BackgroundTikTok is the world’s fastest-growing video application, with 1.6 billion users in 2021. More and more patients are searching for information on genitourinary cancers via TikTok. We aim to evaluate the functional quality and reliability of genitourinary cancer-related videos on it and share our thoughts based on the results for better public health promotion.Materials and MethodsWe retrieved 167 videos on bladder, prostate, and kidney cancer from TikTok. Only 61 videos (36.53%) met the inclusion criteria and were eventually regarded as sample videos. Each video’s length and descriptions, hashtags, number of views/likes/comments, forms of expression, and the uploader’s profile were included. Three validated assessment instruments: the Hexagonal Radar Schema, the Health on the Net Code scale, and the DISCERN instrument, were used for evaluating the quality and reliability of the information. All misinformation was counted and categorized. Univariate analysis of variance was performed for analyzing the results. The Post-Hoc least significant difference test was conducted to explore further explanation.ResultsAmongst 61 sample videos, healthcare practitioners contributed the most content (n = 29, 47.54%). However, 22 posts (36.07%) were misinformative, and the most common type was using outdated data. More than half of the videos could provide good (> 1 point) content on the diseases’ symptoms and examinations. However, the definition and outcomes were less addressed (tied at 21%). The HONcode scale and the DISCERN instrument revealed a consistent conclusion that most videos (n = 59, 96.72%) on TikTok were of poor to mediocre quality. Videos published by media agencies were statistically better in terms of reliability and overall score (P = 0.003 and 0.008, respectively). Fifty-three videos (86.89%) had at least two unexplained medical terms. Healthcare professionals tend to use professional terms most (mean = 5.28 words).ConclusionsMost videos on genitourinary cancers on TikTok are of poor to medium quality and reliability. However, videos posted by media agencies enjoyed great public attention and interaction. Medical practitioners could improve the video quality by cooperating with media agencies and avoiding unexplained terminologies.

Inflammatory cancer-associated fibroblasts (iCAFs) are closely related to progression, anticancer therapeutic resistance, and poor prognosis of bladder cancer (BCa). However, the functional role of iCAFs in BCa has been poorly studied. In our study, two BCa scRNA-seq datasets (GSE130001 and GSE146137) were obtained and integrated by the Seurat pipeline. Based on reported markers (COL1A1 and PDGFRA), iCAFs were identified and the related signature of 278 markers was developed. Following unsupervised consensus clustering, two molecular subtypes of TCGA-BLCA were identified and characterized by distinct dysregulated cancer hallmarks, immunological tumor microenvironments, prognoses, responses to chemotherapy/immunotherapy, and stemness. Subsequently, the robustness of the signature-based clustering, in terms of prognosis and therapeutic response prediction, was validated in a GEO-meta cohort with seven independent GEO datasets of 519 BCa patients, and three immune checkpoint inhibitor (ICI)-treated cohorts. Considering the heterogeneity, re-clustering of iCAFs was performed and a subpopulation, named “LOXL2+ iCAFs”, was identified. Co-culture CM derived from LOXL2 overexpression/silencing CAFs with T24 cells revealed that overexpression of LOXL2 in CAFs promoted while silencing LOXL2 inhibited the proliferation, migration, and invasion of T24 cells through IL32. Moreover, the positive correlation between LOXL2 and CD206, an M2 macrophage polarization marker, has been observed and validated. Collectively, integrated single-cell and bulk RNA sequencing analyses revealed an iCAF-related signature that can predict prognosis and response to immunotherapy for BCa. Additionally, the hub gene LOXL2 may serve as a promising target for BCa treatment.

ObjectiveConsidering the striking evidence revealed by immunotherapy in advanced or metastatic bladder cancer, investigators have explored neoadjuvant immunotherapy and chemoimmunotherapy in muscle-invasive bladder cancer (MIBC). Currently, there have been a large number of studies reporting varied efficacy and safety of these approaches. Herein, we pooled the available evidence in terms of oncological outcomes (pathological complete response [pCR] and pathological partial response [pPR]) and safety outcomes (immune-related adverse events [irAEs], treatment-related adverse events [TRAEs]), through a systematic review and meta-analysis.MethodWe searched PubMed, Embase, Cochrane Library, and American Society of Clinical Oncology meeting abstracts to identify relevant studies up to June 2022. Studies were included if they evaluated the neoadjuvant immunotherapy or chemoimmunotherapy in MIBC and reported at least the pCR.ResultsA total of 22 records involving 843 patients were included. For pCR of immunotherapy, the pooled rate of immune checkpoint inhibitor (ICI) monotherapy and dual-ICIs therapy was 24% (95% confidence interval [CI]: 15.3% - 32.8%) and 32.1% (95%CI: 20.6% - 43.7%), respectively. For pCR of chemoimmunotherapy, the overall pooled rate was 42.6% (95% CI: 34.9% - 50.2%). Subgroup of gemcitabine/cisplatin (GC) plus ICI had a pCR rate of 41.7% (95%CI: 35.8% - 47.5%). In terms of safety, the pooled rate of Grade≥3 irAEs was 11.7% (95% CI: 6.5%-16.9%). In subgroup analysis, the Grade≥3 irAEs rate of ICI monotherapy, dual-ICIs therapy, and GC plus ICI therapy was 7.4% (95% CI: 4.3%-10.5%), 30.3% (95% CI: 15.3%-45.3%), and 14.5% (95% CI: 3.5% - 25.4%), respectively. Besides, the pooled Grade≥3 TRAEs rate for chemoimmunotherapy was 32.4% (95% CI: 13.1% - 51.6%).ConclusionNeoadjuvant immunotherapy and chemoimmunotherapy were effective and safe in the treatment of MIBC. Compared to ICI monotherapy, dual-ICIs therapy or chemoimmunotherapy can improve the response rate, while increasing the morbidity of Grade≥ 3 irAEs or Grade≥ 3 TRAEs.Systematic Review Registrationhttps://www.crd.york.ac.uk/prospero/, identifier CRD4202233771.