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  1. Article ; Online: Reply to Juan Gómez Rivas, Giorgio Gandaglia, and Francesco Montorsi's Letter to the Editor re: Neal D. Shore, Joseph Renzulli, Neil E. Fleshner, et al. Enzalutamide Monotherapy vs Active Surveillance in Patients with Low-risk or Intermediate-risk Localized Prostate Cancer: The ENACT Randomized Clinical Trial. JAMA Oncol 2022;8:1128-36.

    Shore, Neal D

    European urology open science

    2022  Volume 46, Page(s) 145–146

    Language English
    Publishing date 2022-11-16
    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.2022.10.018
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Updates on Management of Biochemical Recurrent Prostate Cancer.

    Cooley, Lauren Folgosa / Srivastava, Abhishek / Shore, Neal D

    Current treatment options in oncology

    2024  Volume 25, Issue 3, Page(s) 284–292

    Abstract: Opinion statement: Patients with biochemical recurrent prostate cancer (BCR) are a heterogeneous group, whereby a personalized approach to management is critical. Patients with high-risk features such as PSA doubling time (PSADT) ≤ 9-12 months warrant ... ...

    Abstract Opinion statement: Patients with biochemical recurrent prostate cancer (BCR) are a heterogeneous group, whereby a personalized approach to management is critical. Patients with high-risk features such as PSA doubling time (PSADT) ≤ 9-12 months warrant earlier imaging for metastasis detection and consideration for intensified therapy (beyond intermittent androgen deprivation alone) during this phase of BCR-only disease. The BCR phase represents a unique opportunity to impact disease survival and delay metastasis progression. There is compelling evidence from the EMBARK trial that ADT monotherapy is no longer the optimal consideration for high-risk BCR patients.
    MeSH term(s) Male ; Humans ; Prostatic Neoplasms/diagnosis ; Prostatic Neoplasms/therapy ; Prostatic Neoplasms/pathology ; Prostate-Specific Antigen ; Androgen Antagonists/therapeutic use ; Neoplasm Recurrence, Local/diagnosis ; Prostatectomy/methods
    Chemical Substances Prostate-Specific Antigen (EC 3.4.21.77) ; Androgen Antagonists
    Language English
    Publishing date 2024-01-03
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 2057351-0
    ISSN 1534-6277 ; 1527-2729
    ISSN (online) 1534-6277
    ISSN 1527-2729
    DOI 10.1007/s11864-023-01164-2
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    Zs.A 5523: Show issues Location:
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  3. Article ; Online: Enzalutamide in Biochemically Recurrent Prostate Cancer. Reply.

    Shore, Neal D / Tarazi, Jamal / Freedland, Stephen J

    The New England journal of medicine

    2024  Volume 390, Issue 1, Page(s) 90–91

    MeSH term(s) Male ; Humans ; Prostatic Neoplasms/drug therapy ; Nitriles ; Phenylthiohydantoin/therapeutic use ; Benzamides
    Chemical Substances enzalutamide (93T0T9GKNU) ; Nitriles ; Phenylthiohydantoin (2010-15-3) ; Benzamides
    Language English
    Publishing date 2024-01-01
    Publishing country United States
    Document type Letter ; Comment
    ZDB-ID 207154-x
    ISSN 1533-4406 ; 0028-4793
    ISSN (online) 1533-4406
    ISSN 0028-4793
    DOI 10.1056/NEJMc2313228
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  4. Article ; Online: Complications of immuno-oncology care: what urologist should know.

    Grajales, Valentina / Martini, Alberto / Shore, Neal D

    BJU international

    2024  Volume 133, Issue 5, Page(s) 524–531

    Abstract: Objectives: To provide a practical review of immune-related adverse events (irAEs) that may be encountered in uro-oncology patients.: Patients and methods: We conducted a literature review of studies reporting irAEs including articles published ... ...

