Mark D. Tyson, II, M.D., M.P.H., explores the current NMIBC landscape, covering risk stratification approaches, established treatments like BCG immunotherapy and TURBT, emerging investigational agents spanning multiple mechanisms of action, and remaining challenges including BCG supply shortages and biomarker development, while highlighting future directions in personalized medicine and novel delivery systems.
A panelist discusses how Non-muscle Invasive Bladder Cancer (NMIBC) treatment varies by risk stratification (low, intermediate, and high-risk), with BCG immunotherapy being standard for high-risk patients, while newer options like pembrolizumab and gene therapies are emerging for BCG-unresponsive cases, and treatment decisions between intravesical versus systemic therapy depend on risk level and previous treatment response.
A panelist discusses how recent advances in transurethral resection of bladder tumor (TURBT) include enhanced visualization techniques like fluorescence-guided surgery and narrow-band imaging to improve tumor detection and complete resection, while radical cystectomy remains a critical option for high-risk NMIBC patients who fail conservative therapies.
A panelist discusses how emerging investigational agents for NMIBC show promise through diverse mechanisms, including oncolytic viruses (CG0070), immune checkpoint inhibitors (durvalumab, sasanlimab), targeted drug delivery systems (TAR-200), mitomycin-containing gels (UGN-102/103), immunotherapies (TARA-002), gene therapies (EG-70), and FGFR inhibitors (erdafitinib), representing a robust pipeline of potential treatment options.
A panelist discusses how significant unmet needs in NMIBC treatment persist around BCG supply shortages, optimal treatment sequencing, biomarker development for patient selection, and reducing treatment toxicity, while expressing optimism about emerging trends in combination therapies, novel delivery systems, and personalized medicine approaches based on molecular profiling.
