Despite promising candidates across tumor, immune, and systemic marker categories, no biomarker yet reliably predicts BCG response or identifies which NMIBC patients would benefit from adding checkpoint inhibitor therapy—a gap that limits informed shared decision-making and broader adoption of IO-BCG combinations despite positive trial data.
On actionable guidance for community practitioners, Kamat's most emphatic recommendation is early pathology review.
Panelists discuss how to approach treatment for a younger (49-year-old) male veteran with bladder cancer, focusing on the rising rates among veterans, challenges with recurrent disease despite BCG therapy, various second- and third-line treatment options, including gemcitabine-docetaxel combination therapy and the importance of thorough monitoring for disease progression.
Panelists discuss how to manage the treatment of a 68-year-old woman with painless intermittent hematuria and positive cytology for high-grade urothelial cancer, addressing gender differences in diagnosis timing, the importance of repeat transurethral resection (TURBT) procedures, BCG therapy options, and considerations for radical cystectomy with pelvic organ preservation when BCG fails.
Panelists discuss how they approach a typical bladder cancer case of a 79-year-old man with hematuria, including initial diagnostic procedures, the importance of proper tumor measurement during resection, BCG therapy protocols, and management options for BCG-unresponsive disease with a focus on nadofaragene firadenovec (Adstiladrin).
Panelists discuss how non–muscle-invasive bladder cancer (NMIBC) is staged, graded, and treated according to risk stratification, with detailed explanations of low-, intermediate-, and high-risk categories and corresponding treatment pathways.
March 30th 2026
