Bladder Ca: Immunotherapy shows promise as neoadjuvant treatment before RC

Other bladder cancer take-home messages covered topics such as artificial intelligence and deep learning for staging of T1 disease as well as a wearable fitness tracker for collecting data on physical activity after radical cystectomy. The take-homes were presented by Cheryl T. Lee, MD, of the Ohio State University, Columbus.

• Pembrolizumab (Keytruda) showed promise as neoadjuvant treatment before RC for muscle-invasive urothelial bladder carcinoma.
• In a validation study, a urinary assay based on methylation and mutation markers demonstrated 93% sensitivity, 81% specificity, 99% negative predictive value, and an area under the curve of 0.95 for detecting bladder cancer in a population of patients with microscopic or macroscopic hematuria.
• The WHO 2004 and WHO 1973 classification systems for grading nonmuscle-invasive bladder cancer (NMIBC) have poor reproducibility, and their prognostic value varies among pathologists.
• Using computer-extracted nuclear shape and orientation features assessed on hematoxylin-eosin stained images, deep learning theory may improve grading accuracy for bladder cancer.
• Artificial intelligence and deep learning showed promise as a tool to improve staging of T1 bladder cancer.
• In a prospective randomized study of patients with medium (1 cm-3 cm) bladder tumors, en-bloc bipolar ablation for tumor resection was associated with a shorter operation time, catheterization period, and hospital stay compared with monopolar transurethral bladder resection of bladder tumors and a lower recurrence rate at 1 and 3 years.
• A study of practice patterns found risk-aligned surveillance is not commonly done for patients with NMIBC.
• A health-oriented clinical dashboard implemented through the electronic health record is being used to automatically detect gaps in guideline-recommended care for bladder cancer patients.
• In a randomized trial comparing nutritional intervention with an oral liquid nutritional supplement and a multivitamin control in radical cystectomy (RC) patients, the intervention group had a numerically lower complication rate (48% vs. 67%) and a significantly lower rate of sarcopenia development.
• A wearable fitness tracker is a patient-accepted method for collecting data on physical activity after RC.
• Remote vital sign monitoring using a smartphone application had good patient compliance and showed promise as a tool for enabling follow-up of patients after RC.
• Adjuvant radiotherapy improved overall survival for patients with adverse pathologic features after RC.