Podcasts about Bladder cancer

With the recent announcement by Deion Sanders, hall of fame NFL player and current head coach for the University of Colorado Buffaloes, that he is undergoing treatment for bladder cancer, we've been seeing a significant increase in interest about the disease. Today's guest is Dr. Bradley Gill, chief of surgery at Cleveland Clinic Hillcrest and Mentor Hospitals and a board-certified urologist, to help us understand the condition, its causes, treatment options and potential outcomes. For more information about the National Association for Continence, click here, and be sure to follow us on Facebook, Instagram, Twitter and Pinterest.Music:Rainbows Kevin MacLeod (incompetech.com)Licensed under Creative Commons: By Attribution 3.0 Licensehttp://creativecommons.org/licenses/by/3.0/If you look at the numbers behind incontinence in women, it's hard to believe just how big an issue it is. Incontinence affects more women than diabetes, breast cancer and heart disease, but it doesn't get the attention it deserves. That's why NAFC has created the We Count campaign, to help you realize that you are not alone, and there are treatments available right now that can make a real difference in your life. Visit NAFC.org/we-count to learn more.

Dr. Sumanta (Monty) Pal and Dr. Petros Grivas discuss innovative new intravesical therapies and other recent advances in the treatment of non-muscle invasive bladder cancer. TRANSCRIPT Dr. Sumanta (Monty) Pal: Hello and welcome. I'm Dr. Monty Pal here at the ASCO Daily News Podcast. I'm a medical oncologist and professor and vice chair of academic affairs at the City of Hope Comprehensive Cancer Center in Los Angeles. And I'm really delighted to be your new host here. Today's episode is going to really sort of focus on an area near and dear to my heart, something I actually see in the clinics, and that's bladder cancer. We're specifically going to be discussing non-muscle invasive bladder cancer, which actually comprises about 75% of new cases. Now, in recent years, there's been a huge shift towards personalized bladder-preserving strategies, including innovative therapies and new agents that really are reducing reliance on more primitive techniques like radical cystectomy and radiation therapy. And I'm really excited about this new trend. And really at the forefront of this is one of my dear friends and colleagues, Dr. Petros Grivas. He's a professor in the Department of Medicine and Division of Hematology Oncology at the University of Washington. It's going to take a while to get through all these titles. He's taken on a bunch of new roles. He is medical director of the International Program, medical director of the Local and Regional Outreach Program, and also professor in the Clinical Research Division at the Fred Hutch Cancer Center. Petros, welcome to the program. Dr. Petros Grivas: Thank you so much, Monty. It's exciting for me to be here. Dr. Sumanta (Monty) Pal: Just FYI for our audience, our disclosures are available in the transcript of this episode.  We're going to get right into it, Petros. Non-muscle invasive bladder cancer, this is a really, really challenging space. We see a lot of recurrence and progression of the disease over time, about 50% to 70% of patients do have some recurrence after initial treatment, and about 30% are ultimately going to progress on to muscle-invasive or metastatic disease. Now, I will say that when you and I were in training, non-muscle invasive bladder cancer was something that was almost relegated to the domain of the urologist, right? They would use treatments such as BCG (Bacillus Calmette-Guérin) in a serial fashion. It was rare, I think, for you and I to really enter into this clinical space, but that's all changing, isn't it? I mean, can you maybe tell us about some of the new therapies, two or three that you're really excited about in this space? Dr. Petros Grivas: Monty, you're correct. Traditionally and conventionally, our dear friends and colleagues in urology have been managing patients with non-muscle invasive bladder cancer. The previous term was superficial bladder cancer. Now, it has changed, to your point, to non-muscle invasive bladder cancer. And this has to do with the staging of this entity. These tumors in superficial layers of bladder cancer, not invading the muscularis propria, the muscle layer, which makes the bladder contract for urine to be expelled. As you said, these patients have been treated traditionally with intravesical BCG, one of the oldest forms of immunotherapy that was developed back in the 1970s, and this is a big milestone of immunotherapy development. However, over the years, in the last 50 years, there were not many options for patients in whom the cancers had progression or recurrence, came back after this intravesical BCG. Many of those patients were undergoing, and many of them still may be undergoing, what we call radical cystectomy, meaning removal of the bladder and the lymph nodes around the bladder. The development of newer agents over the last several years has given the patients the option of having other intravesical therapies, intravesical meaning the delivery of drugs, medications inside the bladder, aiming to preserve the bladder, keep the bladder in place. And there are many examples of those agents. Just to give you some examples, intravesical chemotherapy, chemotherapy drugs that you and me may be giving intravenously, some of them can be given inside the bladder, intravesical installation. One example of that is a combination of gemcitabine and docetaxel. These drugs are given in sequence one after the other inside the bladder, and they have seen significant efficacy, good results, again, helping patients keeping the bladder when they can for patients with what we call BCG unresponsive non-muscle invasive bladder cancer. And again, there's criteria that the International Bladder Cancer Group and the FDA developed, how to define when BCG fails, when we have BCG unresponsive non-muscle invasive bladder cancer. Dr. Sumanta (Monty) Pal: And we're actually going to get into some of the FDA requirements and development pathways and so forth. What I'm really interested in hearing, and I'm sure our audience is too, are maybe some of the new intravesical treatments that are coming around. I do think it's exciting that the gemcitabine and docetaxel go into the bladder indeed, but what are some of the top new therapies? Pick two or three that you're excited about that people should be looking out for in this intravesical space. Dr. Petros Grivas: For sure, for sure. In terms of the new up-and-coming therapies, there are a couple that come to mind. One of them is called TAR-200, T-A-R 200. This agent is actually a very interesting system. It's an intravesical delivery of a chemotherapy called gemcitabine, the one that I just mentioned a few minutes ago, that is actually being delivered through what we call a pretzel, which is like a rounded [pretzel-shaped] structure working like an osmotic pump, and that is being delivered inside the bladder intravesically by urologists. And this drug is releasing, through the osmotic release mechanism, this chemotherapeutic drug, gemcitabine, inside the bladder. And this can be replaced once every 3 weeks in the beginning. And the data so far from early-phase trials are really, really promising, showing that this agent may be potentially regulatory approved down the road. So TAR-200 is something to keep in mind. And similarly, in the same context, there is a different drug that also uses the same mechanism, and this osmotic release, this pretzel, it's just encoded with a different agent. The different agent is an FGFR inhibitor, a target therapy called erdafitinib, a drug that you and me may give in patients with metastatic urothelial carcinoma if they have an FGFR3 mutation or fusion. And that drug is called TAR-210. Dr. Sumanta (Monty) Pal: And can I ask you, in that setting, do you have to have an FGFR3 mutation to receive it? Or what is the context there? Dr. Petros Grivas: So for TAR-210, TAR-2-1-0, usually there is a checking to see if there is an FGFR3 mutation or fusion. And the big question, Monty, is do we have adequate tissue, right? From a limited tissue on what we call the TURBT, right, that urologists do. And now there is a lot of development in technology, for example, urine circulating tumor DNA to try to detect these mutations in the urine to see whether the patient may be eligible for this TAR-210. Both of those agents are not FDA approved, but there are significant promising clinical trials. Dr. Sumanta (Monty) Pal: So now let's go to a rapid-fire round. Give us two more agents that you're excited about in this intravesical space. What do you think? Dr. Petros Grivas: There is another one called cretostimogene. It's a long name. Dr. Sumanta (Monty) Pal: They really make these names very easy for us, don't they? Dr. Petros Grivas: They are not Greek names, Monty, I can tell you, you know. Even my Greek language is having trouble pronouncing them. The cretostimogene, it's actually almost what we call a growth factor, a GM-CSF. The actual name of this agent is CG0070. This is a replicating mechanism where GM-CSF is replicating in cells. And this agent has shown significant results again, like the TAR-200, in BCG unresponsive non-muscle invasive bladder cancer. I would say very quickly, two agents that actually were recently approved and they're already available in clinical practice, is nadofaragene firadenovec, another long name. That's a non-replicating vector that has the gene of interferon alfa-2b that stimulates the immune system in the bladder. It's given once every 3 months. And the last one that was, as I mentioned, already FDA approved, it's an interleukin-15 superagonist. It's another long name, which is hard to pronounce, but I will give it a try. It's a drug that was recently actually approved also in the UK. The previous name was N-803. It's given together with BCG as a combination for BCG unresponsive non-muscle invasive bladder cancer. Dr. Sumanta (Monty) Pal: This is a huge dilemma, I think, right? Because if you're a practicing, I'm going to say urologist for the moment, I guess the challenge is how do you decide between an IL-15 superagonist? How do you decide between a pretzel-eluting agent? How do you decide between that and maybe something that's ostensibly, I'm going to guess, cheaper, like gemcitabine and docetaxel? What's sort of the current thinking amongst urologists? Dr. Petros Grivas: Multiple factors play into our account when the decision is being made. I discuss with urologists all the time. It's not an easy decision because we do not have head-to-head comparisons between those agents. As you mentioned, intravesical chemotherapy with gemcitabine and docetaxel has been used over the years and this is the lowest cost, I would say, the cheapest option with good efficacy results. Obviously, the nadofaragene firadenovec every 3 months and the interleukin-15 superagonist, N-803, plus BCG have also been approved. The question is availability of those agents, are they available? Are they reimbursed? Cost of those agents can come into play. Frequency of administration, you know, once every 3 months versus more frequent. And of course, the individual efficacy and toxicity data, preference of the patients; sometimes the provider, the urologist, may have something that they may be more familiar with. But we lack this head-to-head comparison. Of course, I want to make sure I mention that radical cystectomy may still be the option for appropriate patients. So that complicates also the decision making and has to be individualized, customized, and personalized, taking into account all those factors. And there is not one size fitting all. Dr. Sumanta (Monty) Pal: So I think we discussed five intravesical therapies. As you point out, and you know, I'm going to get some calls about this: I think I referred to radical cystectomy as being a more primitive procedure. Not true at all. I think it's something that still is, you know, a mainstay of management in this disease space. But I guess it gets even more complicated, am I right, Petros? Because now we have systemic therapies that we can actually apply in this non-muscle invasive setting for at this point, refractory disease. Can you maybe just give us a quick two-minute primer on that? Dr. Petros Grivas: Absolutely, and systemic therapies now come into play, as you said. And a classical example of that, Monty, came from the KEYNOTE-057 trial that we published about 6 years ago. This is intravenous pembrolizumab, given intravascularly, intravenously, as opposed to the previously discussed intravesical administration of agents. Pembrolizumab was tested in that KEYNOTE-057 trial and showed efficacy about, I would say, one out of five patients, about 20%, had a complete response of the tumor in the bladder in a year after starting the treatment. Again, it's hard to compare across different agents, but obviously when we give something intravenously, there is a risk of toxicity, side effects systemically, what we call immune-related adverse events. And this can also play in the decision making, right? When you have intravesical agents versus intravascular agents, there is different toxicity profiles in terms of systemic toxicity. But intravenous pembrolizumab has been an option, FDA approved, since, if I remember, it was early 2020 when this became FDA approved. There are other agents being tested in this disease, but like atezolizumab through the SWOG study that Dr. Black and Dr. Singh led, but atezolizumab is not FDA approved for this indication. Again, this is for BCG unresponsive, high-risk, non-muscle invasive bladder cancer. Dr. Sumanta (Monty) Pal: So maybe teach us how it works, for instance, at an expert center like the Fred Hutch. When you see a patient with non-muscle invasive bladder cancer, there's obviously the option of surgery, there's the intravesical therapies, which I imagine the urology team is still really at the helm of. But then, I guess there has to be consideration of all options. So you've got to bring up systemic therapy with agents like pembrolizumab. In that context, are you involved that early on in the conversation? Dr. Petros Grivas: That's a great discussion, Monty. Paradigm is shifting as we mentioned together. The urologists have been treating these patients and still they are the mainstay of the treaters, the managers in this disease. But medical oncologists come to play more and more, especially with the FDA approval of intravenous pembrolizumab about 5 years ago [GC1]  [KM2] . We have the concept of multidisciplinary bladder cancer clinic here at Fred Hutch and University of Washington. This happens every Tuesday morning, and we're very excited because it's a one-stop shop for the patients. We have the urologist, a medical oncologist, radiation oncologist, and experts from radiology and pathology, and we all review cases specifically with muscle-invasive bladder cancer. But every now and then, we see patients with BCG unresponsive non-muscle invasive bladder cancer. And this is where we discuss and we talk to the patient about pros and cons of all those options. And that's a classic example where medical oncologists may start to see those patients and offer their input and expertise. In addition to that, sometimes we have clinical trials, we may see these patients because there are systemic agents that may be administered in this setting. We have the SunRISe trial program that includes also a systemically administered checkpoint inhibitor. So that's another example where we see patients either in the context of multi-clinic or in individual solo clinics to counsel the patients about the pros and cons of the systemically administered agents in the context of clinical trials. Usually checkpoint inhibitors are the class of agents that are being tested in this particular scenario. Dr. Sumanta (Monty) Pal: I can see a scenario where it's really going to require this sort of deep dive, much in the way that we do for prostate cancer, for instance, where the medical oncologist is involved very early on and planning out any sort of systemic therapy component of treatment or at the very least, at least spelling out those options. I think it's going to be really interesting to see what this space looks like 5 or 10 years down the road. In closing, I wanted to go through something that I think is so different in this space, at least for the time being, and that is the paradigm for FDA approval. When you and I have our fellows in the clinics, we always say, “Look, you know, the paradigm in this disease and that disease and the other disease needs to be phase 3 randomized trials, right? Big thousand patient experiences where you're testing clinical endpoints.” That's tough in non-muscle invasive bladder cancer, right? Because thankfully, outcomes can actually be quite good, you know, in this setting, right? It's tough to actually estimate overall survival in some of these early-stage populations. Tell me what the current regulatory bar is, and this is a tough thing to do in 2 minutes or less but tell me where you see it headed. Dr. Petros Grivas: You alluded to that before, Monty, when I was giving the background and we talked about the regulatory approval. And I have to very quickly go back in time about 10 years ago because it's important for context that can help us in other disease types too. We had workshops with the FDA and the NCI with the help of the International Bladder Cancer Group and other colleagues. And we try to define a framework, what endpoints are meaningful for those patients in this disease. It was a multidisciplinary, multiple stakeholders meeting, where we tried to define what is important for patients. What are the available agents? What are the trial designs we can accept? And what are the meaningful endpoints that the regulatory agencies can accept for regulatory approval? And that was critical in that mission because it allowed us to design clinical trials, for example, single-arm trials in a disease where there was no standard of care. There was intravesical valrubicin and chemotherapy anthracycline that was approved for many years, but was not practically used in clinical practice, despite being approved, the valrubicin. And because of that, the FDA allowed these single-arm trials to happen. And obviously the endpoint was also discussed in that meeting. For example, for carcinoma in situ, complete response, clinical complete response, because the bladder remains intact in many patients, clinical complete response was a meaningful primary endpoint, also duration of response is also very important. So what is the durable clinical complete response in 1 year or 18 months is relevant. And when you have papillary tumors like Ta or T1 with CIS, for papillary tumors, event-free survival becomes one of the key endpoints and you look at it over time, for example, at 12 or 18 months, what is the event-free survival? So clinical complete response, duration of response, event-free survival, depending on the CIS presence or papillary tumors, I think these are endpoints that have allowed us to design those trials, get those agents approved.  Now, the question going forward, Monty, and we can close with that is, since now we have the embarrassment of riches, many more options available compared to where we were 6 and 7 years ago, is now the time to do randomized trials? And if we do randomized trials, which can be the control group? Which of those agents should be allowed to be part of the control group? These are ongoing discussions right now with the NCI, with other agencies, cooperative groups, trying to design those trials and move forward from here.[GC3]  Dr. Sumanta (Monty) Pal: Well, it's awesome to have you here on the program so we can get some early looks into some of these conversations. I mean, clearly, you're at the table at a lot of these discussions, Petros. So I want to thank you for sharing your insights with us today. This was just tremendous. Dr. Petros Grivas: Thank you, Monty. You know, patients in the center, I just came back from the Bladder Cancer Advocacy Network meeting in Washington, D.C., and we discussed all those questions, the topics you very eloquently mentioned and asked me today, and patients gave us great feedback and patients guide us in that effort. Thank you so, so much for having me and congratulations for the amazing podcast you're doing. Dr. Sumanta (Monty) Pal: Oh, cheers, Petros, thanks so much.  And thank you to the listeners who joined us today. If you really like the insights that you heard on this ASCO Daily News Podcast, please rate, review, and subscribe wherever you get your podcasts. Thanks, everyone. Disclaimer: The purpose of this podcast is to educate and to inform. This is not a substitute for professional medical care and is not intended for use in the diagnosis or treatment of individual conditions. Guests on this podcast express their own opinions, experience, and conclusions. Guest statements on the podcast do not express the opinions of ASCO. The mention of any product, service, organization, activity, or therapy should not be construed as an ASCO endorsement.   Find out more about today's speakers:      Dr. Sumanta (Monty) Pal  @montypal  Dr. Petros Grivas @PGrivasMDPhD   Follow ASCO on social media:     @ASCO on Twitter    ASCO on Bluesky   ASCO on Facebook     ASCO on LinkedIn     Disclosures:    Dr. Sumanta (Monty) Pal:   Speakers' Bureau: MJH Life Sciences, IntrisiQ, Peerview  Research Funding (Inst.): Exelixis, Merck, Osel, Genentech, Crispr Therapeutics, Adicet Bio, ArsenalBio, Xencor, Miyarsian Pharmaceutical  Travel, Accommodations, Expenses: Crispr Therapeutics, Ipsen, Exelixis  Dr. Petros Grivas: Consulting or Advisory Role: Merck, Bristol-Myers Squibb, AstraZeneca, EMD Serono, Pfizer, Janssen, Roche, Astellas Pharma, Gilead Sciences, Strata Oncology, Abbvie, Bicycle Therapeutics Replimune, Daiichi Sankyo, Foundation Medicine, Bicycle Therapeutics, Eli Lilly, Urogen Pharma, Tyra Biosciences Research Funding (Inst.): Bristol-Myers Squibb, Merck, EMD Serono, Gilead Sciences, Acrivon Therapeutics, ALX Oncology, ALX Oncology, Genentech Travel, Accommodations, Expenses: Gilead Sciences

