Bladder Cancer

"If there’s recurrence of muscle-invasive bladder cancer within the bladder, you can perform salvage cystectomy at that point…. It is a bit more complex, so it’s great to have a high-volume surgeon who has performed these before," says Sophia C. Kamran, MD.

“We know that with that low toxicity and good functional outcomes, it's an excellent treatment to offer patients,” says Sophia C. Kamran, MD.

5-year OS was similar between the cohorts, with a rate of 57% among patients who underwent RARC, compared with 55% among those who underwent ORC.

The investigators assessed data from the UNITE study, a retrospective study of patients treated with enfortumab vedotin and other agents.

“Our results suggest that bladder-sparing treatments may be a safe approach in selected patients. Survival outcomes were not inferior compared to early radical cystectomy," says Wei Shen Tan, MD.

“I would say that overall, the oncologic outcomes are equivalent between the [bladder-sparing treatment and radical cystectomy] for well-selected patients,” says Sophia C. Kamran, MD.

“We're still very interested in early-stage bladder cancer, those at high risk do not respond to BCG,” says Joshua J. Meeks, MD, PhD.

"TAR-200 is a sort of a pretzel device. It's a novel drug delivery mechanism that's placed inside the bladder for sustained release of gemcitabine," explains Siamak Daneshmand, MD.

"The addition of an immune checkpoint inhibitor after tri- or tetra-modality therapy might improve long-term outcomes for patients with bladder cancer,” said Maria De Santis, MD.

“There's not a perfect chemotherapy; there are a lot of different options, and then other factors to consider would be the field and the dose,” says Sophia Kamran, MD.

"There continues to be immense interest in urinary markers for bladder cancer," says Badrinath Konety, MD, MBA.

“I would say that patients who have a very poor bladder function to start with would be a better candidate for radical cystectomy,” says Sophia C. Kamran, MD.

Rohan Garje, MD, highlights the need for molecular profiling of sarcomatoid urothelial carcinoma tumors as a gateway to advancing the treatment paradigm for this rare bladder cancer variant.

“It’s very important to really talk to the patients and understand any toxicities because the side effects are well managed if they’re caught early,” says Shilpa Gupta, MD.

Disitamab vedotin is a HER2-targeted antibody-drug conjugate and toripalimab is a PD1-inhibitor.

“We've made great strides with bladder preservation on many fronts,” says Sophia C. Kamran, MD.

"The emulation framework lends the design and conduct of observational analyses some of the rigor required for the planning of a randomized trial. In doing so, it provides an innovative and principled approach to improve the evidence base on the comparative effectiveness of interventions," writes Boris Gershman, MD, and Aaron Fleishman, MPH.

"This is the first data to show that antegrade instillation of UGN-101 had lower ureteral stricture rates compared [with] retrograde approaches,” said Josh Gottlieb, DO.

Outstanding early-career researchers acknowledged for novel studies to enhance the well-being of patients with bladder cancer.

The investigators found that patients who experienced recurrence following BCG therapy were more likely to have BRS3 tumors compared with BRS1 or BRS2.

The intravesical drug delivery system TAR-210 is designed to provide localized continuous release of erdafitinib in patients with bladder cancer.

The 5-year metastasis-free survival rate was 75% with trimodality therapy vs 74% with radical cystectomy.

Increasing numbers of older patients with cancer necessitates adoption of an age-friendly approach to cancer care.

"With intravesical chemotherapy, there aren't the side effects we see with intravenous chemotherapy because the drugs only treat the bladder lining and very little, if any, of the medicine gets absorbed in the bloodstream," said Nitin Yerram, MD.

Siamak Daneshmand, MD, discusses the safety profile for TAR-200 from the phase 2b SUNRISE-1 trial, which explored the novel intravesical chemo delivery system in patients with BCG-unresponsive on–muscle-invasive bladder cancer.

Siamak Daneshmand, MD, discusses initial findings from the phase 2b SUNRISE-1 trial exploring the novel intravesical chemotherapy delivery system TAR-200 in non–muscle-invasive bladder cancer.

In the study, 69% of patients who underwent complete ablation had no visible disease at first endoscopic evaluation, compared with 40% of patients who underwent chemoablation therapy.

Of all malignant bladder cancer lesions, 28% were only identified with blue light.

"This study looks at comparing BCG, which is our classic mainstay in the treatment of high-risk non-muscle–invasive bladder cancer to intravesical gemcitabine-docetaxel," says Diana Magee, MD.

“The medication is given once a week for 6 weeks. It is an outpatient procedure with general anesthesia. And it is typically covered by insurance,” said Joseph Brito, MD.