POPULARITY
15 episodes with nmibc
11 episodes with nmibc
11 episodes with nmibc
5 episodes with nmibc
5 episodes with nmibc
6 episodes with nmibc
3 episodes with nmibc
4 episodes with nmibc
4 episodes with nmibc
Welcome to this episode of Oncology Brothers, where we dived into the latest advancements in GU malignancies! We welcomed esteemed guests Dr. Brian Rini and Dr. Thomas Powles, both GU medical oncologists and co-hosts of the Uromigos podcast. In this episode, we discussed key studies presented at ASCO 2026 that are set to change clinical practice in prostate, kidney and bladder cancer, and recent FDA approvals in the GU space: PROTEUS: trial comparing ADT monotherapy to apalutamide plus ADT in high-risk localized prostate cancer. We explored its findings, implications, and the ongoing debate surrounding its control arm. TALAPRO-3 Study: impact of PARP inhibitors combined with enzalutamide in metastatic castration-sensitive prostate cancer with homologous recombination repair (HRR) mutations. We discussed the nuances of HRR mutations and their clinical significance. CAPITELLO-281: insights into the recent approval of this AKT inhibitor for metastatic castration-sensitive prostate cancer with PTEN loss, based on the CAPItello-281 study. EV-302 update: combination of EV-pembrolizumab still maintains the doubling of survival benefit with longterm follow up. POTOMAC: durvalumab + BCG induction therapy for high-risk non-muscle invasive bladder cancer (NMIBC) could be a choice for a selected patient population. LITESPARK-022: The new approval of belzutifan with pembrolizumab in the adjuvant setting, discussing its efficacy and the importance of patient selection. Listen us on: Spotify: https://open.spotify.com/show/31BXhY9FM4gPWG10WgE11o ' Apple Podcast: https://podcasts.apple.com/us/podcast/oncology-brothers-practice-changing-cancer-discussions/id1653340966 Follow us on social media: X/Twitter: https://twitter.com/oncbrothers Instagram: https://www.instagram.com/oncbrothers Website: https://oncbrothers.com/ Throughout the episode, we emphasized the importance of balancing treatment benefits with potential adverse events, as well as the need for shared decision-making in clinical practice. #GUOncology, #ASCO2026, #ProstateCancer, #BladderCancer, #RenalCellCarcinoma, #OncologyBrothers
Why does up to 10% of bladder cancer pathology change on expert review, and what does that mean for your intermediate and high-risk patients? In this episode of BackTable, Dr. Bogdana Schmidt interviews urologists Dr. Kristen Scarpato and Dr. Sunil Patel to explore the complexities of diagnosis and risk assessment in non–muscle invasive bladder cancer (NMIBC). They discuss the real-world challenges of pathology interpretation, risk-group assignment, evolving diagnostic tools, and the impact these factors have on treatment decisions and patient outcomes. --- Get the BackTable apphttps://www.backtable.com/app --- This podcast is supported by an educational grant from Johnson & Johnson. --- Timestamps00:00 - Introduction01:02 - Risk Stratification07:22 - Upstaging to High Risk10:06 - Calculators and Patient Education15:22 - Specific Tests Use Cases18:50 - Conflicting Biomarker Results21:36 - Adjunct Tests and Counseling24:03 - Recurrence After Chemo Next Steps27:01 - Escalation Deescalation Balance32:48 - Future Research Priorities35:43 - Biology Based Risk Stratification38:03 - Clinical Pearls and Wrap Up --- More about this episodeThe conversation highlights the heterogeneity of intermediate-risk disease, the role and importance of expert pathology over-reads, and the need to accurately document the risk category for ongoing care. They discuss selective use of urinary and genomic assays and how these tests fit alongside cystoscopy and blue light endoscopy. Practical treatment approaches are reviewed, including when to use intravesical gemcitabine or BCG, managing care during BCG shortages, and balancing escalation versus de-escalation of therapy. Additional topics include strategies for long-term surveillance, upper tract imaging, rising rates of bladder cancer in younger patients, and why thorough TURBT and strong patient-provider communication remain central to optimal management. --- Resources The Memorial Studyhttps://www.mskcc.org/cancer-care/clinical-trials/19-288 The BRIDGE Studyhttps://www.nejm.org/doi/full/10.1056/NEJMoa1501035 --- BackTable Urology is the go-to podcast for urologists, urologic oncologists, and urogynecologists. Download the free BackTable app to get early access to new episodes, cases, and courses curated by physicians in your specialty.► https://www.backtable.com/app
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/AAPA/IPCE information, and to apply for credit, please visit us at PeerView.com/WXE865. CME/AAPA/IPCE credit will be available until June 16, 2027.Maximizing NMIBC Outcomes: Personalized, Risk-Adapted Approaches With Intravesical Therapy and Collaborative Care 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 Ferring Pharmaceuticals, Inc.Disclosure 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/AAPA/IPCE information, and to apply for credit, please visit us at PeerView.com/WXE865. CME/AAPA/IPCE credit will be available until June 16, 2027.Maximizing NMIBC Outcomes: Personalized, Risk-Adapted Approaches With Intravesical Therapy and Collaborative Care 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 Ferring Pharmaceuticals, Inc.Disclosure 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/AAPA/IPCE information, and to apply for credit, please visit us at PeerView.com/WXE865. CME/AAPA/IPCE credit will be available until June 16, 2027.Maximizing NMIBC Outcomes: Personalized, Risk-Adapted Approaches With Intravesical Therapy and Collaborative Care 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 Ferring Pharmaceuticals, Inc.Disclosure 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/AAPA/IPCE information, and to apply for credit, please visit us at PeerView.com/WXE865. CME/AAPA/IPCE credit will be available until June 16, 2027.Maximizing NMIBC Outcomes: Personalized, Risk-Adapted Approaches With Intravesical Therapy and Collaborative Care 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 Ferring Pharmaceuticals, Inc.Disclosure 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/AAPA/IPCE information, and to apply for credit, please visit us at PeerView.com/WXE865. CME/AAPA/IPCE credit will be available until June 16, 2027.Maximizing NMIBC Outcomes: Personalized, Risk-Adapted Approaches With Intravesical Therapy and Collaborative Care 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 Ferring Pharmaceuticals, Inc.Disclosure 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/AAPA/IPCE information, and to apply for credit, please visit us at PeerView.com/WXE865. CME/AAPA/IPCE credit will be available until June 16, 2027.Maximizing NMIBC Outcomes: Personalized, Risk-Adapted Approaches With Intravesical Therapy and Collaborative Care 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 Ferring Pharmaceuticals, Inc.Disclosure information is available at the beginning of the video presentation.
