer recurrence and non-RCC death may be optimised, maximising resources and patient quality of life. Conclusion: There is a clear need to establish evidence-based follow-up protocols and to assess the impact of follow-up protocols on individual patients and society.
MeSH term(s)	Aftercare/methods ; Carcinoma, Renal Cell/surgery ; Humans ; Kidney Neoplasms/surgery ; Neoplasm Recurrence, Local/epidemiology ; Nephrectomy/adverse effects ; Nephrectomy/methods ; Practice Guidelines as Topic
Language	English
Publishing date	2018-05-16
Publishing country	Germany
Document type	Journal Article ; Review
ZDB-ID	380333-8
ISSN	1433-8726 ; 0724-4983
ISSN (online)	1433-8726
ISSN	0724-4983
DOI	10.1007/s00345-018-2338-z
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Article ; Online: Cytoreductive nephrectomy: does CARMENA (Cancer du Rein Metastatique Nephrectomie et Antiangiogéniques) change everything?

Grant, Michael / Szabados, Bernadett / Kuusk, Teele / Powles, Thomas / Bex, Axel

Current opinion in urology

2019 Volume 30, Issue 1, Page(s) 36–40

Abstract: Purpose of review: Over the past few years the treatment options for renal cell cancer (RCC) have rapidly evolved. Even in the setting of metastatic disease, a consistent component of treatment in RCC patients has been cytoreductive nephrectomy based on ...

Abstract	Purpose of review: Over the past few years the treatment options for renal cell cancer (RCC) have rapidly evolved. Even in the setting of metastatic disease, a consistent component of treatment in RCC patients has been cytoreductive nephrectomy based on the results of research carried out over a decade ago. Despite huge shifts in systemic treatment modalities, cytoreductive nephrectomy continued to be recommended despite a lack of evidence for its use in metastatic RCC in those patients receiving state-of-the-art therapies. Recent findings: To address the lack of evidence, two recent trials [Cancer du Rein Metastatique Nephrectomie et Antiangioge[Combining Acute Accent]niques (CARMENA) and SURTIME] sought to assess the role and sequence of cytoreductive nephrectomy in metastatic RCC patients receiving vascular endothelial growth factor-targeted tyrosine kinase inhibitor treatment. The results of one of these trials, namely CARMENA, demonstrated no benefit of cytoreductive nephrectomy when used in combination with the vascular endothelial growth factor-targeted tyrosine kinase inhibitor Sunitinib. However, with further developments in medical treatment and questions regarding the specific methods of the trial - do these results change everything for the role of cytoreductive nephrectomy? Summary: While the results from CARMENA and SURTIME are not conclusive, they suggest that those patients with advanced disease requiring systemic therapy should indeed receive this first prior to any cytoreductive nephrectomy.
MeSH term(s)	Carcinoma, Renal Cell/pathology ; Carcinoma, Renal Cell/surgery ; Cytoreduction Surgical Procedures/methods ; Humans ; Kidney Neoplasms/pathology ; Kidney Neoplasms/surgery ; Nephrectomy/methods ; Vascular Endothelial Growth Factor A
Chemical Substances	Vascular Endothelial Growth Factor A
Language	English
Publishing date	2019-12-02
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	1091792-5
ISSN	1473-6586 ; 0963-0643
ISSN (online)	1473-6586
ISSN	0963-0643
DOI	10.1097/MOU.0000000000000696
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