Could ctDNA testing allow us to treat bladder cancer earlier, smarter, and more effectively? In this episode of BackTable Urology, Dr. Alberto Pieretti, a urologic oncologist at Cleveland Clinic Weston Hospital, joins host Dr. Jose Silva to explore the emerging role of ctDNA in bladder cancer management. --- This podcast is supported by: Ferring Pharmaceuticals --- SYNPOSIS Dr. Pieretti and Dr. Silva discuss how ctDNA can refine staging, identify patients at risk of recurrence, and guide decisions on when to intensify treatment. The conversation also examines its potential to detect actionable mutations, inform precision therapies, and shape the design of future clinical trials in urologic oncology. --- TIMESTAMPS 0:00 - Introduction2:50 - Overview of Bladder Cancer12:59 - Overview of ctDNA20:34 - Current ctDNA Trials27:21 - Clinical Implications of ctDNA31:20 - Conclusion --- RESOURCES Updated Overall Survival by Circulating Tumor DNA Status from the Phase 3 IMvigor010 Trial: Adjuvant Atezolizumab Versus Observation in Muscle-invasive Urothelial Carcinoma - PubMedhttps://pubmed.ncbi.nlm.nih.gov/37500339/ Perioperative Durvalumab with Neoadjuvant Chemotherapy in Operable Bladder Cancer | New England Journal of Medicinehttps://www.nejm.org/doi/abs/10.1056/NEJMoa2408154

- Overview of Bladder Cancer, Including Staging & Grading - Standard of Care - New Treatment Approaches - Update on Clinical Trials: How Clinical Trials Increase Your Treatment Options - The Role of Diagnostic Technologies, Genomics & Precision Medicine - Targeted Treatments: Predicting Response to Treatment - The Emerging Role of Immunotherapy - Communicating with Your Health Care Team About Quality-of-Life Concerns - Follow-Up Care Appointments & Plans - Guidelines to Prepare for Telehealth/Telemedicine Appointments, Including Technology, Prepared List of Questions & Discussion of OpenNotes - Nutrition & Hydration Concerns & Tips - Questions for Our Panel of Experts

- Overview of Bladder Cancer, Including Staging & Grading - Standard of Care - New Treatment Approaches - Update on Clinical Trials: How Clinical Trials Increase Your Treatment Options - The Role of Diagnostic Technologies, Genomics & Precision Medicine - Targeted Treatments: Predicting Response to Treatment - The Emerging Role of Immunotherapy - Communicating with Your Health Care Team About Quality-of-Life Concerns - Follow-Up Care Appointments & Plans - Guidelines to Prepare for Telehealth/Telemedicine Appointments, Including Technology, Prepared List of Questions & Discussion of OpenNotes - Nutrition & Hydration Concerns & Tips - Questions for Our Panel of Experts

In this podcast "Treatment Optimization and Management of AEs with Enfortumab Vedotin + Pembrolizumab for Untreated Locally Advanced/Metastatic Urothelial Cancer: A Podcast", authors discuss the management of adverse events (AEs) with enfortumab vedotin + pembrolizumab based on their personal experiences with clinical trials and in their practices and provide perspectives for healthcare professionals on practical management of common AEs and effective dose management strategies. This may help improve the patient experience and allow patients to stay on therapy for longer, leading to optimized treatment outcomes. This podcast is published open access in Oncology and Therapy and is fully citeable. You can access the original published podcast article through the Oncology and Therapy website and by using this link: https://link.springer.com/article/10.1007/s40487-025-00369-9. All conflicts of interest can be found online. This podcast is intended for medical professionals. Open Access This podcast is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License, which permits any non-commercial use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The material in this podcast is included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by-nc/4.0/.

Researchers have developed an innovative drug delivery device that has shown remarkable success in tackling one of the toughest forms of bladder cancer

For Stewart Greenfield, the third time was the charm.  After checking pictures of his bladder in 2016, two doctors told him he didn't have long to live; a third doctor told him he had Stage IV metastatic bladder cancer, but insisted he needed to be treated.  The cancer had burned a hole in his bladder and attacked lymph nodes from his groin to his neck.  Treatment included a chemotherapy cocktail of cisplatin and gemcidibine, plus qualifying for an immunotherapy, novolumab.  It was a smashing success.  Stewart says his urinary function is normal and he is able to resume his active lifestyle, which includes cycling and scuba diving.   A semi-retired kitchen designer, Stewart Greenfield of Scottsdale, Arizona, thought he was in good health when he went for his annual physical in 2016.  He was an active cyclist and scuba diver.  However, his doctor said his blood work was “inconclusive.”  After a second test was labeled inconclusive, the doctor prescribed antibiotics and called for a third blood test a week later.  The doctor got a similar result and sent Stewart to a urological surgeon.   The surgeon called for Stewart to undergo some scans and upon viewing them, gave Stewart some very bad news.  The surgeon did not mention the word ‘cancer,' but said Stewart should get his affairs in order.   Stewart went to a second urologist who viewed pictures of Stewart's bladder, again did not mention the word cancer, but said the condition of the bladder was so advanced, it was too late to treat it.  He had a hole in his bladder and the cancer had attacked lymph nodes from his groin to his neck.   Stewart had an appointment with a third surgeon.  She said he had Stage IV metastatic bladder cancer.  As he attempted to leave, the doctor blocked his path and insisted on treating his diagnosis.  At first he resisted, thinking he had received a death sentence, but he agreed to be treated.    Stewart was put on a chemotherapy regimen with cisplatin.  The regimen was stepped up with the addition of gemcidibine.  As the regimen had been successful, he qualified for a new immunotherapy, novolumab.   The treatment was a success.  Stewart has normal urinary function and again takes part in cycling and scuba diving.   By way of advice, he urges those diagnosed with bladder cancer to stay positive, never lose hope and “fight the fight.”   Additional Resource:   Support Group:   The Bladder Cancer Advocacy Network   https://www.bcan.org      

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How do you effectively treat your bladder cancer population with an insufficient supply of BCG? Dr. Amy Luckenbaugh, a urologic oncologist at Vanderbilt University Medical Center, joins host Dr. Ruchika Talwar to highlight challenges and solutions to managing bladder cancer amidst ongoing BCG shortages. --- This podcast is supported by an educational grant from UroGen Pharma. --- SYNPOSIS Dr. Luckenbaugh and Dr. Talwar delve into the history and significance of BCG in bladder cancer treatment, exploring the reasons behind the shortages and discussing various coping strategies, including split dosing and alternative intravesical therapies like gemcitabine, docetaxel, and the new mitomycin hydrogel. The conversation also covers emerging treatments for high-risk patients, the role of radical cystectomy, and the importance of standardization and innovation in dealing with medication shortages. Dr. Luckenbaugh highlights the importance of patient quality of life, cost considerations, and the need for resilient pharmaceutical supply chains. --- TIMESTAMPS 00:00 - Introduction01:56 - History and Importance of BCG in Bladder Cancer03:21 - Challenges and Shortages of BCG06:36 - Managing BCG Shortages in Clinical Practice12:33 - New Alternatives and Treatments for Bladder Cancer23:28 - The Role of Cystectomy in Bladder Cancer Treatment26:12 - Future Directions and Final Thoughts --- RESOURCES BCG Shortage AUA Recommendations:https://www.auanet.org/about-us/bcg-shortage-info Reduced-dose bacillus Calmette-Guérin (BCG) in an era of BCG shortage: real-world experience from a tertiary cancer centre: https://pmc.ncbi.nlm.nih.gov/articles/PMC11951178/ Bladder Cancer Advocacy Network (BCAN):https://bcan.org/ Primary Chemoablation of Recurrent Low-Grade Intermediate-Risk Nonmuscle-Invasive Bladder Cancer With UGN-102: A Single-Arm, Open-Label, Phase 3 Trial (ENVISION)https://pubmed.ncbi.nlm.nih.gov/39446087/b FDA Approves Intravesical Mitomycin in Non–Muscle-Invasive Bladder Cancer:https://www.fda.gov/drugs/resources-information-approved-drugs/fda-approves-mitomycin-intravesical-solution-recurrent-low-grade-intermediate-risk-non-muscle TAR-200 - SunRISe-3 Study:https://www.jnjmedicalconnect.com/products/tar-200/medical-content/tar-200-sunrise-3-study First results from TAR-200 - SunRISe-1 Study:https://www.jnj.com/media-center/press-releases/johnson-johnsons-tar-200-monotherapy-achieves-high-disease-free-survival-of-more-than-80-percent-in-bcg-unresponsive-high-risk-papillary-nmibcN-803 Plus BCG Treatment for BCG-Naïve or -Unresponsive Non-Muscle Invasive Bladder Cancer: A Plain Language Review:https://pmc.ncbi.nlm.nih.gov/articles/PMC11524197/

In this powerful episode of Bladder Cancer Matters, host Rick Bangs sits down with Dr. Ruchika Talwar, a leading urologic oncologist and health policy expert, to tackle the growing issue of financial toxicity in bladder cancer care. With candid insights and clear explanations, Dr. Talwar breaks down the hidden and rising costs patients face—from co-pays and lost wages to caregiver burdens and high drug prices—and explains why bladder cancer is the most expensive cancer per patient in the U.S. Listeners will gain practical tips to navigate the system, avoid financial pitfalls, and advocate for support—all while learning why open conversations with healthcare providers matter more than ever. Whether you're a patient, caregiver, or healthcare professional, this episode sheds light on a critical but often overlooked side effect of cancer: the financial toll. Don't miss this eye-opening discussion.