What matters most to patients with non-muscle invasive bladder cancer (NMIBC)? In this episode of BackTable Urology, Dr. Kelly Bree, Dr. Saum Ghodoussipour, and Meredith Donahue, N.P., join host Dr. Vignesh Packiam to discuss the power of shared decision-making across the NMIBC spectrum. They explore risk-adapted treatment selection, when to escalate or de-escalate therapy, and how to navigate conversations about recurrence risk, treatment burden, quality of life, and the possibility of cystectomy. --- Get the BackTable apphttps://www.backtable.com/app --- This podcast is supported by an educational grant from Johnson & Johnson. --- Timestamps 00:00 - Introduction01:55 - Second Opinions and Patient Counseling06:08 - Intermediate Risk Stratification12:13 - Treatment Options for Intermediate Risk NMIBC16:20 - BCG and Alternative Treatments for High Risk NMIBC26:49 - Options for BCG-Unresponsive NMIBC31:42 - Sequencing and Cystectomy37:03 - Financial and Time Toxicity41:08 - Biomarkers and ctDNA44:04 - Future Trials and NMIBC Innovations --- More about this episode They also review emerging therapies such as ZUSDURI, the evolving role of intravesical treatments, and the promise of biomarkers and ctDNA for personalized care. The discussion covers practical strategies for patient counseling, key updates to clinical guidelines, and a preview of innovations shaping the future of NMIBC management. --- Resources Active Surveillance Versus Intravesical Bacillus Calmette-Guérin for High-grade T1 Bladder Cancer with Negative Second Transurethral Resection: The Randomized Noninferiority Phase 3 JCOG1019 Trial:https://pubmed.ncbi.nlm.nih.gov/41571573/ Twelve-Month Results From the CISTO Study Comparing Radical Cystectomy Versus Bladder-Sparing Therapy for Recurrent High-Grade Non–Muscle-Invasive Bladder Cancerhttps://ascopubs.org/doi/10.1200/JCO-25-01324 CIRCULATING TUMOR DNA AS A BIOMARKER FOR UPSTAGING AND ADVERSE PATHOLOGY IN HIGH-RISK NON–MUSCLE-INVASIVE BLADDER CANCER:https://www.auajournals.org/doi/abs/10.1097/01.JU.0001191388.74345.c9.09 Preoperative Circulating Tumor DNA Predicts Upstaging and Recurrence in High-Risk Nonmuscle-Invasive Bladder Cancer Undergoing Radical Cystectomyhttps://pubmed.ncbi.nlm.nih.gov/41843048/ --- BackTable Urology is the go-to podcast for urologists, urologic oncologists, and urogynecologists. Download the free BackTable app to get early access to new episodes, cases, and courses curated by physicians in your specialty. ► https://www.backtable.com/app
Are academic medical conferences falling short when it comes to preparing clinicians for the unpredictable realities of modern surgery and patient care? In this episode of BackTable Industry, co-founder Anish Parikh interviews Dr. Ruchika Talwar about the real-world challenges traditional conferences often overlook and how informal, peer-to-peer exchanges like those at Creator Weekend™ in Nashville bridge the gap. --- Get the BackTable apphttps://www.backtable.com/app --- Timestamps 00:00 - Introduction02:37 - Why Conferences Miss It06:35 - From Training to Practice08:10 - On Call Reality Check10:39 - Learning With Videos14:44 - Keeping Up With New Info16:37 - Rise and Fall of Urology Twitter19:27 - Lifelong Learning and Patients25:44 - CME and Med Ed Revolution28:30 - Closing Thoughts --- More about this episode Together, they unpack what it really takes to bring new NMIBC therapies into clinical practice, from navigating approval barriers and staffing challenges to managing workflow and operational details. Dr. Talwar shares insights on moving from training to independent practice, navigating on-call emergencies with quick learning tools like surgical videos and residency notes, and building patient-centered approaches beyond rigid guidelines. The conversation also explores how surgeons use their own "game tape" to improve, the rise and fall of online medical communities like MedTwitter, and the evolving landscape of CME and lifelong learning for today's physicians. --- Resources Hinman's Atlas of Urologic Surgeryhttps://www.clinicalkey.com/#!/browse/book/3-s2.0-C20210026651 American Urologic Association Guidelines & Video Bankhttps://www.auanet.org/guidelines-and-quality/guidelines --- Backtable Industry is the go-to podcast for healthcare leaders, business-minded providers, and innovators that are shaping the future of healthcare. Download the free BackTable app to get early access to new episodes. ► https://www.backtable.com/app
Are traditional bladder cancer care models falling behind as new therapies flood the field and reshape the landscape? In this episode of BackTable Urology, Dr. Bogdana Schmidt talks with Dr. Amy Luckenbaugh and DNP/APP Meredith Donahue about building a co-managed intravesical therapy clinic that rethinks care for patients with non–muscle invasive bladder cancer (NMIBC). With innovative agents increasing patient volume and complexity, the team discusses adapting care models to new realities. --- Get the BackTable apphttps://www.backtable.com/app --- This podcast is supported by an educational grant from Johnson & Johnson. --- Timestamps 00:00 - Why Clinic Models Need to Change Now04:03 - Overcoming Financial and J-Code Hurdles11:04 - High Volume Workflow14:10 - Pharmacy Coordination And Timing19:02 - Proactive Lower Urinary Tract SYmptom Management22:25 - Handling Difficult Catheters32:08 - Defining Clinic Success --- More about this episode The conversation covers prioritizing clinical trials, managing operational challenges such as prior authorizations and billing hurdles, and the importance of pharmacy coordination and predictable clinic workflows. Donahue describes a high-efficiency installation day model managing up to 50 patients a week with specialized staff, real-time decisions, and tailored logistics for therapies like Adstiladrin. They also discuss symptom prevention, patient triage, and clinic success measures including therapy availability, patient satisfaction, and opportunities to preserve bladder function. --- Resources Gemcitabine IDRS Drug Delivery Trialhttps://ascopubs.org/doi/10.1200/JCO.2026.44.7_suppl.635 BCG-IO Combination Trialhttps://www.astrazeneca.com/media-centre/press-releases/2026/imfinzi-approved-in-us-for-early-bladder-cancer.html --- BackTable Urology is the go-to podcast for urologists, urologic oncologists, and urogynecologists. Download the free BackTable app to get early access to new episodes, cases, and courses curated by physicians in your specialty. ► https://www.backtable.com/app
Ready to move beyond “one-size-fits-all” for BCG-unresponsive NMIBC? In this episode of BackTable Urology, Dr. Ruchika Talwar hosts Dr. Sam Chang to discuss the evolving treatment landscape for BCG-unresponsive non-muscle invasive bladder cancer (NMIBC). They explore why BCG may fail, the science and clinical rationale behind new immunotherapies and gene therapies, practical approaches to patient selection, treatment sequencing, and surveillance, and the value of emerging biomarkers, empowering urologists to make more informed, personalized decisions in complex cases of NMIBC. --- Get the BackTable apphttps://www.backtable.com/app --- This podcast is supported by ImmunityBiohttps://anktiva.com/ --- Timestamps 00:00 - Introduction03:48 - BCG: How it Works and Why it Fails11:13 - Pembrolizumab Role and Limits14:38 - Nadofaragene firadenovec 16:34 - Cretostimogene grenadenorepvec18:39 - BCG + Anktiva Rationale29:50 - Explaining Options to Patients33:05 - Post Treatment Surveillance37:32 - Future of Biomarkers and AI42:05 - Key Takeaways --- Resources N-803 Plus BCG Treatment for BCG-Naïve or -Unresponsive Non-Muscle Invasive Bladder Cancer: A Plain Language Reviewhttps://pmc.ncbi.nlm.nih.gov/articles/PMC11524197/ Safety, Tolerability, and Long-Term Clinical Outcomes of an IL-15 analogue (N-803) Admixed with Bacillus Calmette-Guérin (BCG) for the Treatment of Bladder Cancerhttps://doi.org/10.1080/2162402X.2021.1912885 IL-15 Superagonist NAI in BCG-Unresponsive Non–Muscle-Invasive Bladder Cancerhttps://evidence.nejm.org/doi/full/10.1056/EVIDoa2200167 --- More about this episode This podcast is for informational purposes only. The views and opinions expressed in this podcast are solely those of the moderator and individual guest. --- BackTable Urology is the go-to podcast for urologists, urologic oncologists, and urogynecologists. Download the free BackTable app to get early access to new episodes, cases, and courses curated by physicians in your specialty. ► https://www.backtable.com/app
