Panelists discuss how PD-L1 inhibitors such as durvalumab and sasanlimab represent a promising frontier in non–muscle-invasive bladder cancer (NMIBC) treatment. These immunotherapies work by unleashing the body’s immune response against cancer cells, potentially offering new options for patients whose disease doesn’t respond to conventional therapies such as BCG. Their ongoing phase 3 trials could establish immunotherapy as a valuable addition to the NMIBC treatment landscape.
Panelists examine disease heterogeneity in NMIBC and discuss a balanced treatment approach that prioritizes patient quality of life and surgery effectiveness.
Hear insights from experts on key trial data presented at ASCO GU 2025.
Experts conclude their discussion on non-muscle invasive bladder cancer (NMIBC) highlighting practice considerations for today and the future.
A panelist discusses how urologists considering newer treatment modalities for BCG-unresponsive non–muscle-invasive bladder cancer (NMIBC) should be encouraged by positive clinical trial data while ensuring proper training, patient selection, and establishment of treatment protocols in their practice.
Experts discuss the mental impact of non-muscle invasive bladder cancer (NMIBC) treatment and approaches for developing a care network for those patients.
A panelist discusses how the ability to administer newer non–muscle-invasive bladder cancer (NMIBC) treatments in local urology practices rather than specialized oncology centers reduces patient burden and travel requirements while suggesting that increased education and support could help more health care providers adopt these treatment options.
“Taken altogether, the study remains positive for PFS, but not for overall survival,” says Laurence Albiges, MD, PhD.
"What we're really trying to see now is this integration of imaging and using it with respect to AI and planning," says Dean S. Elterman, MD, MSc, FRCSC.
“Interestingly, the confirmed response rate in the intention to treat population was 32%, but this increases to 53% in the MET driven subset,” says Francesca Jackson-Spence, MBChB, BMedSc, MRCP.
"The median progression-free survival and median overall survival continue to be almost double what we see with chemotherapy," says Gopa Iyer, MD.
"I think this is the next step for testing the clinical activity of this agent," says David A. Braun, MD, PhD.
"We see that among the patients who went on to receiving cystectomy, 84% are metastases free," says Pooja Ghatalia, MD.
"The efficacy findings reported to date are 71% any time response," says John A. Taylor III, MD, MS.
“Both groups benefited, but it would look like earlier is better if we can treat patients with low-volume disease,” says Fred Saad, MD, FRCS
“Of the 3 adrenal androgens, it's DHEA that seems to be most indicative of overall survival,” says Nima Sharifi, MD.
"For the MIRAGE trial specifically, we're going to continue following patients and we'll look at [data at] 5 years as well," says Amar U. Kishan, MD.
Panelists discuss how both TAR-200 and UGN-102/103 represent innovative approaches to intravesical drug delivery for bladder conditions. TAR-200 uses a novel silicone-based system designed for controlled gemcitabine release, potentially offering extended drug exposure compared with conventional instillations. UGN-102 and UGN-103 employ a proprietary RTGel technology that transforms from liquid to gel form at body temperature, allowing for longer retention of mitomycin (UGN-102) and high-dose botulinum toxin (UGN-103), respectively, in the bladder.
Panelists discuss how cretostimogene grenadenorepvec is an intravesical oncolytic virus therapy targeting BCG-unresponsive bladder cancer through selective replication in tumor cells and immune stimulation via granulocyte-macrophage colony-stimulating factor expression.
Panelists examine disease heterogeneity in NMIBC and discuss a balanced treatment approach that prioritizes patient quality of life and surgery effectiveness.
"I think targeting things that make communities more vulnerable would be reasonable things to target to try and affect disease practices," says William Furuyama, MD.
“While I would hesitate to say that reversal is truly better in terms of efficacy, I think this data suggests that it's at least as good,” says Scott D. Lundy, MD, PhD, HCLD.
Experts discuss logistical considerations when providing the best treatment to patients with non-muscle invasive bladder cancer (NMIBC).
A panelist discusses how less frequent treatment administration schedules and simpler delivery requirements of newer gene therapies reduce clinic resource burden by minimizing staff time, equipment usage, and biosafety requirements, allowing for more efficient allocation of health care resources.
A panelist discusses how treatment decisions for BCG-unresponsive non–muscle-invasive bladder cancer (NMIBC) involve careful consideration of patient preferences, long-term cost-effectiveness, and available financial assistance programs, balancing the higher upfront costs of newer therapies with their potential economic benefits from reduced recurrence rates and treatment frequency.
Experts consider other pipeline treatments for non-muscle invasive bladder cancer (NMIBC), including new injectable options being explored.
Smerina and Pearlman discuss recent research collaborations in the field of sexual medicine.
"We need to promote further research and guidelines for safe use of these natural products, because I think we're missing out if we don't monitor them," says Channing J. Paller, MD.
"I want to add that the safety profile was impeccable for this. No one experienced a [device-related] adverse event," says Matthew J. Mutter, MD.
"A lot of shared decision-making has to do with, what is important to the individual man?" says Dean S. Elterman, MD, MSc, FRCSC.
