VI-RADS quality score: development and proposal of a scoring system by the American College of Radiology VI-RADS Steering Committee.

High-quality bladder MRI is essential for reliable detection and characterization of bladder tumors. While the Vesical Imaging Reporting and Data System (VI-RADS) was developed to standardize acquisition, interpretation, and reporting of MRI for bladder cancer staging, no universal scoring system has been established for quality assessment. A systematic review showed that existing efforts for bladder MRI quality assessment have largely relied on study-specific, subjective Likert-type scales, with substantial variability, hindering reproducibility and comparability across studies and institutions.

Long term results of NRG Oncology RTOG 9601, a randomized trial of radiation with or without anti-androgens (AAT) in patients receiving salvage prostate bed radiation therapy post prostatectomy.

Purpose: Salvage radiation therapy (RT) is used in men with prostate cancer (PC) recurrence following radical prostatectomy (RP) signaled by a persistent or delayed elevation in PSA. It was previously reported that the use of AAT with RT improved cancer control and overall survival (OS). Long-term follow-up results are presented here.

Phase 3 Trial of Dose-Escalated Radiation Therapy and Standard Androgen Deprivation Therapy Versus Dose-Escalated Radiation Therapy and Enhanced Androgen Deprivation Therapy With Orteronel for Men With High-Risk Prostate Cancer (NRG/RTOG 1115).

Purpose: NRG/RTOG 1115 was a phase 3 trial evaluating the addition of orteronel, a CYP17A1 inhibitor, to radiation therapy (RT) plus androgen deprivation therapy (ADT) in men with high-risk prostate cancer.

Methods And Materials: The study was designed to evaluate overall survival for 900 men with high-risk prostate cancer (Gleason 9-10, prostate specific antigen (PSA) > 20, or clinical stage T2 or higher with Gleason ≥ 8). Patients were randomized 1:1 to standard of care (SOC) therapy (RT plus 2 years of ADT) or SOC plus 2 years of orteronel.

Prognostic Impact of Lymph Node Yield in a Phase III Clinical Trial (NRG/RTOG 9601) of Prostate Cancer Patients Treated With Salvage Radiation Following Prostatectomy.

Background: We aim to evaluate whether increased lymph node yield at prostatectomy (RP) is associated with improved outcomes in NRG/RTOG 9601, a randomized clinical trial of men who underwent either radiation (RT) alone or RT + bicalutamide for PSA elevation following RP for pT2/T3 prostate cancer.

Methods: We reviewed available pathology reports for patients in NRG/RTOG 9601 to determine the nodal count at RP. Cox proportional hazards models were used to assess effect of lymph nodes yield, arm (RT alone or RT + bicalutamide), Gleason score, positive margins, and seminal vesicle invasion on the following endpoints: times to local and distant failure and overall and disease-specific survival.

Transcriptomic Analysis of Localized High-risk Prostate Cancer Improves Prognostication and Identifies Benefit from Adding Docetaxel to Definitive Radiotherapy with Androgen Suppression in the NRG Oncology/RTOG 0521 Phase 3 Trial.

Background And Objective: NRG/RTOG 0521 randomized men with high-risk localized prostate cancer (PC) to androgen suppression (AS) and definitive radiotherapy (RT) ± docetaxel-based chemotherapy (CT). The overall survival (OS) benefit with CT initially reported was lost on longer follow-up. The Decipher genomic classifier (GC) measures multiple transcripts relevant to docetaxel action.

Radiation Therapy in the Management of Muscle-invasive Bladder Cancer with Carcinoma in Situ: Still a No Go?

Background And Objective: This narrative review explores the impact of carcinoma in situ (CIS) on outcomes in muscle-invasive bladder cancer (MIBC) after trimodal therapy (TMT) comprising transurethral resection of bladder tumor, a radiosensitizing agent and radiation therapy (RT). There is limited and inconsistent evidence on the effect of CIS, often considered a contraindication to TMT, on treatment efficacy.