Send us Fan MailBladder cancer treatment is entering a new era. From gene therapy and bladder preservation to AI-assisted diagnostics and the challenge of detecting “hidden” CIS, Dr. Ravi Chauhan, MD, FACS breaks down the technologies and clinical decisions reshaping urology in 2026.Dr. Ravi Chauhan, MD, FACS ( https://conradpearson.com/our-specialists/ravi-d-chauhan-m-d-facs/ ) is a board-certified urologist, fellowship-trained uro-oncology specialist, and one of the leading voices in advanced kidney and bladder cancer care in the Mid-South.Born and raised in Memphis, Tennessee, Dr. Chauhan graduated Cum Laude from Rhodes College with a degree in molecular biology before earning his M.D. and completing both his general surgery internship and urologic surgery residency at The University of Tennessee Health Science Center. He joined the Conrad Pearson Clinic in 2005 and has since become a recognized leader in the treatment of advanced bladder and kidney cancers, with numerous publications and presentations to his name.Dr. Chauhan's path into medicine was deeply personal. Inspired by watching his father practice medicine and witnessing the profound impact physicians can have on patients and families, he developed a philosophy centered on treating every patient with the same compassion, respect, and attention he would want for his own family.In addition to his expertise in surgical urology and uro-oncology, Dr. Chauhan has become increasingly focused on one of the biggest challenges in modern bladder cancer management: identifying and treating high-risk non–muscle invasive bladder cancer - or NMIBC, particularly carcinoma in situ - or CIS , which can often be difficult to detect in routine clinical practice.Today, we'll discuss the evolving diagnostic landscape for CIS, why missed or under-recognized disease can significantly impact treatment decisions, and the growing importance of collaboration between urologists and pathologists. We'll also explore how community urologists are navigating these rapidly evolving standards of care, the future of precision bladder cancer management, and what it means for patients facing this disease.We'll also discuss bladder-sparing approaches, including Adstiladrin® (nadofaragene firadenovec-vncg), an intravesical gene therapy for adults with high-risk Bacillus Calmette-Guerin (BCG)-unresponsive NMIBC with CIS, with or without papillary ( https://www.adstiladrin.com/ ).ADSTILADRIN should not be used in patients with hypersensitivity to interferon alfa or its components, and individuals who are immunosuppressed or immune-deficient should not handle or receive the therapy. Delaying cystectomy in patients with BCG-unresponsive CIS could lead to development of muscle invasive or metastatic bladder cancer, which can be lethal. If patients with CIS do not have a complete response to treatment after 3 months or if CIS recurs, consider cystectomy.The most common adverse reactions include urinary discharge, fatigue, bladder spasm, urgency to urinate, and blood in urine. Patients should consult their healthcare provider regarding all medications and report any side effects. Please see full Prescribing Information ( https://d2hu1op93domjx.cloudfront.net/wp-content/uploads/sites/12/2026/03/24101239/ADSTILADRIN-USPI-Mar.2026-CLEAN.pdf ) for additional details.#BladderCancer #Urology #CancerResearch #BladderCancerAwareness #NMIBC #CarcinomaInSitu #CIS #UroOncology #GeneTherapy #CancerTreatment #PrecisionMedicine #BCG #BladderPreservation #MedicalInnovation #Oncology #CancerCare #Immunotherapy #HealthcareInnovation #UrologistSupport the show
Welcome to the Oncology Brothers podcast! In this episode, we dived into the evolving treatment algorithms for bladder cancer following the latest data presented at GU ASCO 2026. Listen us on: Spotify: https://open.spotify.com/show/31BXhY9FM4gPWG10WgE11o Apple Podcast: https://podcasts.apple.com/us/podcast/oncology-brothers-practice-changing-cancer-discussions/id1653340966 Follow us on social media: X/Twitter: https://twitter.com/oncbrothers Instagram: https://www.instagram.com/oncbrothers Website: https://oncbrothers.com/ Join us as we explore: The role of immunotherapy in non-muscle invasive bladder cancer, highlighting the recent positive trials: CREST with Sasanlimab and POTOMAC with Durvalumab. Insights on the current standard of care and the implications of combining BCG with immunotherapy. The shift in treatment strategies for muscle-invasive bladder cancer, including the new standard of care with the EV-Pembro combination and its impact on pathologic complete response rates. The challenges and considerations in managing side effects associated with new therapies, as well as the importance of patient selection and coordination between urologists and medical oncologists. The emerging role of ctDNA in guiding treatment decisions and the ongoing discussions around the sequencing of therapies in refractory settings. Hope you enjoy this informative discussion that aims to keep you up to date in the world of cancer treatment, here focusing on bladder cancer. Subscribe to our channel for more episodes and discussions on the latest in oncology! #BladderCancer, #NMIBC, #MIBC, #Immunotherapy, #GU26, #OncologyBrothers
LG-IR-NMIBC Treatment Landscape (Republished) Host: Mark L. Gonzalgo, MD, PhD, MBA Guest: Chad R. Ritch, MD, MBA, FACS CME Available: cme.auanet.org/URL/GUPOD251 ACKNOWLEDGEMENTS: Support provided by independent educational grants from: AstraZeneca Johnson & Johnson LEARNING OBJECTIVES: At the conclusion of this activity, participants will be able to: 1. Differentiate between traditional and emerging intravesical therapies for LG-IR-NMIBC, considering mechanism of action, administration schedules, and patient eligibility to support individualized treatment planning. 2. Incorporate into practice shared decision-making strategies that align clinical recommendations with patient values, preferences, and quality-of-life considerations in the management of LG-IR-NMIBC. 3. Utilize practical approaches for integrating intravesical therapy into routine clinical workflows, including coordination among multidisciplinary teams, patient education, and follow-up to optimize adherence and outcomes.
In this episode, Sam S. Chang, MD, MBA, and Matthew D. Galsky, MD, discuss the rapidly evolving treatment landscape in bladder cancer, highlighting new therapeutic options, emerging clinical trial data, including the latest results presented at ASCO GU 2026, and the growing role of biomarkers and multidisciplinary care, including: New treatment options for BCG-unresponsive non–muscle-invasive bladder cancer Intravesical therapies such as nadofaragene and N-803 The role of ctDNA in measurable residual disease detection Presenters: Sam S. Chang, MD, MBA Patricia and Rodes Hart Chair of Urologic Surgery Chief Surgical Officer Vanderbilt Ingram Cancer Center Nashville, Tennessee Matthew D. Galsky, MD Lillian and Howard Stratton Professor of Medicine Icahn School of Medicine at Mount Sinai Director, Genitourinary Medical Oncology Co-Leader, Cancer Clinical Investigation Program Associate Director for Translational Research Tisch Cancer Institute New York, New York Link to full program: https://bit.ly/479RgQn Get access to all of our new podcasts by subscribing to the Decera Clinical Education Oncology Podcast on Apple Podcasts, YouTube Music, or Spotify. Hosted by Simplecast, an AdsWizz company. See pcm.adswizz.com for information about our collection and use of personal data for advertising.