Coach Prime has a press conference to tell the world he's healed of Bladder Cancer 02:19 The Raiders release Christian Wilkins for ... well ... for allegedly ... being a FREAK? 19:14 Cam Newton releases his top 10 QBs in the NFL and Jalen Hurts isn't one of them 27:01 Supa Dave gets mad at "GRIFF" because HIS list isn't 'perfect' like Dave's??? 31:43 "GRIFF" sits down with Former UGA star and Dallas Cowboy QB Quincy Carter 38:53See omnystudio.com/listener for privacy information.

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Deion Sanders revealed his medical issue, and Ozzy's funeral will be small. Learn more about your ad choices. Visit megaphone.fm/adchoices

NFL legend and Colorado Buffaloes head coach Deion Sanders is officially cancer-free following bladder-removal surgery performed to remove a high-grade tumor. Sanders revealed he drafted his will during the ordeal, describing the journey as emotionally intense. Despite ongoing lifestyle adjustments, Sanders is set to return to coaching this fall and hopes his transparency will raise awareness about early cancer detection. See omnystudio.com/listener for privacy information.

It is Tuesday on The Rickey Smiley Morning Show Podcast and there are a variety of stories the crew discussed today. A tragic mass shooting at 345 Park Avenue—a Midtown Manhattan office building housing the NFL and major finance firms—left five dead, including NYPD officer Didarul Islam, and injured others as the shooter, identified as Las Vegas resident Shane Tamura, took his own life. Authorities found a note suggesting Tamura blamed the NFL for degenerative brain injury (CTE)—though his exact motive remains unclear. In brighter news, NFL legend and Colorado Buffaloes head coach Deion Sanders is officially cancer-free following bladder-removal surgery performed to remove a high-grade tumor. Sanders revealed he drafted his will during the ordeal, describing the journey as emotionally intense. Despite ongoing lifestyle adjustments, Sanders is set to return to coaching this fall and hopes his transparency will raise awareness about early cancer detection. On the entertainment beat, rapper and mogul Jeezy celebrated 20 years of his debut album Thug Motivation 101 during his appearance on The Rickey Smiley Morning Show. He reflects on performing the album with an orchestra and discussing the legacy of the Snowman—tying it into broader conversations about his entrepreneurial evolution and cultural impact. Website: https://www.urban1podcasts.com/rickey-smiley-morning-show See omnystudio.com/listener for privacy information.

Sanders has been absent all offseason from Boulder besides an appearance at Big 12 Media Days, as he informed the media that he had a cancerous tumor in his bladder but had surgery to remove it Despite a history of other health issues (blood clots, amputated toes), he says he's still planning on coaching this year and going forward Show Sponsored by SANDHILLS GLOBALOur Sponsors:* Check out Hims: https://hims.com/EARLYBREAKAdvertising Inquiries: https://redcircle.com/brandsPrivacy & Opt-Out: https://redcircle.com/privacy

In this week's episode the Powell men discuss the shocking news of #CoachPrime and the #CoachPrimeCancer diagnosis. #deionSanders was diagnosed with #BladderCancer. Its a shocking reveal that gives us all pause. Get your check ups. #ColonCancer #ProstateCancer and it seems that #BladderCancer if caught early can be treated and cured. God Speed and prayers for the #Sanders family. 3BubbaWallace won the #Brickyard400. Kudos. #TikTok #contentcreator #AshleyTheeBaroness dropped some more knowledge on us. Stay cool 

Courtland Sutton and the Broncos reached an agreement on a 4-year contract extension worth $92M. Sutton will now be roughly the 18th highest paid WR in the league. How happy were Sutton's teammates that he received a new deal? Also, Alex Singleton broke his thumb in practice yesterday and is expected to miss 7-10 days. Are injuries a major concern at inside linebacker? Yesterday, Deion Sanders announced that he fought bladder cancer and had to have surgery to remove the tumor, but is now cancer-free and ready to coach this season.

During a press conference in Boulder on Monday, head football coach Deion Sanders reveals his fight against bladder cancer and inspires with his words of faith.George Brauchler remains incredulous at how the Solomon Galligan attempted kidnapping case is being handled by his counterpart Amy Padden in the 18th judicial district, why is she only going public with comments now?Father Patrick DiLoreto details the canonization process at The Vatican for Kendrick Castillo to be considered for sainthood.

Will blue-blood programs call?     To advertise on our podcast, please reach out to sales@advertisecast.com or visit https://www.advertisecast.com/TheJeffWardShow

(1) Deion Sander had bladder cancer and had bladder removed, Joshua Henderson (2) Cleveland Guardians gambling scandal

BREAKING: Deion Sanders reveals BLADDER CANCER DIAGNOSIS, but then doctors drop GREAT NEWS!

J&J Show: Deion Sanders had bladder cancer and has his bladder removed

One of college football's high profile coaches says he had cancer. AP correspondent Mike Hempen reports.

AP correspondent Ed Donahue reports on Deion Sanders' health scare.

Alison Birtle, FRCP, FRCR, MD - Case Study Challenge in Advanced Bladder Cancer: Tailoring Treatment to Individual Patients

Alison Birtle, FRCP, FRCR, MD - Case Study Challenge in Advanced Bladder Cancer: Tailoring Treatment to Individual Patients

Alison Birtle, FRCP, FRCR, MD - Case Study Challenge in Advanced Bladder Cancer: Tailoring Treatment to Individual Patients

Dr Matthew D Galsky from The Tisch Cancer Institute in New York, New York, Prof Andrea Necchi from the IRCCS San Raffaele Hospital in Milan, Italy, and Prof Thomas Powles from the Barts Cancer Institute in London provide their perspectives on clinical scenarios and datasets informing the care of patients with urothelial bladder cancer. CME information and select publications here.

Featuring perspectives from Dr Matthew D Galsky, Prof Andrea Necchi and Prof Thomas Powles, moderated by Dr Galsky, including the following topics: Introduction (0:00) Current and Future Management of Muscle-Invasive Bladder Cancer — Prof Powles (1:14) Novel Intravesical Therapies Under Evaluation for Nonmetastatic Urothelial Bladder Cancer (UBC) — Prof Necchi (24:48) Selection and Sequencing of Therapy for Metastatic UBC — Dr Galsky (44:52) CME information and select publications

AUA2025: Management of Non-Muscle Invasive Bladder Cancer: Practical Solutions for Common Problems  CME Available: https://auau.auanet.org/node/43047 At the conclusion of this activity, participants will be able to: 1. Implement current practice guidelines and explain methods and resources to improve transurethral resection of a bladder tumor (TURBT) skills. 2. Identify the best intravesical agent and duration of therapy for low-, intermediate-, and high-risk NMIBC and what to do during a BCG shortage. 3. Identify methods to treat significant toxicities from various intravesical therapies. 4. Define high-risk scenarios that necessitate cystectomy and options for BCG-unresponsive disease. 5. Identify the scientific rationale for investigating immune oncology agents for BCG-unresponsive disease and become familiar with current clinical trial designs. ACKNOWLEDGEMENTS: This educational activity is supported by an independent educational grants from: Janssen Biotech, Inc., administered by Janssen Scientific Affairs, LLC.

In this compelling episode of Bladder Cancer Matters, host Rick Bangs sits down with Dr. Vijay Kasturi, Chief Medical Officer at CG Oncology, for a must-hear conversation that blends science, heart, and hope. From the personal loss that fuels his passion to the groundbreaking clinical trials underway for Cretostimogene—an innovative investigational therapy targeting non-muscle invasive bladder cancer—Dr. Kasturi offers a behind-the-scenes look at how CG Oncology is working to change the game for patients. Whether you're a patient, caregiver, clinician, or advocate, this episode delivers crucial insights into new horizons for bladder cancer treatment.