Methods: We reviewed studies evaluating the influence of TMT and RT alone on clinical outcomes in CIS-associated MIBC.

Duration of Androgen Suppression with Postoperative Radiotherapy (DADSPORT) for Nonmetastatic Prostate Cancer: A Collaborative Systematic Review and Meta-analysis of Aggregate Data.

Background And Objective: To better understand the role of hormone therapy (HT) with postoperative radiotherapy (RT) for nonmetastatic prostate cancer, the DADSPORT Collaboration planned a systematic review and meta-analysis of aggregate data from randomised controlled trials (RCTs).

Methods: RCTs evaluating HT with postoperative RT in people with nonmetastatic prostate cancer were identified. Methods were prespecified prior to results of recent trials being known (CRD42022325769).

The Evolving Management of Radiorecurrent Prostate Cancer.

The detection of local radiorecurrence (LRR) of prostate cancer in the prostate or prostate bed after radiation therapy is increasingly common with the advent of advanced imaging modalities such as the PSMA PET/CT. Our aim is to review the literature and define the optimal workup for identifying LRR and discuss the key principals in management, with a focus on salvage re-irradiation. We performed a narrative review of the literature and ongoing studies centered on LRR workup and treatment.

A Systematic Review and Meta-analysis on Perioperative Stenting/Dwell Time and Postoperative Outcomes in Patients Undergoing Radical Cystectomy and Urinary Diversion for Bladder Cancer.

Background And Objective: Ureteral stents are used to protect the ureteroenteric anastomosis during radical cystectomy and urinary diversion (RCUD); however, complications can occur from its use. The objective of this study was to perform a systematic review of perioperative stenting strategies and postoperative outcomes in patients undergoing RCUD for bladder cancer.

Methods: This review was published via PROSPERO (CRD42024558468) and conducted following the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines.

Combination Metastasis-Targeted External Beam Radiation Therapy With Lu-PSMA-617 in Patients With Advanced Castration-Resistant Prostate Cancer.

Purpose: Lu-PSMA-617 (LuPSMA) is an effective radiopharmaceutical therapy for patients with metastatic castration-resistant prostate cancer. While LuPSMA can treat disseminated disease, additional localized control of metastatic disease may be required. Metastasis-targeted external beam radiation therapy (M-EBRT) can be an effective adjunct.

European Association of Urology Guidelines on Muscle-invasive and Metastatic Bladder Cancer: Summary of the 2025 Guidelines.

Background And Objective: This publication represents a summary of the updated 2025 European Association of Urology (EAU) guidelines for muscle-invasive and metastatic bladder cancer (MMIBC). The aim is to provide practical recommendations on the clinical management of MMIBC with a focus on diagnosis, treatment, and follow-up.

Methods: For the 2025 guidelines, new and relevant evidence was identified, collated, and appraised via a structured assessment of the literature.

Predictive Model of Acute Rectal Toxicity in Prostate Cancer Treated With Radiotherapy.

Purpose: To aid personalized treatment selection, we developed a predictive model for acute rectal toxicity in patients with prostate cancer undergoing radiotherapy with photons and protons.

Materials And Methods: We analyzed a prospective multi-institutional cohort of 278 patients treated from 2012 to 2023 across 10 centers. Dosimetric and nondosimetric variables were collected, and key predictors were identified using purposeful feature selection.

Understanding patient perspectives in the management of their muscle-invasive bladder cancer.

Objectives: To evaluate the impact of advocacy efforts by organisations such as the Bladder Cancer Advocacy Network (BCAN) to increase awareness about the signs, symptoms, diagnosis, treatment and need for a multidisciplinary approach to the care of patients with muscle-invasive bladder cancer (MIBC).

Materials And Methods: We developed a 32-question survey with input from physicians, nurses, patients and caregivers. The survey was posted on the BCAN website between August 2013 and September 2014 (Cohort A) and again between June 2023 and April 2024 (Cohort B).