NMIBC Treatment Landscape (Republished) Host: Mark L. Gonzalgo, MD, PhD, MBA Guest: Janet Kukreja, MD, MPH, FACS CME Available: https://cme.auanet.org/URL/GUPOD253 ACKNOWLEDGEMENTS: Support provided by independent educational grants from: AstraZeneca Johnson & Johnson LEARNING OBJECTIVES: At the conclusion of this activity, participants will be able to: 1. Select and implement immunotherapy regimens for patients with NMIBC in accordance with current AUA Guideline recommendations, tailoring treatment choices to tumor characteristics and individual patient needs. 2. Incorporate FDA-approved gene therapy options into NMIBC management by aligning therapeutic approaches with patient-specific factors, disease risk profile, and evolving clinical evidence. 3. Develop and integrate practical strategies to anticipate, monitor, and manage treatment-related side effects and immune-related adverse events in NMIBC, ensuring patient safety and treatment continuity.
In this episode of the Oncology Brothers podcast, we welcomed Dr. Petros Grivas, medical oncologist from the Fred Hutch Cancer Center, who walked through practice-changing and practice-reinforcing data across bladder cancer, kidney cancer, and prostate cancer. Listen us on: Spotify: https://open.spotify.com/show/31BXhY9FM4gPWG10WgE11o Follow us on social media: X/Twitter: https://twitter.com/oncbrothers Instagram: https://www.instagram.com/oncbrothers Website: https://oncbrothers.com/ Key topics discussed included: CREST & POTOMAC: IO-BCG combination data in high-risk BCG-naive NMIBC, both demonstrating a hazard ratio of 0.68 for DFS / EFS. EV-304/KEYNOTE-B15: established EV-Pembrolizumab as the new perioperative standard of care for resectable muscle-invasive bladder cancer regardless of cisplatin eligibility, with a pathological complete response rate of 56% and overall survival hazard ratio of 0.65. LITESPARK-022 & LITESPARK-011: data exploring Belzutifan combinations in adjuvant and refractory RCC settings, while managing key toxicities of anemia and hypoxia. CAPITELLO-281: evaluating capivasertib in PTEN-deficient metastatic hormone-sensitive prostate cancer, where patient related outcomes were reported. Join us for this comprehensive discussion covering the latest GU oncology advances that will directly impact your clinical practice. Don't forget to like, subscribe, and check out our other episodes for more insights on oncology! #GUASCO2026, #BladderCancer, #RenalCellCarcinoma, #ProstateCancer, #OncBrothers
Guest Dr. John Gore and host Dr. Davide Soldato discuss JCO article, "12-Month Results from the CISTO Study Comparing Radical Cystectomy Versus Bladder-Sparing Therapy for Recurrent Non-Muscle Invasive Bladder Cancer," which compares radical cystectomy and bladder sparing therapy for patients with recurrent high-grade non-muscle invasive bladder cancer. Dr. Gore and Dr. Soldato focus on the study's patient-centered approach, eligibility criteria, and quality of life after treatment. TRANSCRIPT The disclosures for guests on this podcast can be found in the show notes. Dr. Davide Soldato: Hello and welcome to JCO After Hours, the podcast where we sit down with authors from some of the latest articles published in the Journal of Clinical Oncology. I am your host, Dr. Davide Soldato, medical oncologist at Ospedale San Martino in Genoa, Italy. Today, we are joined by JCO author Dr. John Gore, urologist at Fred Hutch Cancer Center and professor of urology at University of Washington School of Medicine. Today, we will be discussing the article titled, "Twelve-Month Results From the CISTO Study Comparing Radical Cystectomy Versus Bladder-Sparing Therapy for Recurrent High-Grade Non-Muscle-Invasive Bladder Cancer." Thank you for speaking with us, Dr. Gore. Dr. John Gore: Thank you so much for having me. Dr. Davide Soldato: So, I just want to jump right in. We know that patients who are diagnosed with recurrent high-grade non-muscle-invasive bladder cancer can be treated with two different approaches. So, one is radical cystectomy, and the other is bladder-sparing therapy. I just wanted to understand: what was the gap that you were trying to fill with this study? In particular, one point that is very important is that this study is very centered on the preference of the patients. Why did you choose this endpoint instead of going for more solid oncology-based endpoints? Dr. John Gore: Yeah, so CISTO was a study that was derived really organically from patient engagement. I think as a clinical gap in care, making a decision about when to pursue radical cystectomy for patients with non-muscle-invasive bladder cancer is a tough decision for us as clinicians. We did some engagement work partnered with the Bladder Cancer Advocacy Network and my partner Angela Smith, and found that it is also a huge gap for patients. You know, they are very anxious about recurrences, and the decision about when to take out the bladder is a very difficult one. We did an evidence synthesis and found that evidence guiding this decision is fairly limited. The reason we chose more of a patient-reported endpoint is several-fold. One is that we, as part of our engagement work, also worked with our patient survey network to identify outcomes that were important to patients. Some of those are the same outcomes that we care about as clinicians - recurrence-free survival and metastasis-free survival - but several outcomes came out that were more patient-centered. These were patient-reported outcomes such as the burden on my finances, the burden on my caregiver or loved one, and the ability to return to physical activities that are important to them. Part of what is unique about CISTO is that this was a contract with PCORI where we knew we would only have about 12-month outcomes for the majority of our patients. That is too early to really derive a lot of the clinical outcomes, but we are able to answer that patient-centered question of, "Am I going to be able to return to physical activities that are important to me?" And that was the genesis of that as the primary endpoint. Dr. Davide Soldato: So, who were the patients that were eligible to participate in the CISTO trial? What were the key eligibility criteria? This is very particular to this study because this was actually an observational study. Why did you think that such a pragmatic approach still can inform us on what is the best treatment approach for these patients? Dr. John Gore: The intent of CISTO was not necessarily to focus on the tightly defined BCG-unresponsive patient population. That is a clearly important patient population, but every day we are all faced in our real-world practice with patients with challenging, high-grade recurrences that don't fit neatly into that BCG-unresponsive box. The reason we chose a broader inclusion was to help doctors and patients answer these same questions they have when it doesn't fit nicely into this BCG-unresponsive category. You know, maybe their BCG exposure was two years ago, but now they are having a recurrence after intravesical chemotherapy. That is no less challenging a clinical conundrum, and we wanted to be able to enroll those patients. Other key inclusions were that all of the patients in CISTO had to have BCG at some point, and they had to have recent exposure to some adjuvant instillational or intravenous therapy like pembrolizumab. We also had some exclusions that were important. They couldn't be participating in a phase 2 clinical trial, and they couldn't have had a prior upper tract urothelial cancer. The other point about the observational trial design is I think a really important one. Part of our engagement work also asked patients about their willingness to randomize. There is a ton of literature in our history of trials that failed to accrue well when they were comparing a large-scale surgical intervention with a more conservative management strategy. What we found is only about 10% of patients would be willing to randomize when the clinical comparison is between radical cystectomy and bladder-sparing therapy. So it was very clear that an observational study design was the only way we were going to get evidence to inform clinical care when one of the key comparators was radical cystectomy. And so that is why we utilized the observational trial design. Dr. Davide Soldato: Starting to go deeper into the results, you mentioned before that the endpoint you chose for this trial was really centered on what patients thought was more important to them. In particular, the primary endpoint of the study was physical function as measured by the EORTC QLQ-C30 questionnaire. I just wanted to understand: first, did you have a solid hypothesis regarding how physical function could be impacted by either radical cystectomy or bladder-sparing treatments? And second, what were the key results of the study? Dr. John Gore: We figured that at 12 months after enrollment, given the burden and morbidity of a radical cystectomy, that patients in the radical cystectomy arm would have worse self-reported physical functioning than patients in the bladder-sparing therapy arm. We did hypothesize that some of our secondary outcomes might potentially be better after radical cystectomy, such as recurrence-free