Mechanisms of Resistance in Genito-Urinary Cancers: Innovative Insights in Signaling and Therapeutic Targetings

Dear Colleagues,

The management of metastatic genito-urinary cancers such as prostate, kidney, and urothelial cancers has dramatically changed in the last ten years.

New insights into the biology of cancer cells, mechanisms of neoangiogenesis, metastatization, cell death, and resistance have served as the foundation for new therapeutic targets that have modified the history of these cancers.

New androgen receptor signaling inhibitors (ARSI), tirosine kinase inhibitors (TKIs), immune check point inhibitors (CPIs), new chemotherapeutic agents (NCA) such as cabazitaxel, and fibroblastic growth factor (FGFR) inhibitors such as erdafitinib represent new therapies, effective options with overall survival, progression-free survival, and quality of life (QoL) improvement.

However, two questions are open today:

• How to select the best drug among several available options considering the absence of predictive factors, elderly age, and clinical conditions of the patients. Preliminary findings have focused on circulating tumor cells (CTC) count and different clones of CTC as prognostic and predictive factors in prostate cancers;
• How to overcome resistance to approved agents. PARP inhibitors and PSMA theranostics in prostate cancer, CPIs plus targeted therapy in kidney cancer, and FGFR inhibitors and CPIs with chemotherapy in selected subtypes of urothelial cancers show preliminary and interesting results. New treatments are also needed in penile and testicular cancers.

In this Special Issue, we will publish original research and reviews that provide new insights in genitourinary cancer, focusing on new mechanisms to overcome resistance to approved therapies and how it can be targeted therapeutically. New insights into AR mutation, the role of CTC, and new chemotherapeutic and immunotherapeutic agents will be particularly welcomed.

Prof. Dr. Giuseppe Di Lorenzo
Guest Editor

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