Summary from the NCI clinical trials planning meeting on next generation of clinical trials in non-muscle invasive bladder cancer.

The National Cancer Institute organized a virtual Clinical Trials Planning Meeting (CTPM) on 'Defining the next generation of clinical trials with combination therapies in non-muscle invasive bladder cancer (NMIBC)' led by the Bladder Cancer Task Force of the NCI Genitourinary Cancers Steering Committee. The purpose of this meeting was to accelerate advances in clinical trials for patients with high-risk NMIBC. The meeting delivered a multidisciplinary expert consensus on optimal strategies for next-generation clinical trial designs in NMIBC with prioritization of combination therapies.

Implementing evidence-based strategies for men with biochemically recurrent and advanced prostate cancer: Consensus recommendations from the US Prostate Cancer Conference 2024.

Current US clinical practice guidelines for advanced prostate cancer management contain recommendations based on high-level evidence from randomized controlled trials; however, these guidelines do not address the nuanced clinical questions that are unanswered by prospective trials but nonetheless encountered in day-to-day practice. To address these practical questions, the 2024 US Prostate Cancer Conference (USPCC 2024) was created to generate US-focused expert clinical decision-making guidance for circumstances in which level 1 evidence is lacking. At the second annual USPCC meeting (USPCC 2024), a multidisciplinary panel of experts convened to discuss ongoing clinical challenges related to 5 topic areas: biochemical recurrence; metastatic, castration-sensitive prostate cancer; poly [ADP-ribose] polymerase inhibitors; prostate-specific membrane antigen radioligand therapy; and metastatic, castration-resistant prostate cancer.

Biopsy-based Basal-luminal Subtyping Classifier in High-risk Prostate Cancer: A Combined Analysis of the NRG Oncology/RTOG 9202, 9413, and 9902 Phase 3 Trials.

Background And Objective: Long-term (LT) androgen deprivation therapy (ADT) has been found to be beneficial to patients with high-risk prostate cancer (PCa). However, administration of LT-ADT to all patients with high-risk PCa may lead to overtreatment. Enhanced risk stratification using genomic classifiers (such as the recently developed prostate subtyping classifier [PSC]) might be useful.

Eligibility and Endpoints for Clinical Trials in Trimodality Therapy for Bladder Cancer.

Background: Trimodality therapy (TMT) is a viable option for muscle-invasive localized bladder cancer, providing an alternative to radical cystectomy in properly selected patients. The approval of novel therapeutics in different stages of bladder cancer treatment has sparked interest in exploring concurrent systemic therapies with radiation in clinical trials to enhance long-term outcomes. Achieving uniformity in trial eligibility criteria and endpoint definitions is imperative in describing clinical significance, comparing trials, and changing standard of care guidelines.

Setting the Stage: Feasibility and Baseline Characteristics in the PARTIQoL Trial Comparing Proton Therapy Versus Intensity Modulated Radiation Therapy for Localized Prostate Cancer.

Purpose: Men with localized prostate cancer may receive either photon-based intensity modulated radiation therapy (IMRT) or proton beam therapy (PBT). The PARTIQoL trial (NCT01617161) demonstrates the feasibility of performing a large, multicenter phase 3 randomized trial comparing IMRT with PBT for localized prostate cancer. Here, we report baseline features of patients enrolled on this trial and present strategies to improve feasibility of other similar trials.

The Role of Multiparametric Magnetic Resonance Imaging and the Vesical Imaging-Reporting and Data System (VI-RADS) in the Management of Patients with Bladder Cancer: Vision of the American College of Radiology VI-RADS Steering Committee.

The American College of Radiology Vesical Imaging-Reporting and Data System (VI-RADS) Steering Committee will strive to ensure high-quality imaging practices for bladder cancer (BC) and improve outcomes for BC patients. Work will involve evaluation of the current status of magnetic resonance imaging for BC and identify actionable areas to improve its utility in clinical practice. Current VI-RADS gaps related to unmet clinical needs, research areas to address, and future steps and timelines will be identified.