In the treatment of cancer, immune checkpoint inhibitors (ICIs) have demonstrated significantly greater effectiveness compared to conventional cytotoxic or platinum-based chemotherapies. To assess the efficacy of ICI’s in penile squamous cell carcinoma (pSCC) we performed a retrospective observational study. We reviewed electronic medical records of patients with penile squamous cell carcinoma (SCC), diagnosed between January 2020 and February 2023. Nine patients were screened, of whom three were ineligible for chemotherapy and received immunotherapy, cemiplimab, in a first-line setting. Each of the three immunotherapy-treated patients achieved almost a complete response (CR) after only a few cycles of therapy. The first patient had cerebral arteritis during treatment and received a high-dose steroid treatment with resolution of the symptoms of arteritis. After tapering down the steroids dose, the patient continued cemiplimab without further toxicity. The other two patients did not have any toxic side effects of the treatment. To the best of our knowledge, this is the first real world report of near CR with cemiplimab as a first-line treatment in penile SCC.

Background: Immune checkpoint inhibitors (ICIs) have significantly improved outcomes in metastatic non-small cell lung cancer (NSCLC), yet only a subset of patients derives durable benefit, suggesting that host and tumor-related factors may modify treatment efficacy. The renin–angiotensin system has been implicated in regulation of the tumor microenvironment, and angiotensin-converting enzyme inhibitors (ACEIs) have therefore been proposed as potential modulators of immunotherapy response. Material and methods: We conducted a retrospective observational cohort study including patients with advanced metastatic NSCLC treated in the first-line setting with treatment-based immunotherapy, with or without chemotherapy, between January 2017 and September 2025. Chronic ACEI exposure was defined as continuous use for at least two years prior to initiation of immunotherapy. Progression-free survival (PFS) and overall survival (OS) were analyzed using Kaplan–Meier estimates and compared using the log-rank test, and multivariable Cox proportional hazards models were adjusted. Results: Among 446 eligible patients, 71 (16%) received ACEIs and 375 (84%) did not. The median age of the cohort was 67.5 years, and 70% were male. Adenocarcinoma was the predominant histology (67.7%), and most patients received chemo–immunotherapy (81.6%), while 18.4% received immunotherapy alone. PD-L1 expression ≥ 1% was present in 59.2% of patients. In the overall cohort, median PFS and OS were 12 and 15 months, respectively. Median OS was 17 months in the ACEI group compared with 14 months in the non-ACEI group (log-rank p < 0.047), while median PFS was 14 months versus 11 months, respectively (p = 0.066). The survival advantage was more pronounced for OS than for PFS and remained consistent after adjustment for clinical characteristics including age, sex, ECOG performance status, smoking status, histology, treatment regimen, and PD-L1 expression. Conclusions: These findings suggest that chronic ACE inhibitor use may be associated with improved outcomes in metastatic NSCLC patients treated with immune checkpoint inhibitors.

Background: The integration of immune checkpoint inhibitors (ICIs) has transformed metastatic non-small cell lung cancer (NSCLC) therapy. However, the immunomodulatory influence of concurrent medications, including angiotensin-converting enzyme inhibitors (ACEIs), remains poorly defined in real-world practice. Methods: This retrospective observational study included 452 patients with metastatic NSCLC treated with first-line ICI-based therapy (ICI monotherapy or chemo-immunotherapy) between 2017 and 2025. Patients were stratified according to chronic ACEI exposure, defined as administration for >2 years. Primary endpoints were overall survival (OS), progression-free survival (PFS), and immune-related adverse events (irAEs). Results: Among 452 patients, 71 (15.7%) were chronic ACEI users. ACEI use was associated with significantly longer median OS in univariable analysis (17.0 vs. 14.0 months; HR = 0.78, 95% CI: 0.61–0.99; p = 0.047) and a favorable trend toward improved PFS (14.0 vs. 11.0 months; HR = 0.81, 95% CI: 0.64–1.02; p = 0.066). ACEI users had higher rates of cutaneous rash (25.4% vs. 13.1%; p = 0.011) and transaminase elevation (29.6% vs. 8.9%; p < 0.001). Severe grade 3–5 irAEs remained uncommon and did not differ significantly between groups (p > 0.05). Conclusions: Chronic ACEI use was associated with longer OS in univariable analysis, but this association was not statistically significant after multivariable adjustment. ACEI use was also associated with increased low-grade cutaneous and hepatic toxicities without a significant increase in severe irAEs. Prospective studies are warranted to clarify the clinical significance of these associations.