    Abstract Objectives: To provide a practical review of immune-related adverse events (irAEs) that may be encountered in uro-oncology patients.
    Patients and methods: We conducted a literature review of studies reporting irAEs including articles published through September 2023 for uro-oncology patients and the potential relevancy for the practicing urologist.
    Results: Immunotherapy has revolutionised cancer treatment, extending its impact to urological malignancies including for patients with urothelial, kidney, and prostate cancers. Immuno-oncology (IO) compounds have achieved measurable and durable responses in these cancers. Urologists, choosing to administer or co-manage IO patient care, should be prepared to understand, evaluate, and treat irAEs. This review discusses the spectrum of irAEs that can be encountered. Ongoing trials are exploring the use of immunotherapy at earlier stages of uro-oncological diseases, thus underscoring the evolving landscape of urological cancer treatment. Paradoxically, some data suggests that the occurrence of irAEs is associated with improved oncological outcomes.
    Conclusions: Immune-related AEs, while manageable, may be life-threatening and require lifelong therapy. A thorough understanding of AEs and toxicity of a novel drug class is imperative.
    MeSH term(s) Humans ; Urologic Neoplasms/drug therapy ; Urologic Neoplasms/immunology ; Urologic Neoplasms/therapy ; Immunotherapy/adverse effects ; Male ; Antineoplastic Agents, Immunological/adverse effects ; Antineoplastic Agents, Immunological/therapeutic use ; Prostatic Neoplasms/therapy ; Prostatic Neoplasms/drug therapy ; Urologists ; Immune Checkpoint Inhibitors/adverse effects
    Chemical Substances Antineoplastic Agents, Immunological ; Immune Checkpoint Inhibitors
    Language English
    Publishing date 2024-03-04
    Publishing country England
    Document type Journal Article ; Review
    ZDB-ID 1462191-5
    ISSN 1464-410X ; 1464-4096 ; 1358-8672
    ISSN (online) 1464-410X
    ISSN 1464-4096 ; 1358-8672
    DOI 10.1111/bju.16310
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  5. Article: Current and Future Management of Locally Advanced and Metastatic Prostate Cancer.

    Shore, Neal D

    Reviews in urology

    2020  Volume 22, Issue 3, Page(s) 110–123

    Abstract: With increasing treatment options available, the management of locally advanced and metastatic prostate cancer (PCa) is growing more complex, nuanced, and individualized. Strategies for combining surgery, radiation, chemotherapy, and androgen deprivation ...

    Abstract With increasing treatment options available, the management of locally advanced and metastatic prostate cancer (PCa) is growing more complex, nuanced, and individualized. Strategies for combining surgery, radiation, chemotherapy, and androgen deprivation therapy (ADT) continue to evolve, as do ADT and immunotherapy options. Additionally, multiple adjunctive agents for metastatic PCa have been recently approved or are pending approval. As the number of locally advanced and metastatic prostate cancers being diagnosed rises, so does the need to consider patients' clinical situations and personal preferences. This review discusses current and potential future approaches to managing locally advanced and metastatic PCa.
    Language English
    Publishing date 2020-11-10
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 2108895-0
    ISSN 2153-8182 ; 1523-6161
    ISSN (online) 2153-8182
    ISSN 1523-6161
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  6. Article ; Online: Plain language summary of the HERO study comparing relugolix with leuprolide for men with advanced prostate cancer.

    Shore, Neal D / Sutton, Jennifer

    Future oncology (London, England)

    2022  Volume 18, Issue 21, Page(s) 2575–2584

    Abstract: What is this summary about?: This is a summary of a research study (known as a clinical trial) called HERO. The HERO study compared how well relugolix and leuprolide worked in lowering blood testosterone to sustained castration levels in men with ... ...