With BCG in short supply and recurrence rates still high, the race is on for better intravesical options. In this episode of BackTable Tumor Board, Dr. Lindsey Herrel, urologic oncologist at the University of Michigan, joins Dr. Ruchika Talwar to explore the evolving landscape of intravesical therapy for intermediate risk bladder cancer. --- This podcast is supported by an educational grant from UroGen Pharma. --- SYNPOSIS The doctors break down the nuances of defining this risk category and the clinical gray zones that complicate treatment decisions. Dr. Herrell shares her patient-centered approach to surveillance and therapy, and introduces promising new agents, including Anktiva, UGN-102, and the gemcitabine-releasing TAR-200 "pretzel" device. The discussion also highlights how advances in molecular profiling are reshaping care strategies.This episode underscores the urgent need for clearer guidelines and continued innovation to improve outcomes and quality of life for patients with this nuanced disease subtype. --- TIMESTAMPS 00:00 - Introduction02:03 - Defining Intermediate Risk Bladder Cancer06:12 - Intravesical Therapy Options08:47 - Quality of Life and Patient Counseling10:18 - New Treatments on the Horizon12:56 - Practical Tips for TURBT Recovery17:03 - In-Office Procedure Management21:38 - Managing Symptoms and Quality of Life31:50 - A Note on Smoking Cessation33:37 - Conclusion and Future Directions