survival and potentially some other cancer-specific outcomes, because it is a more definitive management strategy. For our primary endpoint, however, we hypothesized that it would be worse. What we found, and the key finding of our study, is that at 12 months after enrollment, physical functioning was not different between patients undergoing radical cystectomy and patients undergoing bladder-sparing therapy, which is just important in terms of clinical counseling because it just means that you can tell your patients, "Gosh, if we could fast-forward your life six to nine months after this procedure, your physical functioning would be similar to as if you had been able to keep your bladder." Dr. Davide Soldato: And you mentioned that there were some key secondary endpoints of the study, which included both other dimensions of quality of life and also hard clinical outcomes. We mentioned metastasis-free survival, for example. Going a little bit into the key secondary quality of life outcomes, we know that radical cystectomy can impact physical functioning, but we also know that bowel, sexual symptoms, and also genitourinary symptoms might potentially be impacted by this type of treatment. We also know that, especially in a system like the US, financial toxicity can be a significant burden for patients. Considering the two different approaches, was radical cystectomy better also in other key secondary quality of life outcomes, and was financial toxicity different between the two arms? Dr. John Gore: Thank you for highlighting some of the really important secondary outcomes that I think are really important to trying to figure out what's best for your patients. Some of the main ones were some of the bladder cancer-specific quality of life outcomes you highlight. Urinary quality of life was worse at enrollment in patients in the radical cystectomy arm but was no different 12 months after. What is unique about how we measure that is we used an instrument called the Bladder Cancer Index because we're comparing a population of patients who have lost their bladder with a population of patients who have retained their bladder, and there are different considerations by gender. And so that instrument is agnostic to urinary diversion status and gender. We found that bowel function and sexual function were worse in the radical cystectomy arm. It appeared that bowel functioning was getting better to the point of near equivalence at 12 months in the radical cystectomy arm but was still inferior to bladder-sparing therapy, and that probably relates to the fact that we use the bowel as part of the urinary diversion, and that causes some transient disruption in bowel function. Financial toxicity is an outcome we weren't initially planning on having as part of the CISTO study, but based on that patient feedback, we made that one of our key secondary outcomes. That actually demonstrated superiority in the radical cystectomy arm. I think it's important that we remember that when we do bladder-sparing therapy, those patients are predisposed to a number of visits to our office, whether they're for instillational therapies or cystoscopy surveillance visits. Sometimes that involves the patient themselves, and sometimes that involves a caregiver. We live in an area with a very large geographic catchment, so sometimes that involves overnight hotel stays and airfare. It can be a particular burden, as you made mention, especially in our healthcare system. Dr. Davide Soldato: Going back to the quality of life dimensions and especially considering the different treatments, 50% of the patients received radical cystectomy with robotic surgery. Did you look a little bit into whether the type of surgery that they received might potentially impact on these dimensions of quality of life? Dr. John Gore: These are some questions that a lot of urologists have asked us in the surgical arm, related to surgical approach, so robotic versus open, and urinary diversion type. We sometimes reconstruct the urinary tract with an incontinent diversion called an ileal conduit where the urine drains tonically into a bag, and we sometimes do a continent diversion where someone typically will have a neobladder, where you reconstruct a sphere reservoir out of intestines and sew it to the urethra. About 20% of patients in the radical cystectomy arm in CISTO had a neobladder. We have not yet looked at specific surgical factors and some of those outcomes. That is one of the secondary analyses that we have planned, but we have not drilled into how different surgical approach factors can affect some of our outcomes. Fortunately, we have about 200 patients in the radical cystectomy arm, so it's enough patients that hopefully we can look at some of those factors in the future. Dr. Davide Soldato: Going back to the clinical endpoints, you mentioned that several of these were measured. There was metastasis-free survival, cancer-specific survival, and progression-free survival. We now have the data at 12 months. I am just wondering if you can comment on those when comparing the radical cystectomy with the bladder-sparing techniques. Dr. John Gore: I think importantly, bladder cancer-specific survival was very high in both arms, over 95% at one year. So both patient populations do very well in terms of cancer-specific and overall survival at one year. You know, when you take out the bladder, you're taking out a big source of recurrences. Not surprisingly, there was a marked reduction in recurrences in the radical cystectomy arm, so they had better recurrence-free survival. There actually was worse progression-free survival in the radical cystectomy arm, but there is a big asterisk to that. As you noted, it is an observational study, and one of the areas of imbalance in the study is that we had higher cancer severity in the radical cystectomy arm. So there was about a 20% rate of progression at the time of radical cystectomy to muscle-invasive and node-positive disease. Of those progressions, the overwhelming majority of them were progressions at the time of radical cystectomy, which I think speaks to a couple of important factors. Number one is the challenge in staging these patients. Our staging of non-muscle-invasive bladder cancer is very reliant on our resection. And so there is this risk of understaging our patients. Number two is just the challenge of decision making, that we fear losing our window of cure in this patient population, which is why we try to steer some patients toward radical cystectomy, and that progression figure kind of speaks to that. Dr. Davide Soldato: Also, one of the factors that was most common in the patients who received radical cystectomy was the presence of other high-risk features. For example, non-urothelial histology, which I think is something that in clinical practice we tend to fear a little bit in terms of recurrence, and so it might potentially bias a little bit towards proposing more strongly radical cystectomy to the patient. Another thing that I wanted to have a comment on, so this is not really in the paper, but I think it speaks a little bit to how the data will evolve over time. Do you imagine these clinical outcomes changing over time, and do you think that with higher maturity of these endpoints, this study might be even more informative when counseling patients regarding what they are obtaining with a radical cystectomy versus the other type of treatments? Dr. John Gore: You know, I think in this cancer universe, 12-month outcomes are great, but I think we all want to see two-year and five-year outcomes. We're very fortunate to supplement the work that we've done in the initial CISTO study, we're very fortunate that we've gotten supplementary funding from the National Cancer Institute to get long-term outcomes in this patient population. So we are continuing to follow all of our CISTO study patients to get two-year and five-year outcomes. What we expect to find is the accrual of new events in the bladder-sparing therapy arm. About 7% of patients in the bladder-sparing therapy arm underwent cystectomy in the first year, but that number will probably go up either as they have recurrences or progression events. We definitely expect the recurrence-free survival to continue to have superiority in the cystectomy arm, but we probably will see the progression events equilibrate as more progression events accrue in the bladder-sparing therapy arm. Maybe by five years, we hypothesize that we'll see clinical superiority in the radical cystectomy arm. By then, we might also see mortality events that separate bladder cancer-specific survival and overall survival between the two arms potentially. But we don't know. Hypothetically, cystectomy has its own downstream risks. It is a major reconstruction with some metabolic sequelae and renal functional sequelae, and so there may be some general medical events that accrue in the cystectomy arm that are also impactful. Dr. Davide Soldato: One other thing that I think should be complimented on this study is that you also looked at several other endpoints that might be important for patients. For example, anxiety symptoms and depression symptoms. Dr. John Gore: Yeah, I think one of the other