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Cancers
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Advances in Neoadjuvant Therapy for Urologic Cancer
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Advances in Neoadjuvant Therapy for Urologic Cancer

A Special Issue of Cancers (ISSN 2072-6694) belonging to the section "Cancer Therapy".

Deadline for manuscript submissions: closed (30 June 2026) | Viewed by 3786

Editor

Dr. Carlo Messina

E-Mail Website
Guest Editor
ARNAS Civico-Di Cristina-Benfratelli, P.Za Leotta Nicola, 4, 90127 Palermo, Italy
Interests: prostate cancer; renal cell carcinoma; urothelial cancer; germ cell tumor

Special Issue Information

Dear Colleagues,

In the last few decades, unprecedented improvements in the knowledge of the biology of genitourinary cancers have led to dramatic changes in the therapeutic landscape of these diseases.

Immune checkpoint inhibitors (ICIs) led to a paradigm shift in the treatment of genitourinary tumors, showing a significant improvement in survival outcomes. However, in other tumors, such as prostate and testis cancer, the role of ICIs remains marginal.

Recently, new targeted therapies, such as tyrosine kinase inhibitors (TKIs), antibody–drug conjugates (ADCs), and anti-FGFR drugs, are revolutionizing the treatment landscape of these tumors, and further studies are currently underway.

The present Special Issue aims to explore the implications of novel treatment strategies and biomarkers in neoadjuvant settings for patients suffering from genitourinary tumors.

Dr. Carlo Messina
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as communications are invited. For planned papers, a title and short abstract (about 250 words) can be sent to the Editorial Office for assessment.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-anonymized peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Cancers is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2900 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • neoadjuvant treatment
  • bladder cancer
  • prostate cancer
  • renal cell carcinoma
  • penile cancers
  • immunotherapy
  • antibody–drug conjugates

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Published Papers (2 papers)

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Research

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15 pages, 1270 KB  
Article
Pretreatment NPLH as a Potential Predictor of Pathologic Complete Response to Accelerated MVAC Neoadjuvant Chemotherapy in Muscle-Invasive Bladder Cancer: Comparison with NLR and PLR
by Łukasz Kwinta, Kamil Konopka, Krzysztof Okoń, Mateusz Łobacz, Maciej Lubaś, Piotr Chłosta, Przemysław Dudek and Piotr J. Wysocki
Cancers 2026, 18(13), 2046; https://doi.org/10.3390/cancers18132046 - 24 Jun 2026
Viewed by 385
Abstract
Background. Accurate prediction of pathologic complete response (pCR) to neoadjuvant chemotherapy (NAC) in muscle-invasive urothelial bladder cancer (MIBC) remains an unmet clinical need. The neutrophil-to-platelet/hemoglobin-to-lymphocyte (NPLH) ratio, a composite hematologic index that reflects both systemic inflammation and nutritional oxygen-carrying capacity, has not been [...] Read more.
Background. Accurate prediction of pathologic complete response (pCR) to neoadjuvant chemotherapy (NAC) in muscle-invasive urothelial bladder cancer (MIBC) remains an unmet clinical need. The neutrophil-to-platelet/hemoglobin-to-lymphocyte (NPLH) ratio, a composite hematologic index that reflects both systemic inflammation and nutritional oxygen-carrying capacity, has not been previously evaluated as a predictor of NAC response in this setting. Methods. We retrospectively analyzed 114 consecutive patients with MIBC (cT2–T4, N0–N3) who received accelerated MVAC (aMVAC) NAC followed by radical cystectomy at a single academic center. Pretreatment NPLH (calculated as [neutrophils × platelets]/[hemoglobin × lymphocytes]) was assessed as a predictor of pCR (ypT0N0) and tumor regression grade (TRG). Receiver operating characteristic (ROC) curve analysis, Mann–Whitney U test, and logistic regression were used. NPLH performance was compared to NLR and PLR. Results. pCR was achieved in 35 patients (30.7%). Median NPLH was significantly lower in pCR vs. non-pCR patients (33.9 [IQR 23.1–42.4] vs. 47.6 [IQR 30.7–90.4]; p = 0.0007). NPLH yielded an AUC of 0.700 (bootstrap 95% CI 0.596–0.794) for pCR prediction, numerically superior to NLR (AUC 0.645 [0.542–0.741]) and PLR (AUC 0.643 [0.533–0.747]); DeLong test: NPLH vs. NLR p = 0.079, NPLH vs. PLR p = 0.090. At the optimal cut-off of 44.5, NPLH demonstrated 80.0% sensitivity and 57.0% specificity. pCR rates declined progressively across NPLH quartiles: 48.3% (Q1) to 10.3% (Q4). On multivariate logistic regression, log-transformed NPLH was the only independent predictor of pCR (parsimonious model, OR 0.292, 95% CI 0.131–0.652; p = 0.003; EPV = 17.5). A positive correlation was observed between NPLH and TRG score (Spearman r = 0.284; p = 0.0022), with significant differences between TRG 1 and TRG 3 subgroups (p = 0.0036). Conclusions. Pretreatment NPLH is an independent predictor of pCR to aMVAC in MIBC and is numerically superior to NLR and PLR (DeLong p = 0.079). Consisting exclusively of standard complete blood count parameters, NPLH is readily available and inexpensive. This single-center exploratory study is hypothesis-generating and requires prospective external validation before clinical implementation. Full article
(This article belongs to the Special Issue Advances in Neoadjuvant Therapy for Urologic Cancer)
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Review