Dr. Neeraj Agarwal and Dr. Jeanny Aragon-Ching discuss important advances in the treatment of prostate, bladder, and kidney cancers that were presented at the 2025 ASCO Annual Meeting. TRANSCRIPT Dr. Neeraj Agarwal: Hello, and welcome to the ASCO Daily News Podcast. I am Dr. Neeraj Agarwal, your guest host of the ASCO Daily News Podcast today. I am the director of the Genitourinary Oncology Program and a professor of medicine at the University of Utah Huntsman Cancer Institute and editor-in-chief of the ASCO Daily News.  I am delighted to be joined by Dr. Jeanny Aragon-Ching, a GU medical oncologist and the clinical program director of the GU Center at the Inova Schar Cancer Institute in Virginia. Today, we will be discussing some key abstracts in GU oncology that were presented at the 2025 ASCO Annual Meeting.  Our full disclosures are available in the transcript of this episode.  Jeanny, it is great to have you on the podcast. Dr. Jeanny Aragon-Ching: Oh, thank you so much, Neeraj. Dr. Neeraj Agarwal: Jeanny, let's begin with some prostate cancer abstracts. Let's begin with Abstract 5017 titled, “Phase 1 study results of JNJ-78278343 (pasritamig) in metastatic castration-resistant prostate cancer.” Can you walk us through the design and the key findings of this first-in-human trial? Dr. Jeanny Aragon-Ching: Yeah, absolutely, Neeraj. So this study, presented by Dr. Capucine Baldini, introduces pasritamig, a first-in-class T-cell redirecting bispecific antibody that simultaneously binds KLK2 on prostate cancer cells and CD3 receptor complexes on T cells. KLK2 is also known as human kallikrein 2, which is selectively expressed in prostate tissue. And for reference, KLK3 is what we now know as the PSA, prostate-specific antigen, therefore making it an attractive and specific target for therapeutic engagement. Now, while this was an early, first-in-human, phase 1 study, it enrolled 174 heavily pretreated metastatic CRPC patients. So many were previously treated with ARPIs, taxanes, and radioligand therapy. So given the phase 1 nature of this study, the primary objective was to determine the safety and the RP2D, which is the recommended phase 2 dose. Secondary objectives included preliminary assessment of antitumor activity. So, pasritamig was generally well tolerated. There were no treatment-related deaths. Serious adverse events were rare. And in the RP2D safety cohort, where patients received the step-up dosing up to 300 mg of IV every 6 weeks, the most common treatment-related adverse events were low-grade infusion reactions. There was fatigue and grade 1 cytokine release syndrome, what we call CRS. And no cases of neurotoxicity, or what we call ICANS, the immune effector cell-associated neurotoxicity syndrome, reported. Importantly, the CRS occurred in just about 8.9% of patients. All were grade 1. No patients required tocilizumab or discontinued treatment due to adverse events. So, this suggests a favorable safety profile, allowing hopefully for outpatient administration without hospitalization, which will be very important when we're thinking about bispecifics moving forward. In terms of efficacy, pasritamig showed promising activity. About 42.4% of evaluable patients achieved a PSA50 response. Radiographic PFS was about 6.8 months. And among patients with measurable disease, the objective response rate was about 16.1% in those with lymph node or bone metastases, and about 3.7% in those with visceral disease, with a median duration of response of about 11.3 months. So, altogether, this data suggests that pasritamig may offer a well-tolerated and active new potential option for patients with metastatic CRPC.   Again, as a reminder, with the caveat that this is still an early phase 1 study. Dr. Neeraj Agarwal: Thank you, Jeanny. These are promising results for a bispecific T-cell engager, pasritamig, in prostate cancer. I agree, the safety and durability observed here stand out, and this opens the door for further development, possibly even in earlier disease settings.  So, shifting now from immunotherapy to the evolving role of genomics in prostate cancer. So let's discuss Abstract 5094, a real-world, retrospective analysis exploring the prognostic impact of homologous recombination repair gene mutations, especially BRCA1 and BRCA2 mutations, in metastatic hormone-sensitive prostate cancer. Can you tell us more about this abstract, Jeanny? Dr. Jeanny Aragon-Ching: Sure, Neeraj. So this study was presented by Dr. David Olmos, represents one of the largest real-world analyses we have evaluating the impact of homologous recombination repair, or what we would call HRR, alterations in metastatic hormone-sensitive prostate cancer. So, this cohort included 556 men who underwent paired germline and somatic testing. Now, about 30% of patients had HRR alterations, with about 12% harboring BRCA1 or BRCA2 mutations and 16% having alterations in other HRR genes. Importantly, patients were stratified via CHAARTED disease volume, and outcomes were examined across treatment approaches, including ADT alone, doublet therapy, and triplet therapy. The prevalence of BRCA and HRR alterations were about similar between the metastatic hormone-sensitive prostate cancer and the metastatic castrate-resistant prostate cancer, with no differences observed, actually, between the patients with high volume versus low volume disease.  So, the key finding was that BRCA and HRR alterations were associated with poor clinical outcomes in metastatic hormone-sensitive prostate cancer. And notably, the impact of these alterations may actually be even greater in metastatic hormone-sensitive prostate cancer than previously reported in metastatic CRPC. So, the data showed that when BRCA mutations are present, the impact of the volume of disease is actually limited. So, poor outcomes were observed across the board for both high-volume and low-volume groups. So, the analysis showed that patients with HRR alterations had significantly worse outcomes compared to patients without HRR alterations. Median radiographic progression-free survival was about 20.5 months for the HRR-altered patients versus 30.6 months for the non-HRR patients, with a hazard ratio of 1.6. Median overall survival was 39 months for HRR-altered patients compared to 55.7 months for the non-HRR patients, with a hazard ratio of 1.5. Similar significant differences were observed when BRCA-mutant patients were compared with patients harboring non-BRCA HRR mutations. Overall, poor outcomes were independent of treatment of ARPI or taxanes. Dr. Neeraj Agarwal: Thank you, Jeanny. So, these data reinforce homologous recombination repair mutations as both a predictive and prognostic biomarker, not only in the mCRPC, but also in the metastatic hormone-sensitive setting as well. It also makes a strong case for incorporating genomic testing early in the disease course and not waiting until our patients have castration-resistant disease. Dr. Jeanny Aragon-Ching: Absolutely, Neeraj. And I think this really brings home the point and the lead up to the AMPLITUDE trial, which is LBA5006, a phase 3 trial that builds on this very concept of testing with a PARP inhibitor, niraparib, in the hormone-sensitive space. Can you tell us a little bit more about this abstract, Neeraj? Dr. Neeraj Agarwal: Sure. So, the AMPLITUDE trial, a phase 3 trial presented by Dr. Gerhardt Attard, enrolled 696 patients with metastatic hormone-sensitive prostate cancer and HRR gene alterations. 56% of these patients had BRCA1 and BRCA2 mutations. Patients were randomized to receive abiraterone with or without niraparib, a PARP inhibitor. The majority of patients, 78% of these patients, had high-volume metastatic hormone-sensitive prostate cancer, and 87% of these patients had de novo metastatic HSPC. And 16% of these patients received prior docetaxel, which was allowed in the clinical trial. So, with a median follow-up of nearly 31 months, radiographic progression-free survival was significantly prolonged with the niraparib plus abiraterone combination, and median was not reached in this arm, compared to abiraterone alone, which was 29.5 months, with a hazard ratio of 0.63, translating to a 37% reduction in risk of progression or death. This benefit was even more pronounced in the BRCA1 and BRCA2 subgroup, with a 48% reduction in risk of progression, with a hazard ratio of 0.52. Time to symptomatic progression also improved significantly across all patients, including patients with BRCA1, BRCA2, and HRR mutations. Although overall survival data remain immature, early trends favored the niraparib plus abiraterone combination. The safety profile was consistent with prior PARP inhibitor studies, with grade 3 or higher anemia and hypertension were more common but manageable. Treatment discontinuation due to adverse events remained low at 11%, suggesting that timely dose modifications when our patients experience grade 3 side effects may allow our patients to continue treatment without discontinuation. These findings support niraparib plus abiraterone as a potential new standard of care in our patients with metastatic hormone-sensitive prostate cancer with HRR alterations, and especially in those who had BRCA1 and BRCA2 mutations. Dr. Jeanny Aragon-Ching: Thank you, Neeraj. This trial is especially exciting because it brings PARP inhibitors earlier into the treatment paradigm. Dr. Neeraj Agarwal: Exactly. And it is exciting to see the effect of PARP inhibitors in the earlier setting.  So Jeanny, now let's switch gears a bit to bladder cancer, which also saw several impactful studies. Could you tell us about Abstract 4502, an exploratory analysis from the EV-302 trial, which led to approval of enfortumab vedotin plus pembrolizumab for our patients with newly diagnosed metastatic bladder cancer? So here, the authors looked at the outcomes in patients who achieved a confirmed complete response with EV plus pembrolizumab. Dr. Jeanny Aragon-Ching: Sure, Neeraj. So, EV-302 demonstrated significant improvements in progression-free and overall survival for patients previously treated locally advanced or metastatic urothelial cancer, I'll just call it metastatic UC, as a frontline strategy, establishing EV, which is enfortumab vedotin, plus pembro, with pembrolizumab as standard of care in this setting.  So, this year at ASCO, Dr Shilpa Gupta presented this exploratory responder analysis from the phase 3 EV-302 trial. Among 886 randomized patients, about 30.4% of patients, this is about 133, in the EV+P arm, and 14.5% of the patients in the chemotherapy arm, achieved a confirmed complete response. They call it the CCR rates. So for patients who achieved this, median PFS was not reached with EV+P compared to 26.9 months with chemotherapy, with a hazard ratio of 0.36, translating to a 64% reduction in the risk of progression. Overall survival was also improved. So the median OS was not reached in either arm, but the hazard ratio favored the EV+P at 0.37, translating to a 63% reduction in the risk of death. The median duration of complete response was not reached with EV+P compared to 15.2 months with chemotherapy. And among those patients who had confirmed CRs at 24 months, 78% of patients with the EV+P arm remained progression-free, and around 95% of the patients were alive, compared to 54% of patients who were progression-free and 86% alive of the patients in the chemotherapy arm. Safety among responders were also consistent with prior reports. Grade 3 or higher treatment-related adverse events occurred in 62% of EV+P responders and 72% of chemotherapy responders. Most adverse events were managed with dose modifications, and importantly, no treatment-related deaths were reported among those who were able to achieve complete response.  So these findings further reinforce EV and pembro as the preferred first-line therapy for metastatic urothelial carcinoma, offering a higher likelihood of deep, durable responses with a fairly manageable safety profile. Dr. Neeraj Agarwal: Thank you for the great summary, Jeanny. These findings underscore the depth and durability of responses achievable with this combination and also suggest that achieving a response may be a surrogate for long-term benefit in patients with metastatic urothelial carcinoma.  