A panelist discusses how treatment decisions involve balancing clinical efficacy with financial considerations, noting that patients often prefer treatments with fewer office visits and minimal lifestyle disruption when presented with multiple effective options.
According to Sanda, future advancements may involve gene and RNA sequencing, the use of AI in imaging, and multidisciplinary collaboration.
"There is new technology emerging for skin stimulation of the perineum that is just recently evolving to help control OAB symptoms," says Anne Pelletier Cameron, MD, FRCSC, FPMRS.
"We are trying to develop epigenetic biomarkers that can predict patients that are starting to progress to neuroendocrine prostate cancer," says Jindan Yu, MD, PhD.
"The notion that the urine is sterile should be hopefully abolished by now, especially in this group where we know that these individuals do have a lot of bacteria growing in their bladders," says Brendan T. Frainey, MD.
"My biggest hope for people reading this review is to understand that there are some golden opportunities for research," says Laura Bukavina, MD, MPH, MSc.
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.
Panelists discuss how managing overactive bladder in older adults requires a holistic approach that integrates treatment of comorbidities, emerging therapeutic options, and quality-of-life considerations to optimize patient outcomes.
"Just having someone with another set of eyes I think is always helpful and gives you a lot of inspiration as well as a lot of encouragement on exactly what you need to do next," says Gia Ching.
“The patients I find that have the most pronounced benefit are the patients with the very large prostates, or the patients who are catheter dependent with concern for neurogenic or myogenic bladder failure,” says Brendan M. Browne, MD.
"I think integrating microbiome surveillance into clinical trials can bridge the gap between research and also therapeutic applications," says Ilaha Isali, MD, MSc.
“What creates job satisfaction are 3 principles: mastery, autonomy, and a sense of purpose,” says Mark T. Edney, MD.
Max Kates, MD, discusses how early complete response rates exceeding 50% at 3 months with newer therapies are encouraging, though long-term follow-up remains critical for evaluating durability of response and establishing real-world effectiveness compared with clinical trial outcomes.
A panelist discusses how targeted gene therapy, particularly nadofaragene firadenovec, represents a paradigm shift in BCG-unresponsive NMIBC treatment.
“It's hard for us, based on our evidence here, to say that neoadjuvant chemotherapy is causal in any way or is resulting in prolonged survival,” says Fed Ghali, MD.
"It was a daunting task, although I will say the original core was exceptional, so I had a wonderful framework from which to work," says Jeffrey A. Albaugh, PhD, APRN, CUCNS.
"I think the first thing you need to identify is, do you have a following, or do you have a niche that you know that you're not currently able to fill with your current role?" says Gia Ching.
“One of the ways we make the most difference for our patients is we take care of the people who are taking care of them,” says Chad Ritenour, MD.
“As long as APPs are properly supported, they will take off and they will change your practice,” says Mark T. Edney, MD.
“Another aspect is how to make this more and more complex diagnostic chain for prostate cancer work in practice, because we now have so [many] more tools than we had a decade ago,” says Tobias Nordström, MD, PhD.
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.
"Studying the microbiome overall is challenging because it's dirty science. You have to be incredibly careful with contamination," says Ilaha Isali, MD, MSc, and Laura Bukavina, MD, MPH, MSc.
"If we synergize our efforts and our energy, as the level of the sea rises, all ships on the sea will rise with it," says Wayne Kuang, MD.
“The key take home message of that study was that having assumptions about basic medical terminology that we think are simple may actually leave patients confused,” says Vikram M. Narayan, MD.
“If there's enough radiation, then the cells can't repair themselves and die because of the radiation,” says Scott T. Tagawa, MD, MS, FACP, FASCO.
“I think promoting women in leadership positions, promoting mentorship for women applicants and women already in this field, and working on policy changes are the top 3,” says Michelle S. Sheng, MD.
"The interplay between the microbiome and bladder cancer is very complex," says Ilaha Isali, MD, MSc.
A panelist discusses how intravesical chemotherapy offers localized treatment with minimal systemic effects but requires frequent administration, while PD-L1 inhibitors show promising response rates yet come with immune-related adverse events, highlighting how each current treatment option presents distinct trade-offs among efficacy, safety, and convenience.
Max Kates, MD, discusses how BCG-unresponsive non-muscle invasive bladder cancer patients historically faced limited treatment options beyond radical cystectomy, with significant unmet needs in preserving bladder function while effectively treating this aggressive disease.
“It's a good problem to have, because we're thinking about a previous era in which we didn't have many options besides more BCG vs cystectomy,” says Vikram M. Narayan, MD.
