Rare genitourinary malignancies: where do we stand?

Rare genitourinary malignancies remain a diverse and often challenging subset of tumor types for clinicians to care for. There are a number of reasons for the resulting challenges imparted in caring for these patients including the infrequent number of cases cared for within large healthcare systems as well as the paucity of prospective studies aimed at redefining the treatment standards for these poorly funded malignancies attracting limited industry support. This dedicated issue of the AME Medical Journal (AMJ) highlights exciting advances which have been made in caring for many of these tumors and encompass the topics of adrenocortical carcinoma, extra-gonadal germ cell, melanoma, penile, sarcoma, scrotal, and urethral cancers. These featured articles focus on key clinical concepts and treatment principles which offer the most contemporary and evidence based therapeutic approaches for our endearing patients. In addition, several unique and intriguing case presentations detail the challenging dilemmas, healthcare providers are plagued with in managing these cases with an emphasis on multidisciplinary care in which individual specialty expertise and insight allows to formulate a personalized treatment plan aimed at optimizing oncological outcomes as well as accounting for patient expectations and ensuing quality of life. In conclusion, I would like to highlight that advances in genomic profiling and development of exciting novel systemic therapies like combination immunotherapies, tumor vaccines, and/or chimeric antigen receptor T cell therapy often a new horizon of hope and discovery for many patients refractory to conventional therapies and faced with these often debilitating and life-threatening malignancies.

Acknowledgments

Funding: None.

Footnote

Provenance and peer review: This article was commissioned by the editorial office, AME Medical Journal for the series “Rare Genitourinary Malignancies”. The article did not undergo external peer review.

Conflicts of Interest: The author has completed the ICMJE uniform disclosure form (available at https://amj.amegroups.com/article/view/10.21037/amj.2020.01.02/coif). The series “Rare Genitourinary Malignancies” was commissioned by the editorial office without any funding or sponsorship. Dr. Spiess served as the unpaid Guest Editor of the series and serves as unpaid Associate Editor-in-Chief of AME Medical Journal from March 2020 to February 2025. He is the Panel member and vice-chair of the NCCN Committee on Bladder and Penile Cancer (non-financially compensated). The author has no other conflicts of interest declare.

Ethical Statement: The author is accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the non-commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0/.

Philippe E. Spiess