So now, let's move to Abstract 4503, an exploratory ctDNA analysis from the NIAGARA trial, which evaluated perioperative durvalumab, an immune checkpoint inhibitor, in muscle-invasive bladder cancer. So what can you tell us about this abstract? Dr. Jeanny Aragon-Ching: Absolutely, Neeraj. So, in NIAGARA, presented by Dr. Tom Powles, the addition of perioperative durvalumab to neoadjuvant chemotherapy, gem/cis, significantly improved event-free survival, overall survival, and pathologic complete response in patients with cisplatin-eligible muscle-invasive bladder cancer. Recall that this led to the U.S. FDA approval of this treatment regimen on March 28, 2025.  So, a planned exploratory analysis evaluated the ctDNA dynamics and their association with clinical outcomes, which was the one presented recently at ASCO. So, the study found that the incidence of finding ctDNA positivity in these patients was about 57%. Following neoadjuvant treatment, this dropped to about 22%, with ctDNA clearance being more common in the durvalumab arm, about 41%, compared to the chemotherapy control arm of 31%. Notably, 97% of patients who remained ctDNA positive prior to surgery failed to achieve a pathologic CR. So, this indicates a strong association between ctDNA persistence and lack of tumor eradication. So, postoperatively, only about 9% of patients were ctDNA positive. So, importantly, durvalumab conferred an event-free survival benefit regardless of ctDNA status at both baseline and post-surgery. Among patients who were ctDNA positive at baseline, durvalumab led to a hazard ratio of 0.73 for EFS. So, this translates to a 27% reduction in the risk of disease recurrence, progression, or death compared to the control arm. In the post-surgical ctDNA-positive group, the disease-free survival was also improved with a hazard ratio of 0.49, translating to a 51% reduction in the risk of recurrence.  So, these findings underscore the prognostic value of ctDNA and suggest that durvalumab provides clinical benefit irrespective of molecular residual disease status. So, the data also supports that ctDNA is a promising biomarker for future personalized strategies in the perioperative treatment of muscle-invasive bladder cancer. Dr. Neeraj Agarwal: Thank you, Jeanny. It is great to see that durvalumab is improving outcomes in these patients regardless of ctDNA status. However, based on these data, presence of ctDNA in our patients warrants a closer follow-up with imaging studies, because these patients with positive ctDNA seem to have a higher risk of recurrence. Dr. Jeanny Aragon-Ching: I agree, Neeraj.  Let's round out the bladder cancer discussion with Abstract 4518, which reported the interim results of SURE-02, which is a phase 2 study evaluating neoadjuvant sacituzumab govitecan plus pembrolizumab in cisplatin-ineligible muscle-invasive bladder cancer. Can you tell us more about this abstract, Neeraj? Dr. Neeraj Agarwal: Sure, Jeanny. So, Dr Andrea Necchi presented interim results from the SURE-02 trial. This is a phase 2 study evaluating neoadjuvant sacituzumab govitecan plus pembrolizumab, followed by a response-adapted bladder-sparing treatment and adjuvant pembrolizumab in patients with muscle-invasive bladder cancer.  So, in this interim analysis, 40 patients were treated and 31 patients were evaluable for efficacy. So, the clinical complete response rate was 38.7%. All patients achieving clinical complete response underwent bladder-sparing approach with a repeat TURBT instead of radical cystectomy. Additionally, 51.6% of patients achieved excellent pathologic response with a T stage of 1 or less after neoadjuvant therapy. The treatment was well tolerated, with only 12.9% of patients experiencing grade 3 or higher adverse events without needing dose reduction of sacituzumab. Molecular profiling, interestingly, showed that clinical complete response correlated with luminal and genomically unstable subtypes, while high stromal gene expression was associated with lack of response.  These results suggest that sacituzumab plus pembrolizumab combination has promising activity in this setting, and tolerability, and along with other factors may potentially allow a bladder preservation approach in a substantial number of patients down the line. Dr. Jeanny Aragon-Ching: Yeah, agree with you, Neeraj. And the findings are very provocative and support completing the full trial enrollment and further exploration of this strategy in muscle-invasive bladder cancer in order to improve and provide further bladder-sparing strategies. Dr. Neeraj Agarwal: Agree. So, let's now turn to the kidney cancer, starting with Abstract 4505, the final overall analysis from CheckMate-214 trial, which evaluated nivolumab plus ipilimumab, so dual checkpoint inhibition strategy, versus sunitinib in our patients with metastatic clear cell renal cell carcinoma. Dr. Jeanny Aragon-Ching: Yeah, absolutely, Neeraj. So, the final 9-year analysis of the phase 3 CheckMate-214 trial confirms the long-term superiority of nivolumab and ipilimumab over sunitinib for first-line treatment of advanced metastatic renal cell carcinoma. So, this has a median follow-up of 9 years. Overall survival remains significantly improved with the combination. So, in the ITT patient population, the intention-to-treat, the hazard ratio for overall survival was 0.71. So, this translates to a 29% reduction in the risk of death. 31% of patients were alive at this 108-month follow-up compared to 20% only in those who got sunitinib. So, similar benefits were observed in the intermediate- and poor-risk groups with a hazard ratio of 0.69, and 30% versus 19% survival at 108 months.  Importantly, a delayed benefit was also seen in those favorable-risk patients. So, the hazard ratio for overall survival improved from 1.45 in the initial report and now at 0.8 at 9 years follow-up, with 35% of patients alive at 108 months compared to 22% in those who got sunitinib. Progression-free survival also favored the nivo-ipi arm across all risk groups. At 96 months, the probability of remaining progression-free was about 23% compared to 9% in the sunitinib arm in the ITT patient population, 25% versus 9% in the intermediate- and poor-risk patients, and 13% compared to 11% in the favorable-risk patients. Importantly, at 96 months, 48% of patients in the nivo-ipi responders remained in response compared to just 19% in those who got sunitinib. And in the favorable-risk group, 36% of patients who responded remained in response, although data were not available for sunitinib in this subgroup.  So, this data reinforces the use of nivolumab and ipilimumab as a durable and effective first-line effective strategy for standard of care across all risk groups for advanced renal cell carcinoma. Dr. Neeraj Agarwal: Thank you, Jeanny. And of course, since ipi-nivo data were presented, several other novel ICI-TKI combinations have emerged. And I'm really hoping to see very similar data with TKI-ICI combinations down the line. It is really important to note that we are not seeing any new safety signals with the ICI combinations or ICI-based therapies, which is very reassuring given the extended exposure. Dr. Jeanny Aragon-Ching: Absolutely agree with you there, Neeraj.  Now, going on and moving on to Abstract 4514, which is the KEYNOTE-564 trial, and they reported on the 5-year outcomes of adjuvant pembrolizumab in clear cell RCC in patients who are at high risk for recurrence. Can you tell us a little bit more about this abstract, Neeraj? Dr. Neeraj Agarwal: Sure. So, the KEYNOTE-564 trial established pembrolizumab monotherapy as the first adjuvant regimen to significantly improve both disease-free survival and overall survival compared to placebo after surgery for patients with clear cell renal cell carcinoma. So, Dr Naomi Haas presented the 5-year update from this landmark trial.  A total of 994 patients were randomized to receive either pembrolizumab or placebo. The median follow-up at the time of this analysis was approximately 70 months. Disease-free survival remained significantly improved with pembrolizumab. The median DFS was not reached with pembrolizumab compared to 68.3 months with placebo, with a hazard ratio of 0.71, translating to a 29% reduction in risk of recurrence. At 5 years, 60.9% of patients receiving pembrolizumab remained disease-free compared to 52.2% with placebo. Overall survival also favored pembrolizumab. The hazard ratio for OS was 0.66, translating to a 34% reduction in risk of death, with an estimated 5-year overall survival rate of 87.7% with pembrolizumab compared to 82.3% for placebo. Importantly, these benefits were consistent across all key subgroups, including patients with sarcomatoid features. In addition, no new serious treatment-related adverse events have been reported in the 3 years since treatment completion.  So, these long-term data confirm pembrolizumab as a durable and effective standard adjuvant therapy for patients with resected, high-risk clear cell renal cell carcinoma. Dr. Jeanny Aragon-Ching: Thank you for that wonderful summary, Neeraj. Dr. Neeraj Agarwal: That wraps up our kidney cancer highlights. Any closing thoughts, Jeanny, before we conclude? Dr. Jeanny Aragon-Ching: It's been so wonderful reviewing these abstracts with you, Neeraj. So, the 2025 ASCO Annual Meeting showcased a lot of transformative data across GU cancers, from first-in-class bispecifics to long-term survival in RCC. And these findings are already shaping our clinical practices. Dr. Neeraj Agarwal: I agree. And we have covered a broad spectrum of innovations in GU cancers with strong clinical relevance.  So, thank you, Jeanny, for joining me today and sharing your insights.  And thank you to our listeners for joining us. You will find links to the abstracts discussed today in the transcript of this episode. If you find these conversations valuable, please take a moment to rate, review, and subscribe to the ASCO Daily News Podcast wherever you listen. Thank you so much. Disclaimer: The purpose of this podcast is to educate and to inform. This is not a substitute for professional medical care and is not intended for use in the diagnosis or treatment of individual conditions.  Guests on this podcast express their own opinions, experience, and conclusions. Guest statements on the podcast do not express the opinions of ASCO. The mention of any product, service, organization, activity, or therapy should not be construed as an ASCO endorsement. Find out more about today's speakers:    Dr. Neeraj Agarwal     @neerajaiims     Dr. Jeanny Aragon-Ching   Follow ASCO on social media:       @ASCO on Twitter       ASCO on Bluesky   ASCO on Facebook       ASCO on LinkedIn       Disclosures:   Dr. Neeraj Agarwal:   Consulting or Advisory Role: Pfizer, Bristol-Myers Squibb, AstraZeneca, Nektar, Lilly, Bayer, Pharmacyclics, Foundation Medicine, Astellas Pharma, Lilly, Exelixis, AstraZeneca, Pfizer, Merck, Novartis, Eisai, Seattle Genetics, EMD Serono, Janssen Oncology, AVEO, Calithera Biosciences, MEI Pharma, Genentech, Astellas Pharma, Foundation Medicine, and Gilead Sciences  Research Funding (Institution): Bayer, Bristol-Myers Squibb, Takeda, Pfizer, Exelixis, Amgen, AstraZeneca, Calithera Biosciences, Celldex, Eisai, Genentech, Immunomedics, Janssen, Merck, Lilly, Nektar, ORIC Pharmaceuticals, Crispr Therapeutics, Arvinas  Dr. Jeanny Aragon-Ching:   Honoraria: Bristol-Myers Squibb, EMD Serono, Astellas Scientific and Medical Affairs Inc., Pfizer/EMD Serono   Consulting or Advisory Role: Algeta/Bayer, Dendreon, AstraZeneca, Janssen Biotech, Sanofi, EMD Serono, MedImmune, Bayer, Merck, Seattle Genetics, Pfizer, Immunomedics, Amgen, AVEO, Pfizer/Myovant, Exelixis,    Speakers' Bureau: Astellas Pharma, Janssen-Ortho, Bristol-Myers Squibb, Astellas/Seattle Genetics