key secondary outcomes we looked at were mental health outcomes. We utilized the PROMIS domains of anxiety and depression. Not unexpectedly, our radical cystectomy arm patients exhibited higher anxiety symptoms and higher depression symptoms at enrollment. What we found is at 12 months, they actually had significantly lower anxiety and depression than patients in the bladder-sparing therapy arm. We hypothesized in this paper that that actually relates probably mostly to cancer-specific anxiety. You know, when you experience this cavalcade of recurrences, it just breeds an anxiety about adverse cancer-specific outcomes, and by taking out the bladder, you kind of eliminate this prevalent source of anxiety. We followed up the study with a qualitative piece where we interviewed 50 patients and 20 caregivers. Based on those interviews, and that's just a sample of the patient population, it did seem to be cancer-specific anxiety that was driving a lot of those responses. Dr. Davide Soldato: I would like to end with a methodological consideration on your part because we said that this was an observational study. Frequently we tend to think that observational studies come with a lot of bias, and so we tend to downgrade a little bit the results. But I think that a lot of the merit that goes in the CISTO study that was published in the JCO, and I think it also speaks to the fact that this is very high-quality data, comes with the fact that the methodology behind this study was really robust in terms of informing us. Even with this observational study that, as you said, was the only one that we could perform considering the patient population. So just a comment on your part also to speak to the solidity of the data that was published. Dr. John Gore: Importantly, you know, if you look at ClinicalTrials.gov or other sources, CISTO is the only trial that has radical cystectomy as a major comparator. In many ways, this study is our only source of evidence for radical cystectomy. So we'd rather have flawed observational evidence than no evidence at all. We all experience flaws of our RCTs as well. They tend to be these narrowly defined patient populations that may not match the patient in front of you. So I think there are unrecognized flaws on the other side as well. The way that we try to counterbalance that, and none of these techniques are perfect, but we used a strategy called 'targeted maximum likelihood estimation'. Like many methods, such as propensity scores or instrumental variable analysis, what we're trying to do theoretically is coax randomization from non-randomized data. And TMLE, which is the technique we use, tends to be pretty robust to that. So it's the best available way that we can try to counterbalance the bias based on age and clinical severity between the two patient arms. I also think what's important about this is that even when there are biases, I think we are able to infer those out and still extract meaningful details from the data. So even with the biased data, I think we all glean some really important clinical learnings from it. Dr. Davide Soldato: Absolutely, but I would also say that in terms of observational data, the work that you have done is really something that makes us quite confident about what you found in the CISTO study. So with this, I would like to thank you again for joining us today. Dr. John Gore: Thank you so much, and thank you for highlighting the CISTO study. We are very excited about the data. Dr. Davide Soldato: So Dr. Gore, we appreciate you sharing more on your JCO article titled, "Twelve-Month Results From the CISTO Study Comparing Radical Cystectomy Versus Bladder-Sparing Therapy for Recurrent High-Grade Non-Muscle-Invasive Bladder Cancer." If you enjoy our show, please leave us a rating and review and be sure to come back for another episode. You can find all ASCO shows at asco.org/podcasts. 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. Guest Disclosure Dr. Gore:Consulting or Advisory Role: Astellas Pharma
We had the opportunity to dive into the evolving landscape of bladder cancer treatment in this insightful podcast episode at GU ASCO 2026. Featuring expert guests Dr. Chad Reichard, Dr. Shilpa Gupta, Dr. Matt Galsky, and Dr. Sia Daneshmand, the discussion covered the latest FDA-approved options for muscle-invasive bladder cancer (MIBC) and non-muscle-invasive bladder cancer (NMIBC), and exciting data that we are seeing presented at GU ASCO 2026. Listen us on: Spotify: https://open.spotify.com/show/31BXhY9FM4gPWG10WgE11o Apple Podcast: https://podcasts.apple.com/us/podcast/oncology-brothers-practice-changing-cancer-discussions/id1653340966 Follow us on social media: X/Twitter: https://twitter.com/oncbrothers Instagram: https://www.instagram.com/oncbrothers Website: https://oncbrothers.com/ In this episode, you'll learn about: The current treatment options for MIBC, including neoadjuvant Gem/Cis with perioperative durvalumab vs. EV/pembrolizumab combination Key findings from pivotal studies like KEYNOTE-905, NIAGARA, and KEYNOTE-B15 The implications of these studies on clinical practice and patient management The importance of a multidisciplinary approach in treating bladder cancer Emerging data on BCG plus immunotherapy combinations for NMIBC and their potential impact on treatment protocols Tune in for a comprehensive discussion that highlights the importance of collaboration between medical oncologists and urologists in optimizing patient care. Don't forget to like, subscribe, and hit the notification bell for more episodes from the Oncology Brothers! #BladderCancer, #MIBC, #NMIBC, #Immunotherapy, #EVpembro
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/MOC/AAPA/IPCE information, and to apply for credit, please visit us at PeerView.com/ARY865. CME/MOC/AAPA/IPCE credit will be available until January 18, 2027.Elevating NMIBC Care: Putting the Latest Innovations for Intravesical Therapies Into Practice 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 Johnson & Johnson.Disclosure 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/MOC/AAPA/IPCE information, and to apply for credit, please visit us at PeerView.com/ARY865. CME/MOC/AAPA/IPCE credit will be available until January 18, 2027.Elevating NMIBC Care: Putting the Latest Innovations for Intravesical Therapies Into Practice 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 Johnson & Johnson.Disclosure information is available at the beginning of the video presentation.
PeerView Kidney & Genitourinary Diseases CME/CNE/CPE Video Podcast
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/MOC/AAPA/IPCE information, and to apply for credit, please visit us at PeerView.com/ARY865. CME/MOC/AAPA/IPCE credit will be available until January 18, 2027.Elevating NMIBC Care: Putting the Latest Innovations for Intravesical Therapies Into Practice 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 Johnson & Johnson.Disclosure 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/MOC/AAPA/IPCE information, and to apply for credit, please visit us at PeerView.com/ARY865. CME/MOC/AAPA/IPCE credit will be available until January 18, 2027.Elevating NMIBC Care: Putting the Latest Innovations for Intravesical Therapies Into Practice 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 Johnson & Johnson.Disclosure information is available at the beginning of the video presentation.
PeerView Kidney & Genitourinary Diseases CME/CNE/CPE Audio Podcast
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/MOC/AAPA/IPCE information, and to apply for credit, please visit us at PeerView.com/ARY865. CME/MOC/AAPA/IPCE credit will be available until January 18, 2027.Elevating NMIBC Care: Putting the Latest Innovations for Intravesical Therapies Into Practice 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 Johnson & Johnson.Disclosure 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/MOC/AAPA/IPCE information, and to apply for credit, please visit us at PeerView.com/ARY865. CME/MOC/AAPA/IPCE credit will be available until January 18, 2027.Elevating NMIBC Care: Putting the Latest Innovations for Intravesical Therapies Into Practice 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 Johnson & Johnson.Disclosure information is available at the beginning of the video presentation.
NMIBC Treatment Landscape Host: Mark L. Gonzalgo, MD, PhD, MBA Guest: Janet Kukreja, MD, MPH, FACS CME Available: auau.auanet.org/node/44076 ACKNOWLEDGEMENTS: Support provided by independent educational grants from: AstraZeneca Johnson & Johnson LEARNING OBJECTIVES: At the conclusion of this activity, participants will be able to: 1. Select and implement immunotherapy regimens for patients with NMIBC in accordance with current AUA Guideline recommendations, tailoring treatment choices to tumor characteristics and individual patient needs. 2. Incorporate FDA-approved gene therapy options into NMIBC management by aligning therapeutic approaches with patient-specific factors, disease risk profile, and evolving clinical evidence. 3. Develop and integrate practical strategies to anticipate, monitor, and manage treatment-related side effects and immune-related adverse events in NMIBC, ensuring patient safety and treatment continuity.
