European Association of Urology (EAU)

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A health-economic analysis of the ASPIRE trial data found that the steerable ureteroscopic renal evacuation (SURE) procedure was linked to roughly $3464 in downstream savings per patient over 2 years compared with standard ureteroscopy, with lead investigator Brett Johnson, MD, framing this as a value-committee benchmark rather than a full cost comparison, since the analysis deliberately excludes the index procedure's incremental cost due to wide variability across payers and care settings.

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.