Navigating the growing complexity of bladder cancer care is essential to improving patient access and treatment closer to home. In this episode, CANCER BUZZ speaks with Suzanne Merrill, MD, urologic oncologist at Colorado Urology about barriers and solutions to delivering high-quality bladder cancer care in community settings. CANCER BUZZ also speaks with Patrick Hensley, MD, urologist at University of Kentucky Markey Cancer Center, about implementing the Delivering High-Quality Bladder Cancer Care infographic in the community setting. Created by ACCC and BCAN, the infographic describes the 10 elements of excellent bladder cancer care. Cancer programs that align their practices with these guidelines can join a public registry so that patients and caregivers can identify quality bladder cancer care close to where they live. “The best strategies and tools to deliver high quality bladder cancer care out in the community lie first and foremost with having a bladder cancer clinician. It could be a urologist, it could be a urologic oncologist, could even be a medical oncologist or a radiation oncologist...their discipline doesn't matter as much as [having] the core clinical expert that is excited and dedicated to developing and instituting a comprehensive bladder cancer program.” - Suzanne Merrill, MD, FACS “Everybody assumes comprehensive care is being delivered at academic university settings, which it is, but there's so much...bladder cancer care being performed out in the community. So [the question is] how can we achieve comprehensive programs out in the community?” - Suzanne Merril, MD, FACS “I think it's really important that subspecialists and community providers work together to streamline those referrals and anticipate when the patients are coming in and what their needs are going to be, from a procedural standpoint, imaging standpoint, etc, so that you can avoid some of those undue delays in diagnosis and treatment.” - Patrick Hensley, MD Suzanne Merrill, MD, FACS Urologic Oncologist Colorado Urology Aurora, CO Patrick Hensley, MD Urologist Markey Cancer Center – Urology University of Kentucky Lexington, KY   Resources: Infographic: Delivering High Quality Cancer Care in the Community Addressing Disparities in Bladder Cancer Care Understanding and Mitigating Disparities in Bladder Cancer Care Bladder Cancer Advocacy Network (BCAN)   Funder Statement This program is supported by Astellas Pfizer Alliance, EMD Serano, and Gilead.

This content has been developed for healthcare professionals only. Patients who seek health information should consult with their physician or relevant patient advocacy groups.For the full presentation, downloadable Practice Aids, slides, and complete CME information, and to apply for credit, please visit us at PeerView.com/SDR865. CME credit will be available until May 20, 2026.Adopting Innovation in Bladder Cancer: Aligning the Evidence on Antibody–Drug Conjugates to Inform Treatment Decisions In support of improving patient care, PVI, PeerView Institute for Medical Education, is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.SupportThis activity is supported by an educational grant from Astellas and Pfizer, IncDisclosure information is available at the beginning of the video presentation.

This content has been developed for healthcare professionals only. Patients who seek health information should consult with their physician or relevant patient advocacy groups.For the full presentation, downloadable Practice Aids, slides, and complete CME information, and to apply for credit, please visit us at PeerView.com/SDR865. CME credit will be available until May 20, 2026.Adopting Innovation in Bladder Cancer: Aligning the Evidence on Antibody–Drug Conjugates to Inform Treatment Decisions In support of improving patient care, PVI, PeerView Institute for Medical Education, is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.SupportThis activity is supported by an educational grant from Astellas and Pfizer, IncDisclosure information is available at the beginning of the video presentation.

This content has been developed for healthcare professionals only. Patients who seek health information should consult with their physician or relevant patient advocacy groups.For the full presentation, downloadable Practice Aids, slides, and complete CME information, and to apply for credit, please visit us at PeerView.com/SDR865. CME credit will be available until May 20, 2026.Adopting Innovation in Bladder Cancer: Aligning the Evidence on Antibody–Drug Conjugates to Inform Treatment Decisions In support of improving patient care, PVI, PeerView Institute for Medical Education, is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.SupportThis activity is supported by an educational grant from Astellas and Pfizer, IncDisclosure information is available at the beginning of the video presentation.

This content has been developed for healthcare professionals only. Patients who seek health information should consult with their physician or relevant patient advocacy groups.For the full presentation, downloadable Practice Aids, slides, and complete CME information, and to apply for credit, please visit us at PeerView.com/SDR865. CME credit will be available until May 20, 2026.Adopting Innovation in Bladder Cancer: Aligning the Evidence on Antibody–Drug Conjugates to Inform Treatment Decisions In support of improving patient care, PVI, PeerView Institute for Medical Education, is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.SupportThis activity is supported by an educational grant from Astellas and Pfizer, IncDisclosure information is available at the beginning of the video presentation.

