Glucagon-like peptide-1 (GLP-1), an incretin hormone renowned for its role in post-meal blood sugar regulation and glucose-dependent insulin secretion, has gained attention as a novel treatment for diabetes through GLP-1 receptor agonists (GLP-1-RA). Despite their efficacy, concerns have been raised regarding the potential associations between GLP-1-RA and certain malignancies, including medullary thyroid cancer. However, evidence of its association with prostate cancer (PCa) remains inconclusive. This review delves into the intricate relationship between GLP-1-RA and PCa, exploring the mechanisms through which GLP-1-Rs may impact PCa cells. We discuss the potential pathways involving cAMP, ERK, AMPK, mTOR, and P27. Furthermore, we underscore the imperative for additional research to elucidate the impact of GLP-1-RA treatment on PCa progression, patient outcomes, and potential interactions with existing therapies. Translational studies and clinical trials are crucial for a comprehensive understanding of the role of GLP-1-RA in PCa management.

Contemporary prostate cancer (PCa) screening uses first-line prostate-specific antigen (PSA) testing, possibly followed by multiparametric magnetic resonance imaging (mpMRI) for men with elevated PSA levels. First-line biparametric MRI (bpMRI) screening has been proposed as an alternative. To evaluate the comparative effectiveness and cost-effectiveness of first-line bpMRI versus PSA-based screening. Decision analysis using a microsimulation model. Surveillance, Epidemiology, and End Results database; randomized trials. U.S. men aged 55 years with no prior screening or PCa diagnosis. Lifetime. U.S. health care system. Biennial screening to age 69 years using first-line PSA testing (test-positive threshold, 4 µg/L) with or without second-line mpMRI or first-line bpMRI (test-positive threshold, PI-RADS [Prostate Imaging Reporting and Data System] 3 to 5 or 4 to 5), followed by biopsy guided by MRI or MRI plus transrectal ultrasonography. Screening tests, biopsies, diagnoses, overdiagnoses, treatments, PCa deaths, quality-adjusted and unadjusted life-years saved, and costs. For 1000 men, first-line bpMRI versus first-line PSA testing prevented 2 to 3 PCa deaths and added 10 to 30 life-years (4 to 11 days per person) but increased the number of biopsies by 1506 to 4174 and the number of overdiagnoses by 38 to 124 depending on the biopsy imaging scheme. At conventional cost-effectiveness thresholds, first-line PSA testing with mpMRI followed by either biopsy approach for PI-RADS 4 to 5 produced the greatest net monetary benefits. First-line PSA testing remained more cost-effective even if bpMRI was free, all men with low-risk PCa underwent surveillance, or screening was quadrennial. Performance of first-line bpMRI was based on second-line mpMRI data. Decision analysis suggests that comparative effectiveness and cost-effectiveness of PCa screening are driven by false-positive results and overdiagnoses, favoring first-line PSA testing with mpMRI over first-line bpMRI. National Cancer Institute.

To evaluate the incidence, timing, and clinical predictors of radiation‐induced hematuria following robotic stereotactic body radiation therapy (SBRT) for localized prostate cancer. This retrospective single‐center cohort study included 397 patients treated with robotic SBRT between 2013 and 2019 for localized prostate cancer. All patients received 36.25 Gy in 5 fractions with the urethral sparing technique. Radiation‐induced hematuria was defined as gross hematuria or clinically significant microscopic hematuria without alternative etiology. Incidence, time to first event, and related interventions were assessed. Severity was graded using CTCAE version 5.0. Candidate predictors were selected based on the literature. Cox proportional hazards modeling identified clinical predictors of radiation‐induced hematuria. At a median follow‐up of 56 months (IQR 29–79), 48 patients (12.1%) developed radiation‐induced hematuria, occurring at a median of 30 months (IQR 19–49) after radiation treatment. Severe events (grade 3) were rare, affecting only 5 patients (1.3%). Diagnostic cystoscopy was performed in 35 patients (72.9%) and 6 patients (12.5%) required a total of 10 therapeutic interventions. Diabetes was the only independent predictor (HR 2.63, 95% CI 1.37–5.00, p = 0.004), while age, anticoagulant use, prostate volume, and Charlson Comorbidity Index showed no significant association. Radiation‐induced hematuria following robotic SBRT is predominantly low‐grade and late‐occurring, confirming the favorable genitourinary toxicity profile. These findings help clinicians better understand this SBRT‐related toxicity and provide more accurate patient counseling regarding timing and severity of potential hematuria. Diabetes was identified as an independent risk factor and may have clinical implications; however, whether optimization of glycemic control reduces hematuria risk remains uncertain and requires further investigation.