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Introduction We assessed the association of genitourinary microbiomes with prostate cancer (PCa) tumorigeneses and cancer characteristics. Material and methods A systematic search and meta-analysis was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. The primary endpoints were the association between relative abundance of genitourinary microbiomes and PCa compared to non-cancerous men/prostate specimen, high grade disease, and disease progression. The odds ratio (OR) was used as the summary statistic, and results were reported with 95% condence intervals (CI). Results Seventeen studies, comprising 2,195 patients were eligible for review and meta-analysis. The specific microbiomes in urine, prostate tissue, and prostate (or seminal) secretions were significantly more abundant in patients with PCa compared to men in the control groups in individual studies. Certain bacterial phyla, genuses, and species were significantly associated with PCa aggressiveness and disease progression in individual studies. The relative abundance meta-analysis of five urine microbiomes revealed no statistically significant differences between PCa patients and control groups (pooled OR, 1.35; 95% CI: 0.70–2.59). Conclusions Our systematic review indicates that specific genitourinary microbiomes are more abundant in PCa and have a potential to predict/prognosticate disease aggressiveness and clinical outcomes. Nevertheless, these findings should be interpreted with caution owing to the significant heterogeneity among studies in terms of microbiome analysis method, assessed sample’s characteristics, and individual biological behavior of microbiomes for analysis. Further studies are needed to validate these observations and shed more light on the role of the microbiome across the development and natural history of PCa. [ABSTRACT FROM AUTHOR]

(1) Background: Intravesical chemotherapy is the standard of care in intermediate-risk non-muscleinvasive bladder cancer (NMIBC). Different agents are used across the world based on availability, cost, and practice patterns. Epirubicin (EPI), one of these agents, has been used by many centers over many decades. However, its true differential efficacy compared to other agents and its tolerability are still poorly reported. We aimed to assess the differential efficacy and safety of intravesical EPI in NMIBC patients. (2) Methods : This study aimed to systematically review the efficacy and safety profile of Epirubicin (EPI) in the management of non-muscle invasive bladder cancer (NMIBC) compared to other adjuvant therapies. A systematic search of the PUBMED, Web of Science, clinicaltrials.gov, and Google Scholar databases was conducted on 31 December 2023, using relevant terms related to EPI, bladder cancer, and NMIBC. The inclusion criteria targeted studies that evaluated patients treated with EPI following the transurethral resection of bladder tumors (TURBT) for NMIBC and compared oncological outcomes such as recurrence and progression with other adjuvant therapies, including Mitomycin C (MMC), Gemcitabine (GEM), and Bacillus Calmette-Guérin (BCG). Additionally, studies investigating the safety profile of EPI administered intravesically at room temperature and under hyperthermia, as well as oncological outcomes associated with hyperthermic intravesical EPI administration, were included. (3) Results: Eleven studies reported adverse events after adjuvant intravesical instillations with EPI; the most frequently reported adverse events included cystitis (34%), dysuria, pollakiuria, hematuria, bladder irritation/spasms, fever, nausea and vomiting, and generalized skin rash (2.3%). Nine studies compared EPI to BCG in terms of recurrence and progression rates; BCG instillations showed a lower recurrence rate compared to EPI, with limited or non-significant differences in progression rates. Two studies found no significant differences between EPI and MMC regarding progression and recurrence rates. One study showed statistically significant lower recurrence and progression rates with GEM in high-risk NMIBC patients. Another study found no significant differences between EPI and GEM regarding recurrence and progression. (4) Conclusions : EPI exhibits similar oncological performances to Gemcitabine and Mitomycin C currently used for adjuvant therapy in NMIBC. Novel delivery mechanisms such as hyperthermia are interesting newcomers.