Food manufacturers cave to RFK Jr. agenda to eliminate artificial dyes; Diet, exercise ameliorate tinnitus symptoms in overweight seniors; Long work hours may foster deleterious brain changes; Blood in urine—why is it such a big deal? Suggestions for a dog with panic attacks ahead of weather fronts; Diets high in fruits and vegetables counter disordered sleep.

Non-muscle invasive bladder cancer is common, recurrent, and often misunderstood. Urologist Jed Ferguson, M.D., and urologic oncologist Chaz Peyton, M.D., explain how it differs from muscle invasive disease, why recurrence increases the risk of progression, and the complex factors that determine treatment sequencing. Learn about UAB's clinical trials and emerging therapies that aim to preserve the bladder without compromising care.

Bladder cancer remains a significant clinical concern, with more than 85,000 new diagnoses and nearly 19,000 deaths reported annually in the United States. While current treatments like surgery, chemotherapy, and radiation can be effective for early-stage disease, many patients with advanced or recurrent cancer face limited options. A recent review, published in Oncotarget by researchers from the University of California, Irvine, analyzes the growing body of evidence supporting the combination of radiation therapy and immunotherapy for bladder cancer. Led by Nazmul Hasan, the work synthesizes clinical data and biological mechanisms that suggest this strategy could enhance anti-tumor responses in specific patient groups. Full blog - https://www.oncotarget.org/2025/06/16/exploring-a-combined-approach-radiation-and-immunotherapy-in-bladder-cancer/ Paper DOI - https://doi.org/10.18632/oncotarget.28723 Correspondence to - Nazmul Hasan - nhasan1@hs.uci.edu Video short - https://www.youtube.com/watch?v=AxrZhIUXrOQ Sign up for free Altmetric alerts about this article - https://oncotarget.altmetric.com/details/email_updates?id=10.18632%2Foncotarget.28723 Subscribe for free publication alerts from Oncotarget - https://www.oncotarget.com/subscribe/ To learn more about Oncotarget, please visit https://www.oncotarget.com and connect with us: Facebook - https://www.facebook.com/Oncotarget/ X - https://twitter.com/oncotarget Instagram - https://www.instagram.com/oncotargetjrnl/ YouTube - https://www.youtube.com/@OncotargetJournal LinkedIn - https://www.linkedin.com/company/oncotarget Pinterest - https://www.pinterest.com/oncotarget/ Reddit - https://www.reddit.com/user/Oncotarget/ Spotify - https://open.spotify.com/show/0gRwT6BqYWJzxzmjPJwtVh MEDIA@IMPACTJOURNALS.COM

Josh Meeks joins us to give stellar overview of the emerging data in this space. We also discuss the recent ODAC ruling for lower risk patients.

Jerome was diagnosed with muscle invasive bladder cancer on January 29, 1997. The diagnosis was based on a transurethral resection surgery. Having done his research, he contacted a doctor at Harvard and Mass General Hospital about a clinical trial for a bladder sparing protocol. To Jermoe's surprise, Dr.Shipley called back and shared the protocol with Jerome's medical team and the treatment began a couple of weeks later. The treatment involved chemotherapy in conjunction with radiation therapy.  Jerome experienced several recurrences over the years, each time treating them with surgery and infusions. In 2018 a recurrence involved hospitalization and tubes were placed in each kidney. This time Jerome was faced with a decision to have a radical cystectomy or given the choice to do immunotherapy. By 2019 there was little evidence of bladder cancer and infusions continued, with no side effects. He still has a tube in one kidney and is otherwise thriving! email: Jerome@mountainsangha.org phone: 415-299-0428 website: www.mountainsangha.org Book: Healing with the 7 Principles of Mindfulness, by Jerome FreedmanHere is what Dr. Kelly Turner, PhD has to say about Healing with the 7 Principles of Mindfulness: “Dr. Freedman speaks from experience, both as a cancer survivor himself, and the father of a Radical Remission cancer survivor. His book, “Healing with the 7 Principles of Mindfulness” gives readers a nurturing, helping hand throughout the entire cancer journey, especially with regard to developing a meditation practice. –Kelly Turner, PhD, Author of the NYTimes Bestseller “Radical Remission: Surviving Cancer Against All Odds” Stop Cancer in Its Tracks: How to Embrace Mindfulness In Healing by Jerome Freedman ___________________________ To learn more about the 10 Radical Remission Healing Factors, connect with a certified RR coach or join a virtual or in-person workshop visit www.radicalremission.com. To watch Episode 1 of the Radical Remission Docuseries for free, visit our YouTube channel here.  To purchase the full 10-episode Radical Remission Docuseries visit Hay House Online Learning. To learn more about Radical Remission health coaching with Liz or Karla, Click Here Follow us on Social Media: Facebook  Instagram YouTube __________________________ Thank you to our friends from The Healing Oasis for sponsoring this episode of the podcast.  The Healing Oasis is a first of its kind in beautiful British Columbia, Canada where we encourage the body to heal from cancer using alternative therapies & cancer fighting meals at a wellness retreat center in nature. Our top naturopathic cancer doctor will prescribe a protocol tailored specifically for you. There's no place quite like it. Start your healing journey today! Learn More about The Healing Oasis by visiting these links: Website   Testimonials Video Overview

Jeannie Hoffman-Censits discusses her randomized phase 2 adding SG to maintenence avelumab in mUC.

In today's episode, we spoke with Matthew Galsky, MD, about the FDA approval of neoadjuvant durvalumab (Imfinzi) plus gemcitabine and cisplatin followed by adjuvant durvalumab monotherapy after radical cystectomy for the treatment of adult patients with muscle-invasive bladder cancer (MIBC). Dr Galsky is a professor of medicine (hematology and medical oncology), a professor of urology, director of Genitourinary Medical Oncology, co-director of the Center of Excellence for Bladder Cancer, and director for Translational Research at The Tisch Cancer Institute in New York, New York. In our exclusive interview, Dr Galsky discussed the significance of this approval, key efficacy and safety data from the pivotal phase 3 NIAGARA trial (NCT03732677), and the role of this regimen in the MIBC treatment paradigm, including for cisplatin-eligible patients with mild renal impairment.

Featuring perspectives from Dr Shilpa Gupta and Dr Jonathan E Rosenberg, including the following topics: Management of Nonmetastatic Urothelial Bladder Cancer (UBC) — Dr Gupta (0:00) Optimizing the Treatment of Metastatic UBC — Dr Rosenberg (21:52) CME information and select publications

“Ten years ago, there were relatively few treatment options [for bladder cancer] compared to what we have today which is a relative wealth of options,” said Debasish Sundi, MD, a James urologist and bladder cancer specialist. In this episode, Dr. Sundi explained the function of the bladder (storing urine), the different types of bladder cancer (contained within the bladder and metastatic), how new immunotherapies have led to better options and outcomes, and his research which focuses on identifying the biomarkers in a patient's bladder cancer by analyzing their urine, instead of a more invasive procedure using a scope. There are about 80,000 new cases of bladder cancer diagnosed ever year in the United States and “about 75 to 80 percent are in males,” Dr. Sundi said, adding “the number one cause is exposure to tobacco smoke and tobacco products.” The primary symptom is blood in the urine. “If you see blood in your urine, even if it's just pink, it is worthwhile to talk to your primary care doctor or see a urologist.” Clinical trials have led to the development and approval of several new immunotherapy treatments. “The challenge is we do not have any good biomarkers to tell us how our patients will respond,” Dr. Sundi said. “My lab is developing an assay [test] to non-invasively make an assessment. We've learned that if we look at the immune cells in the urine of someone with bladder cancer, they are similar to the immune cells in their tumor … And this could lead to significantly improving the therapeutic options and helping doctors pick the best medicine for their patients from the start.” Dr. Sundi said his research is motivated by his patients. “When I started in this field the experiences of patients with bladder cancer was something we could and should improve,” he said. “Working toward this is the fuel that is self-sustaining and there is so much excitement in terms of the innovation happening in the bladder-cancer field.”

Are you or a loved one facing a diagnosis of bladder cancer, melanoma, or skin cancer? Tune in to this essential episode of Navigating Cancer TOGETHER for expert guidance and compassionate insights. Join host Talaya Dendy as she welcomes back Dr. Thomas Eanelli, a highly respected radiation oncologist based in New York. We also feature Angel Santana, co-host of The CROC Podcast, sharing powerful motivational perspectives. In observance of May Cancer Awareness, this special episode dives into critical aspects of three specific cancers: bladder, melanoma, and skin cancer. Dr. Eanelli provides invaluable medical expertise on the latest cancer treatments, diagnosis, and management of these diseases. Angel Santana offers heartfelt inspiration and emphasizes the power of support and positivity throughout the cancer journey. This episode is packed with vital information and moving stories to offer hope and guidance for anyone navigating cancer.