    Abstract What is this summary about?: This is a summary of a research study (known as a clinical trial) called HERO. The HERO study compared how well relugolix and leuprolide worked in lowering blood testosterone to sustained castration levels in men with advanced prostate cancer. Sustained castration is a blood testosterone level below 50 ng/dl from Day 29 through 48 weeks of treatment.
    What were the results?: Researchers looked at 930 adult men with advanced prostate cancer: 622 of these men took relugolix (by mouth once daily) and 308 received leuprolide (injected every 3 months). The HERO study showed that more men taking relugolix (97%) achieved sustained castration through 48 weeks than men receiving leuprolide (89%). This decrease in testosterone also happened more quickly in men taking relugolix. In 184 men who were followed up for 90 days after completing treatment, blood levels of testosterone returned to normal in more men who took relugolix than men who received leuprolide. Side effects were similar among men taking relugolix or receiving leuprolide, and most were identified as mild or moderate in terms of how bad they were.
    What do the results of the study mean?: In men with advanced prostate cancer and compared with those receiving leuprolide, more men taking relugolix had lower levels of blood testosterone. ClinicalTrials.gov NCT number: NCT03085095.
    MeSH term(s) Adult ; Antibodies, Monoclonal, Humanized ; Antineoplastic Agents, Hormonal/administration & dosage ; Antineoplastic Agents, Hormonal/adverse effects ; Humans ; Ipilimumab/therapeutic use ; Language ; Leuprolide/administration & dosage ; Leuprolide/adverse effects ; Male ; Melanoma/drug therapy ; Phenylurea Compounds ; Prostatic Neoplasms/blood ; Prostatic Neoplasms/drug therapy ; Pyrimidinones ; Testosterone/blood
    Chemical Substances Antibodies, Monoclonal, Humanized ; Antineoplastic Agents, Hormonal ; Ipilimumab ; Phenylurea Compounds ; Pyrimidinones ; relugolix ; Testosterone (3XMK78S47O) ; pembrolizumab (DPT0O3T46P) ; Leuprolide (EFY6W0M8TG)
    Language English
    Publishing date 2022-05-19
    Publishing country England
    Document type Journal Article ; Review ; Comment
    ZDB-ID 2274956-1
    ISSN 1744-8301 ; 1479-6694
    ISSN (online) 1744-8301
    ISSN 1479-6694
    DOI 10.2217/fon-2022-0172
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    Zs.A 6478: Show issues Location:
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  7. Article ; Online: Clinical and economic impact of blue light cystoscopy in the management of NMIBC at US ambulatory surgical centers: what is the site-of-service disparity?

    Shore, Neal D / Gavaghan, Meghan B

    Urologic oncology

    2022  Volume 41, Issue 4, Page(s) 207.e9–207.e16

    Abstract: Introduction and objective: Management of non-muscle-invasive bladder cancer (NMIBC) significantly impacts healthcare resource utilization due to requirements for ongoing surveillance. White light cystoscopy (WLC) represents the traditional approach to ... ...

    Abstract Introduction and objective: Management of non-muscle-invasive bladder cancer (NMIBC) significantly impacts healthcare resource utilization due to requirements for ongoing surveillance. White light cystoscopy (WLC) represents the traditional approach to NMIBC disease surveillance, though physicians utilizing WLC alone may fail to detect all cancerous lesions. The approval of blue light cystoscopy (BLC) as an adjunct to WLC enhances the urologist's ability to more readily detect cancerous tissue. A more complete resection will reduce recurrences and could result in reduced costs for the US healthcare system. This analysis quantifies the clinical and economic impact of the incorporation of BLC in the management of NMIBC in ambulatory surgical centers (ASCs) considering current Center for Medicare Services (CMS) patient-physician coverage and reimbursement.
    Methods and materials: A budget impact model was developed to assess projected ASC costs for a cohort of 50 newly diagnosed bladder cancer patients over a 2-year follow-up comparing WLC alone vs. WLC + BLC. Treatment and surveillance intervals were based on AUA/SUO clinical guidelines. Clinical and cost metrics for staging and biopsy rates were assessed, with cost inputs based on Medicare reimbursement rates.
    Results: Use of WLC + BLC for NMIBC surveillance resulted in the identification of 5 additional NMIBC recurrences compared to WLC alone. There was an associated increased cost of performing BLC in an ASC setting, with a net increase in the total cost of care for NMIBC of $110 per cystoscopy over a 2-year period. If recurrences missed using WLC alone were to progress prior to detection, the model projects an increase in treatment costs borne by Medicare of $9,097 to $34,538 due to more intensive treatments required for the increased risk of recurrence.
    Conclusions: Modeled results suggests that the Medicare program will incur increased costs, due to the gap between added costs per cystoscopy due to BLC. The current discrepancy in reimbursement disincentivizes community-based ASCs from adopting BLC, resulting in suboptimal patient care while increasing downstream treatment costs to Medicare, necessitated when missed disease progresses to higher stage/grade disease. The findings have important clinical implications for the optimal management of NMIBC and should inform healthcare policies that promote cost-effectiveness and enhanced patient outcomes.
    MeSH term(s) Humans ; Aged ; United States ; Cystoscopy/methods ; Aminolevulinic Acid ; Medicare ; Urinary Bladder Neoplasms/diagnosis ; Urinary Bladder Neoplasms/surgery ; Urinary Bladder Neoplasms/pathology ; Biopsy
    Chemical Substances Aminolevulinic Acid (88755TAZ87)
    Language English
    Publishing date 2022-12-22
    Publishing country United States
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 1336505-8
    ISSN 1873-2496 ; 1078-1439
    ISSN (online) 1873-2496
    ISSN 1078-1439
    DOI 10.1016/j.urolonc.2022.11.014
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    Zs.A 4817: Show issues Location:
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  8. Article: LUGPA Celebrates Its 10th Anniversary at Its 2018 Annual Meeting.

