Vignesh Packiam, MD, on choosing between options in NMIBC

There has been an explosion of treatment options in non–muscle invasive bladder cancer (NMIBC) in recent years, with even more coming down the pike. Many of these agents have demonstrated encouraging efficacy and manageable safety in clinical trials, meaning that patients and urologists must consider other factors when choosing between options.

As Vignesh T. Packiam, MD, explains, this is a good challenge to have. The wealth of options will allow urologists to tailor treatment to both the individual’s preferences and, as we learn more, hopefully the patient’s specific disease characteristics.

He notes, “At the end of the day, it's going to be unlikely that we're going to use a single therapy for all of our patients. I think precision medicine is going to become more widespread as we understand who is going to respond best to which treatment, so I'm really excited to develop biomarkers that might help us guide us to what the best therapy is for each specific patient.”

Packiam is an associate professor of surgery at Rutgers Robert Wood Johnson Medical School as well as the director of clinical and translational research in urologic oncology at Rutgers Cancer Institute in New Jersey.

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Specifically, Packiam says that long-term bladder symptoms associated with treatment, in addition to the short-term tolerability data, will be important for patients to understand as we gather more data.

“I think each therapy is going to have its own unique profile with how it affects the bladder in the long-term,” he stated.

Packiam also noted, “The other difference between various therapies that are out there is logistics, both in storage and administration. Some of these products have to be kept under certain temperature conditions, or they're given at a certain dosing regimen. Those details are going to become important to different patients as well.”