Background: Invasive BC patients are at risk of loco-regional recurrence, distant MTS, and the development of second primary tumors. SPMs comprise the sixth most common group of malignancies. Material and methods: The records of 125 consecutive patients with primary invasive TCC of the bladder seen in the Oncology Department of Soroka University Medical Center were reviewed between January 2016 and December 2023. We recorded demographic details, the type of primary treatment, tumor site, time to diagnosis of MTS, and occurrence of SPMs. Results: The primary treatments included RC in 58 patients (median age 66 years, range 43–86), PC in 9 patients (median age 64 years, range 22–73), and XRT in 23 patients (median age 74 years, range 22–87). Five patients from the PC group were also treated by XRT. A total of 90 (72%) patients developed MTS or SPMs, with 66 of these developing MTS and 24 developing SPMs. The median age was 70 years (range 22–87). The most frequent site of MTS was in the pelvic LNs (34 patients), followed by bone (18 patients), liver (8 patients), and lung (6 patients), with 4 patients developing synchronous MTS in the pelvic LNs and liver. The median time from diagnosis to MTS was 14.3 months. The distribution of MTS varied according to primary treatment. After RC, 17 patients developed LN MTS, 7 liver, 6 bone, and 3 lung MTS. The average times for developing MTS were as follows: LNs, 14.8 months, liver, 59.7 months, bone, 6.8 months, and lung, 16 months. Following XRT, LN MTS developed in 17 patients: 12 bone, 3 lung, and 1 liver. The most frequent SPMs were prostate cancer with 11 patients and lung cancer with 6 patients, with the median time from TCC diagnosis of 54 months. Conclusion: A regular extended follow-up for invasive BC patients is vital to ensure the early detection of frequently occurring MTS and SPMs. Through the early diagnosis of local recurrences, MTS, and SPMs, treatment results and patient prognosis can be significantly improved.

Background: Merkel cell carcinoma (MCC) is an aggressive cutaneous neuroendocrine malignancy with a high risk of recurrence. While adjuvant radiotherapy is standard following surgical resection in high-risk disease, the additional benefit of platinum–etoposide chemotherapy and the prognostic role of tumor anatomical location remain uncertain. Methods: We conducted a multicenter retrospective cohort study including patients with high-risk MCC (stage IIB–III) treated with surgery followed by adjuvant radiotherapy with or without platinum–etoposide chemotherapy. Tumor sites were classified according to sun-exposure status. Disease-free survival (DFS) and overall survival (OS) were estimated using Kaplan–Meier methods and compared using the log-rank test, with subgroup analyses by anatomical region and stage. Results: A total of 103 patients were included, of whom 77 (74.8%) received adjuvant chemoradiotherapy and 26 (25.2%) received radiotherapy alone. Patients with non-sun-exposed tumors demonstrated longer survival outcomes than those with sun-exposed tumors, with a median DFS of 57 months versus 42 months (p = 0.15), and a median OS of 179 months versus 109 months (p = 0.054), respectively. Among patients with sun-exposed tumors, chemoradiotherapy was associated with numerically improved DFS (42 vs. 34 months; p = 0.051) and OS (128 vs. 98 months; p = 0.08) compared with radiotherapy alone. In patients with non-sun-exposed tumors, chemoradiotherapy demonstrated a more pronounced improvement in OS (178 vs. 56 months; p = 0.054), while DFS also favored combined treatment (49 vs. 78 months; p = 0.078). Conclusions: In this multicenter cohort, adjuvant chemotherapy did not demonstrate a uniform survival benefit overall but was associated with improved outcomes in head and neck MCC, suggesting a potential site-specific effect. Similar outcomes across stage III subgroups suggest that chemotherapy may mitigate stage-related prognostic differences. These findings support a selective approach to adjuvant chemotherapy and highlight the need for prospective studies incorporating modern immunotherapy strategies.

Upper tract urothelial carcinoma (UTUC) in a duplex collecting system (DCS) is a relatively uncommon presentation with unclear management guidelines. Herein, we retrospectively reviewed all published cases of DCS with UTUC aiming to suggest personalized clinical care options for future cases. We conducted a systematic search for all cases of UTUC in DCS from published literature using the following keywords: UTUC, urothelial carcinoma (UC), collecting duct carcinoma, and DCS. The cases were summarized based on demographics, clinical presentation, predisposing risk factors, tumor location, management, and follow-up. We present an additional case based on our experience with a 69-year-old female with high-grade (HG) UTUC of the upper moiety in complete DCS. The patient underwent a robotic upper pole hemi-nephroureterectomy (hemi-NU) with a common sheath distal ureterectomy and a bladder cuff, followed by lower pole ureteral reimplantation. Overall, 34 patients with 35 renal units of UTUC in DCS were included and analyzed. To conclude, UTUC of DCS is rare and underreported. Hence, it is difficult to define a standard treatment. Although hemi-NU has been previously described, to the best of our knowledge, this is the first case report of robot-assisted hemi-NU for complete DCS with single-moiety UC.