This EAUN edition of EAU Podcasts presents the latest update of the intravesical instillation guidelines, featuring insights from experts Bente Thoft Jensen RN, PhD, Susanne Vahr Lauridsen RN, PhD, and Lisbeth Leinum RN, PhD.They discuss the key recommendations and changes since the previous version, as well as the impact on clinical practice, and how nurses and patients benefit from the guidelines. They also outline the evidence-based development process of the guidelines and highlight the focus on nurse and patient safety, education, risk stratification and management of complications. The speakers emphasise growing evidence on managing side effects and the increasing attention to patient perspectives and quality of life.A key message is the importance of improving patient adherence and ensuring nurses understand the differences between BCG and Mitomycin to maintain safety.-----Host: Lisbeth Leinum, EAUN board memberSpeakers: Bente Thoft Jensen, RN, senior researcher, chair of the Bladder Cancer SIG and the guideline panel; Susanne Vahr Lauridsen, RN, senior researcher, member of the guidelines panel.-----For more EAU podcasts, please go to your favourite podcast app and subscribe to our podcast channel for regular updates: Apple Podcasts, Spotify, EAU YouTube channel.
LG-IR-NMIBC Treatment Landscape Host: Mark L. Gonzalgo, MD, PhD, MBA Guest: Chad R. Ritch, MD, MBA, FACS CME Available: auau.auanet.org/node/44036 ACKNOWLEDGEMENTS: Support provided by independent educational grants from: AstraZeneca Johnson & Johnson LEARNING OBJECTIVES: At the conclusion of this activity, participants will be able to: 1. Differentiate between traditional and emerging intravesical therapies for LG-IR-NMIBC, considering mechanism of action, administration schedules, and patient eligibility to support individualized treatment planning. 2. Incorporate into practice shared decision-making strategies that align clinical recommendations with patient values, preferences, and quality-of-life considerations in the management of LG-IR-NMIBC. 3. Utilize practical approaches for integrating intravesical therapy into routine clinical workflows, including coordination among multidisciplinary teams, patient education, and follow-up to optimize adherence and outcomes.
One of the most common dilemmas in urologic oncology: what do you do when a patient has T1 disease in both the bladder and the ureter? In the final episode of the 2025 NMIBC Creator Weekend™ series, Dr. Vignesh Packiam, Dr. Mark Tyson and Dr. Sarah Psutka share how they approach complex bladder cancer cases with upper tract involvement. --- This podcast is supported by: Ferring Pharmaceuticalshttps://ad.doubleclick.net/ddm/trackclk/N2165306.5658203BACKTABLE/B33008413.420220578;dc_trk_aid=612466359;dc_trk_cid=234162109;dc_lat=;dc_rdid=;tag_for_child_directed_treatment=;tfua=;gdpr=${GDPR};gdpr_consent=${GDPR_CONSENT_755};gpp=${GPP_STRING_755};gpp_sid=${GPP_SID};ltd=;dc_tdv=1 --- SYNPOSIS The doctors discuss complex bladder cancer cases, sequencing treatments for patients with dual ureteral and bladder T1 disease, the impact of cystectomy on quality of life, and the use of blue light cystoscopy and intravesical therapy. They also delve into the rise of bladder cancer in younger patients, considerations for low-grade intermediate-risk disease, and emerging therapeutic options. --- TIMESTAMPS 00:00 - Introduction05:52 - Upper Tract Positive Cytology Dilemma09:10 - Cystectomy Considerations15:55 - Developing Better Patient-Reported Outcomes20:26 - Challenges with New Therapeutics26:31 - Deescalating Treatment for Low-Grade Cancer33:29 - Closing Remarks --- RESOURCES CISTO Trialhttps://pubmed.ncbi.nlm.nih.gov/37980511/
When standard therapy fails, it does not have to be the end of the road for high-risk bladder cancer patients. Modern treatments, biomarkers, and clinical studies have opened up new avenues for treating recurrent non-muscle invasive bladder cancer (NMIBC). The penultimate episode of the 2025 NMIBC Creator Weekend™ series features urologic oncologists Dr. Vignesh Packiam, Dr. Mark Tyson, and Dr. Sarah Psutka discussing how they navigate complex bladder cancer scenarios. --- This podcast is supported by: Ferring Pharmaceuticalshttps://ad.doubleclick.net/ddm/trackclk/N2165306.5658203BACKTABLE/B33008413.420220578;dc_trk_aid=612466359;dc_trk_cid=234162109;dc_lat=;dc_rdid=;tag_for_child_directed_treatment=;tfua=;gdpr=${GDPR};gdpr_consent=${GDPR_CONSENT_755};gpp=${GPP_STRING_755};gpp_sid=${GPP_SID};ltd=;dc_tdv=1 --- SYNPOSIS The doctors share treatment strategies, staging processes, and post-therapy patient management techniques. They address recurrent disease, approaches to different stages of cancer, the role of biomarkers in determining treatment paths, and considerations for both high-risk and intermediate-risk patients. Additionally, the episode touches on new treatments, clinical trials, and patient quality of life post-treatment. --- TIMESTAMPS 00:00 - Introduction02:08 - Case Study: Initial Patient Assessment04:59 - Surgical Considerations and Techniques10:22 - Managing Bladder Cancer Recurrence11:15 - Treatment Options and Clinical Trials15:12 - Advanced Treatment Strategies28:14 - Closing Remarks and Credits --- RESOURCES VISTA Trial https://abstracts.mirrorsmed.org/abstracts/vista-phase-3-trial-vicinium-epcam-targeted-pseudomonas-exotoxin-bcg-unresponsive-non BRIDGE Trialhttps://pmc.ncbi.nlm.nih.gov/articles/PMC10515442/ CORE-008 Trialhttps://www.sciencedirect.com/science/article/abs/pii/S1078143924010147 GAIN Trialhttps://pmc.ncbi.nlm.nih.gov/articles/PMC10176900/
In this episode of the Oncology Brothers podcast, we dived deep into the rapidly evolving landscape of non-muscle invasive bladder cancer (NMIBC) treatment. Joined by expert guests Dr. Joshua Meeks, a urologist from Northwestern University, and Dr. Shilpa Gupta, a medical oncologist from Cleveland Clinic, the discussion focused on the integration of immunotherapy into non-muscle invasive bladder cancer. Key topics included: The definition and characteristics of high-risk non-muscle invasive bladder cancer. Recent clinical trials, including the CREST and POTOMAC, exploring the combination of immunotherapy with BCG treatment. The evolving role of medical oncologists in managing NMIBC and the importance of a multidisciplinary approach. Patient-centered discussions on treatment options, event-free survival, and managing side effects of immunotherapy. Join us as we unpack the latest data and real-life scenarios in NMIBC, emphasizing the critical need for collaboration between urologists and medical oncologists to improve patient outcomes. Follow us on social media: X/Twitter: https://twitter.com/oncbrothers Instagram: https://www.instagram.com/oncbrothers Website: https://oncbrothers.com/ Don't forget to like, subscribe, and check out our other episodes for more insights into the world of oncology! #NMIBC #BladderCancer #Immunotherapy #BCG #Urology #OncologyBrothers #GUCancer
UROONCO BCa associate editor Dr. Elisabeth Grobet-Jeandin (CH) and Dr. Laura Mertens (NL) interview Dr. Laura Bukavina (US) on managing high-risk non-muscle invasive bladder cancer (NMIBC). This interview was recorded at EMUC25 in Prague, Czech. For more updates on bladder cancer, please visit our educational platform UROONCO BCa.For more EAU podcasts, please go to your favourite podcast app and subscribe to our podcast channel for regular updates: Apple Podcasts, Spotify, EAU YouTube channel.
