"We're trying to understand where these new therapeutic agents might fit into our paradigms of care," says John L. Gore, MD, MS.
In this video, John L. Gore, MD, MS, gives an overview the presentation titled, “Innovative and Pragmatic Methods to Study BCG Unresponsive Nonmuscle-Invasive Bladder Cancer,” which was presented at the 2023 ASCO Genitourinary Cancers Symposium in San Francisco, California. Gore is a urologic oncologist in the department of urology at the University of Washington in Seattle.
We were talking about pragmatic approaches to trying to understand how to take care of patients with BGG-unresponsive non–muscle-invasive bladder cancer. I broke it down into which patients are we talking about. The definition of BGG-unresponsive non–muscle-invasive bladder cancer was really to help inform clinical trial design and help us select who should be eligible for clinical trials. One of the things we talked about today was that – that is important and critical – but also, any sort of episode of recurrent high-risk non–muscle-invasive bladder cancer is a really challenging decision point. It's really a numerator of a much broader patient population, all of whom are clinical conundrums. We talked a little bit about that.
The other thing that's important is that we're trying to understand where these new therapeutic agents might fit into our paradigms of care, but there are other therapies that are still an important part of the management of BGG-unresponsive non–muscle-invasive bladder cancer, like radical cystectomy. So, if we think about trial designs, one thing that can be really challenging is randomizing patients to an intervention that's a major operation versus a more conservative organ sparing strategy. We [need to] think pragmatically about trial design. What will allow us to obtain data that can inform clinical practice, even if we know that a randomized clinical trial would not be possible?
This transcription has been edited for clarity.