Bladder Cancer

As urologists maneuver through the third shortage of bacillus Calmette-Guérin during the past decade, there is a sense of urgency to find short- and long-term alternative treatments to the only FDA-approved BCG strain as a therapeutic agent for nonmuscle-invasive bladder cancer.

The combination of an IL-15 cytokine agonist known as N-803 and bacillus Calmette–Guérin (BCG) was well tolerated and offered promising activity in patients with nonmuscle-invasive bladder cancer (NMIBC) who did not respond to BCG therapy, according to phase I and II study results.

New data suggest it may be possible to use computer-augmented cystoscopy to aid in diagnostic decision-making and improve the diagnostic yield of papillary bladder cancers.

Routine use of positron emission tomography/computed tomography prior to radical cystectomy is unlikely to benefit clinically node-negative patients, results of a recent investigation suggest.

Poor outcomes in women may stem from diagnostic, therapeutic, and biologic factors.

A new investigational diagnostic imaging technique based on analyzing nanoscale resolution maps of cell surfaces performed favorably compared to what might be expected with cystoscopy in detecting bladder cancer.

The risk of high-grade postoperative complications after radical cystectomy might be predicted using a model that incorporates several routinely collected preoperative variables.

“The results with neoadjuvant atezolizumab are preliminary but promising in this area of high unmet need,” says researcher Thomas Powles, MD.

Widowed bladder cancer patients are more likely to die from the disease than married patients, according to a recent study.

Errors related to bladder cancer site and symptom codes could lead to take backs.

“I hope we can continue to improve ERAS, but it’s already a significant advance,” says one urologist.

“This is more evidence that [dose-dense methotrexate, vinblastine, doxorubicin, and cisplatin] is highly effective for patients with bladder cancer,” says researcher Scott M. Gilbert, MD, MS.

A simple blood test, much like that used to detect tuberculosis, might identify as many as half of bladder cancer patients likely to fail intravesical bacillus Calmette-Guérin immunotherapy.

Findings of a multi-institutional cohort study provide further evidence that favorable outcomes can be achieved by carefully selected patients with muscle-invasive bladder cancer who forgo radical cystectomy after achieving a clinical complete response to neoadjuvant chemotherapy.

Even though patients with muscle-invasive bladder cancer and significant comorbidity are likely to benefit from bladder-sparing treatment approaches, increasing comorbidity burden appears to have no correlation with receiving such treatments.

“I think this study indicates that this is a procedure that not only improves detection, but also has a high rate of perceived value for patients, and therefore would be worthwhile to use in practice,” says researcher Angela B. Smith, MD.

“We believe that our study underscores the importance of improving dissemination of the guidelines and their implementation and uptake in practice,” says researcher Nikhil Waingankar, MD, MSHP.

The investigational oncolytic immunotherapy CG0070 produced an overall 30% complete response rate at 12 months for patients with high-risk BCG-unresponsive non-muscle-invasive bladder cancer.

Despite improved patient awareness and established guidelines, compliance remains low.

Be prepared to supply supporting clinical reasons as part of your appeal to the payer.

In this video, Trinity J. Bivalacqua, MD, PhD, presents the case of a 63-year-old man with history of carcinoma in situ found to have low-grade Ta non-muscle invasive bladder cancer.

Fluorescent blue light cystoscopy improves 3-year recurrence-free survival rates in patients with recurrent bladder tumors compared to white light cystoscopy, and researchers believe its use should be expanded.

"Numerous clinical studies have exhibited significantly improved tumor detection rates with BLC," write Zachary L. Smith, MD, and Norm D. Smith, MD.

A look at Urology Times' most-read articles on bladder cancer reveals a variety of topics, ranging from radical cystectomy to the role of protein- and cell-based urinary biomarkers for bladder cancer detection and surveillance.

The use of intravesical cisplatin nanoparticles reduces cancer cell proliferation while limiting drug absorption beyond the bladder barrier, according to early findings.

Researchers from The Cancer Genome Atlas Research Network have outlined five distinct expression subtypes of muscle-invasive bladder cancer, each of which may be targetable by different treatments.

A bladder-sparing approach for the treatment of muscle-invasive bladder cancer increases quality-adjusted life years compared with radical cystectomy in appropriately selected patients.

Trimodal therapy could offer superior overall survival versus radical cystectomy in certain subsets of patients with bladder cancer, according to a retrospective analysis presented at the 2017 Society of Urologic Oncology annual meeting in Washington.

Mitomycin C instillation within 24 hours after transurethral resection of non-muscle invasive bladder cancer significantly reduces the risk of recurrence and delays the time to recurrence.

"We will review the evidence and identify potential areas of improvement that can help reduce costs associated with UCB management while improving outcomes," write Daniel J. Lee, MD, and Sam S. Chang, MD.