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16 pages, 534 KB  
Review
The Management of Muscle Invasive Bladder Cancer: State of the Art and Future Perspectives
by Antonio Cigliola, Brigida Anna Maiorano, Doga Dengur, Valentina Tateo, Chiara Mercinelli, Michela Piacentini, Sara Inguglia, Carlo Messina and Andrea Necchi
Cancers 2025, 17(24), 4017; https://doi.org/10.3390/cancers17244017 - 17 Dec 2025
Cited by 1 | Viewed by 2802
Abstract
Background: Muscle-invasive bladder cancer (MIBC) represents a highly aggressive malignancy associated with significant morbidity and mortality. The current standard treatment, which includes radical cystectomy and platinum-based chemotherapy, is burdened by high toxicity and a substantial risk of relapse. For this reason, over the [...] Read more.
Background: Muscle-invasive bladder cancer (MIBC) represents a highly aggressive malignancy associated with significant morbidity and mortality. The current standard treatment, which includes radical cystectomy and platinum-based chemotherapy, is burdened by high toxicity and a substantial risk of relapse. For this reason, over the past decade, novel therapeutic strategies involving immune checkpoint inhibitors (ICIs), antibody–drug conjugates (ADCs), and targeted therapies have been investigated. This review aims to summarize current clinical evidence and ongoing trials evaluating these approaches in the perioperative setting. Methods: A systematic search was conducted using PubMed, EMBASE, and Cochrane databases, along with abstracts from major oncology conferences (ASCO, ESMO, SGO). Clinical trials assessing ICIs, ADCs, and targeted therapies, either alone or in combination with each other or with chemotherapy, in MIBC, were included. Results: Several early-phase and phase III trials have investigated the perioperative management of MIBC. Various studies evaluated the addition of ICIs to standard chemotherapy, demonstrating promising results in terms of pathological complete response. In parallel, the encouraging outcomes with ICIs and ADCs alone in the neoadjuvant or adjuvant setting paved the way for their combination in integrated strategies. Biomarker-driven approaches, based on circulating tumor DNA and specific genomic alterations, are being actively explored to improve patient selection and personalize treatment. Conclusions: ICIs, ADCs, and targeted therapies are reshaping the therapeutic landscape of MIBC. While early results are promising, further data and biomarker validation are essential to establish their definitive role and guide clinical decision-making in the perioperative setting. Full article
(This article belongs to the Special Issue Advances in Neoadjuvant Therapy for Urologic Cancer)
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