Volume 17 Issue 1, January 2020

Cancer care is currently experiencing rapid development in novel therapeutics, with an associated rise in treatment costs. These changes not only create a critical challenge for therapeutic decision-making but also highlight the need to prioritize therapies of high clinical and economic value. Health technology assessment methodology is a novel approach that could help guide value-based decision-making.

Data from a new study suggests that prostate-specific membrane antigen (PSMA)-targeted positron emission tomography (PET) imaging is superior to ¹⁸F-fluciclovine PET for detecting biochemical recurrence in men with prostate cancer. However, whether one of these radiotracers improves patient survival over the other is unknown and further research is needed to determine which has the greater effect.

Here, Linxweiler and Junker provide an update on our understanding of the functional role of extracellular vesicles in urological malignancies and discuss their applicability as diagnostic, prognostic and predictive biomarkers in the three most prevalent urological cancers.

Imber et al. summarize current knowledge of the risks of financial toxicity in patients with localized prostate cancer, proposing a framework of contributing factors, and discuss emerging assessment strategies to inform future research efforts.

In this Review, Stabile and colleagues describe the current status of the role of mpMRI in prostate cancer diagnosis, its clinical application and consider its future direction in this disease.