Bladder Cancer

“The combination of NAI plus BCG was safe, it was effective, and it serves as a feasible and viable alternative to other agents in this disease space,” says Karim Chamie, MD.

The FDA will be evaluating findings from cohorts A and K from the phase 1b/2 EV-103 trial.

“First and foremost, it’s great that we have multiple lines of therapy for our bladder cancer patients,” says Tanya Dorff, MD.

Nadofaragene firadenovec is a non-replicating adenoviral vector based gene therapy.

"It is safe to give 24 hours or less of antibiotics for radical cystectomy. It does not decrease your infectious complications to have extended duration antibiotics," says Megan Prunty, MD.

The phase 2 trial is assessing the MetAP2 inhibitor APL-1202 and the PD-1 inhibitor tislelizumab as a non-chemotherapy–based neoadjuvant regimen for patients with muscular invasive bladder cancer.

The confirmatory phase 3 IMvigor130 trial did not show an overall survival advantage with frontline atezolizumab plus chemotherapy vs chemotherapy alone in patients with advanced urothelial carcinoma.

“There is a critical unmet need for efficacious bladder-sparing therapies for patients with BCG-unresponsive bladder cancer,” said Roger Li, MD.

A retrospective multi-center trial assessed the safety and feasibility of antegrade administration of Jelmyto in patients with low-grade UTUC.

“Cigarette smoking and continued smoking exposes patients [with bladder cancer] to a lot of continued risk, and I don't think we're doing our job as a doctor by ignoring this critical part of counseling and education,” says Dr. Matulewicz.

The findings are from the phase 2/3 FORT-1 study published in the Journal of Clinical Oncology.

“We used this study as a first step in understanding at a baseline what patients with non–muscle-invasive bladder cancer thought and what they believe to be risk factors for their bladder cancer,” says Richard S. Matulewicz, MD, MSCI.

Richard S. Matulewicz, MD, MSCI, MS, discusses the findings from his recent study that looked at patient knowledge about the link between smoking and bladder cancer.

“It doesn’t necessarily mean that you have cancer. But the more you smoke, the more mutations accumulate in your cells, and the more you increase your risk for developing cancer," said study author Marcos Díaz-Gay, PhD.

The study also identifies potential ways to make immunotherapy more effective in this setting.

“Our work indicates that these genetic signatures may prove to be tremendously valuable in predicting immunotherapy response in patients with bladder cancer, but also other tumor types," says Dan Theodorescu, MD, PhD.

The FDA has updated the label for mitomycin-containing reverse thermal gel (Jelmyto) in low-grade upper-tract urothelial cancer by extending the in-use period for pyelocalyceal solution admixture.

Moshe Ornstein, MD, discusses the mechanism of action, approved indications, and safety profile of the antibody-drug conjugate sacituzumab govitecan for patients with urothelial cancer.

Shilpa Gupta, MD, explains that the toxicities of sacituzumab govitecan and enfortumab vedotin “are not overlapping.”

The phase 2 study explored the combination of the PD-1 inhibitor toripalimab and chemotherapy as neoadjuvant treatment for patients with upper tract urothelial carcinoma.

The phase 3 Laser trial showed that outpatient laser photocoagulation of bladder tumors is as effective as conventional inpatient TURBT in patients with Ta low-grade bladder cancer recurrence.

“The management of patients with advanced urothelial carcinoma whose cancer has progressed on immunotherapy presents a unique challenge,” says Moshe Ornstein, MD.

The initial results from JAVELIN Bladder 100 supported the FDA approval of avelumab for the maintenance treatment of patients with locally advanced or metastatic urothelial carcinoma.

Vignesh Packiam, MD, discusses study results showing sequential intravesical gemcitabine and docetaxel is an effective and well-tolerated therapy for BCG-naïve NMIBC.

Vignesh Packiam, MD, explains how innovation driven by the BCG shortage led to a potential promising new regimen of sequential intravesical gemcitabine and docetaxel for patients with BCG-naïve non–muscle-invasive bladder cancer.

“Several of these patients were able to undergo surgery that spared them the need to remove their ureter and their kidney,” says Matthew T. Campbell, MD.

“The NRG SWOG 1806 trial is a phase 3 trial randomizing patients to standard trimodality therapy or trimodality therapy plus atezolizumab,” says Sophia Kamran, MD.

“We call it ‘trimodality therapy,’ because it involves the 3 main disciplines: surgery, radiation oncology, and medical oncology,” says Kamran.

Pramit Khetrapal, MD, discusses the abstract, “Results of the intracorporeal robotic vs open cystectomy multi-centre randomised trial,” which he presented at the 2022 AUA Annual Meeting.

“The open operation is obviously done using a single incision that is quite big,” says Khetrapal.