    Shore, Neal D

    Reviews in urology

    2018  Volume 20, Issue 3, Page(s) 131–132

    Language English
    Publishing date 2018-11-14
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2108895-0
    ISSN 2153-8182 ; 1523-6161
    ISSN (online) 2153-8182
    ISSN 1523-6161
    DOI 10.3909/riu0816
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  9. Article ; Online: Combined advanced prostate cancer treatments: are they additive?

    Srivastava, Abhishek / Shore, Neal D

    Nature reviews. Urology

    2021  Volume 18, Issue 6, Page(s) 325–326

    MeSH term(s) Androgen Antagonists/therapeutic use ; Humans ; Male ; Prostatic Neoplasms/therapy
    Chemical Substances Androgen Antagonists
    Language English
    Publishing date 2021-03-16
    Publishing country England
    Document type Journal Article ; Comment
    ZDB-ID 2493737-X
    ISSN 1759-4820 ; 1759-4812
    ISSN (online) 1759-4820
    ISSN 1759-4812
    DOI 10.1038/s41585-021-00459-z
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    Zs.A 6030: Show issues Location:
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  10. Article: Relugolix: a novel androgen deprivation therapy for management of patients with advanced prostate cancer.

    Saad, Fred / Shore, Neal D

    Therapeutic advances in medical oncology

    2021  Volume 13, Page(s) 1758835921998586

    Abstract: Androgen deprivation therapy (ADT) is the foundation of treatment for patients with locally advanced, recurrent and metastatic prostate cancer, most commonly using luteinizing releasing hormone (LHRH) agonists. More recently, a new approach to ADT has ... ...

    Abstract Androgen deprivation therapy (ADT) is the foundation of treatment for patients with locally advanced, recurrent and metastatic prostate cancer, most commonly using luteinizing releasing hormone (LHRH) agonists. More recently, a new approach to ADT has emerged with the development of gonadotropin-releasing hormone (GnRH) antagonists, which aim to overcome some of the potential adverse physiologic effects of LHRH agonists. This article focuses on the newest GnRH antagonist, relugolix - a once-daily treatment and the only oral GnRH antagonist that has now been approved for the treatment of advanced prostate cancer. In phase II and III studies, relugolix achieved rapid and sustained castration without the testosterone surge associated with LHRH agonists, thus avoiding the potential clinical consequences of tumor flare and the necessity for concomitant anti-androgen therapy. Relugolix also achieved rapid testosterone recovery, which may potentially reduce ADT-related adverse events and offer opportunities for combination and intermittent therapy strategies. Cardiovascular safety is a particular concern in men with prostate cancer and ADT further increases cardiovascular risk: indeed, LHRH agonists are required to have a drug label warning about an increased risk of cardiovascular disease. Data from the phase III HERO study demonstrate an improved cardiac safety profile for the GnRH antagonist relugolix compared with the LHRH agonist leuprolide, including a significantly reduced risk for a major adverse cardiovascular event. Taken together, the data indicate that relugolix may mitigate some of the cardiovascular concerns surrounding ADT and has the potential to become a new standard of care for men with prostate cancer. In summary, relugolix represents a novel and recently available prostate cancer management strategy, incorporating the mechanistic advantages of GnRH antagonists and the potential benefits of oral administration.
    Language English
    Publishing date 2021-03-24
    Publishing country England
    Document type Journal Article ; Review
    ZDB-ID 2503443-1
    ISSN 1758-8359 ; 1758-8340
    ISSN (online) 1758-8359
    ISSN 1758-8340
    DOI 10.1177/1758835921998586
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