In this episode of AUANews Inside Tract, join Dr. Kyle A. Richards and Dr. Kathryn Marchetti as they celebrate Bladder Health Month by talking about innovations in bladder cancer. In this conversation, they explore the rapidly evolving landscape of non–muscle invasive bladder cancer (NMIBC) — from FDA-approved advances like ZUSDURI (mitomycin gel) to emerging chemoablation therapies, the BCG shortage, and the promise of gene-based treatments for BCG-unresponsive disease. This episode is supported by Natera.
Two Onc Docs, hosted by Samantha A. Armstrong, MD, and Karine Tawagi, MD, is a podcast dedicated to providing current and future oncologists and hematologists with the knowledge they need to ace their boards and deliver quality patient care. Dr Armstrong is a hematologist/oncologist and assistant professor of clinical medicine at Indiana University Health in Indianapolis. Dr Tawagi is a hematologist/oncologist and assistant professor of clinical medicine at the University of Illinois in Chicago. In this episode, OncLive On Air® partnered with Two Onc Docs to review exciting updates from the 2025 ESMO Congress about bladder cancer management that have the potential to change guidelines. In non–muscle-invasive bladder cancer (NMIBC), 2 trials added immunotherapy to BCG. The phase 3 POTOMAC trial (NCT03528694) combining durvalumab (Imfinzi) with BCG for high-risk, BCG-naive NMIBC was positive, demonstrating improved disease-free survival with the combination. This regimen might become a new standard of care and could reduce the need for early radical cystectomy, the experts highlighted. For muscle-invasive bladder cancer, the phase 3 KEYNOTE-905 study (NCT03924895) combined perioperative enfortumab vedotin-ejfv (Padcev) and pembrolizumab (Keytruda) for cisplatin-ineligible patients. This positive trial demonstrated strong event-free survival and overall survival (OS) with the combination. Furthermore, the phase 3 IMvigor011 trial (NCT04660344) provided data on a risk-adapted approach using adjuvant atezolizumab (Tecentriq) for post-cystectomy patients with circulating tumor DNA (ctDNA)–positive disease. For these patients, atezolizumab generated benefits in disease-free survival and OS, supporting the future use of ctDNA for personalized therapy. Updates in metastatic bladder cancer emphasized the importance of testing for FGFR alterations and HER2 expression in the second-line setting, Armstrong and Tawagi explained. The phase 1 FORAGER-1 study (NCT05614739) showed the efficacy of an oral FGFR3 inhibitor in heavily pretreated patients and showed lower rates of hypophosphatemia with the agent compared with erdafitinib (Balversa). Overall, the conference yielded many new and exciting data points for the treatment of patients with bladder cancer.
As new genetic and AI-powered tools emerge for bladder cancer screening, are we getting closer to reducing the need for invasive cystoscopies? In part five of the 2025 BackTable NMIBC Creator Weekend™ series, host Dr. Vignesh Packiam engages in an insightful discussion with Dr. Sarah Psutka from the University of Washington and Dr. Katie Murray from NYU about the complexities and potential benefits of using biomarkers in non-muscle invasive bladder cancer (NMIBC). --- This podcast is supported by: Ferring Pharmaceuticals https://www.ferring.com/home-classic/people-and-families/uro-uro-oncology/bladder-cancer/ --- SYNPOSIS The conversation covers the current challenges of interpreting positive biomarkers without clinical correlates, the gold standard of biopsies, and the potential of various biomarkers such as urine cytology, FISH, and newer genomic tests like the Decipher Bladder Genomic Classifier. They also touch upon the role of AI in pathology, the cost implications of biomarkers, and how these tools might influence future clinical practices and patient decisions. The episode emphasizes the need for precision medicine, careful patient counseling, and the impact of false positives and negatives on both patients and healthcare providers. --- TIMESTAMPS 00:00 - Introduction05:25 - Challenges with Current Biomarkers08:10 - New Biomarkers and Genomic Classifiers21:10 - AI and Pathology in Bladder Cancer35:13 - Screening and Future Directions41:20 - Challenges and Future Directions in Bladder Cancer Surveillance57:51 - Conclusion --- RESOURCES DaBlaCa-15 Trialhttps://pubmed.ncbi.nlm.nih.gov/40280776/ Sam Chang CHAI Studyhttps://pubmed.ncbi.nlm.nih.gov/40514253/
Brian takes the role of FDA and critically appraises the data. Then Tom (CREST) and Jonathan Rosenberg (POTOMAC) defend the data on behalf of each Sponsor. Our expert panel then asks tough questions and votes for or against approval.
With the introduction of checkpoint inhibitors into non-muscle invasive bladder cancer (NMIBC) management, who's on point for planning, administering, and optimizing combination therapies? Is it still the urologist, or does medical oncology play a more significant role now than it did before? In this episode of the BackTable 2025 NMIBC Creator Weekend™ series, host Dr. Bogdana Schmidt sits down with Dr. Tyler Stewart, medical oncologist from the University of California San Diego, to discuss the contemporary role of medical and surgical oncology in treating non-muscle invasive bladder cancer.---This podcast is supported by:Ferring Pharmaceuticalshttps://www.ferring.com/home-classic/people-and-families/uro-uro-oncology/bladder-cancer/---SYNPOSISThe conversation covers the efficacy and safety of checkpoint inhibitors like pembrolizumab, the importance of a multidisciplinary approach, and the challenges of balancing systemic and localized treatments. They also touch upon the potential future role of biomarkers in reducing invasive procedures and improving patient outcomes.---TIMESTAMPS00:00 - Introduction02:04 - The Role of Medical Oncologists in Bladder Cancer12:58 - Combination Therapies and Patient Outcomes21:18 - The CREST Study26:59 - Managing Adverse Events34:44 - Collaboration Between Urologists and Oncologists41:06 - Conclusion and Final Thoughts---RESOURCESCREST Trialhttps://www.nature.com/articles/s41591-025-03738-zCISTO Studyhttps://pubmed.ncbi.nlm.nih.gov/37980511/
UROONCO BCa chief editor Dr. Benjamin Pradere (FR) interviews Prof. Maria De Santis (DE) about the result of the final analysis of the phase III, open-label, randomised POTOMAC trial: Durvalumab (D) in combination with Bacillus Calmette-Guérin (BCG) for BCG-naïve, high-risk non-muscle-invasive bladder cancer (NMIBC). This interview was recorded at ESMO 2025 in Berlin, Germany. For more updates on bladder cancer, please visit our educational platform UROONCO BCa.For more EAU podcasts, please go to your favourite podcast app and subscribe to our podcast channel for regular updates: Apple Podcasts, Spotify, EAU YouTube channel.
New FDA-approved therapies for BCG-refractory non-muscle invasive bladder cancer (NMIBC)–where do they fit in the treatment algorithm, and how do you administer them? This installment of the 2025 NMIBC Creator Weekend™ series features host Dr. Bogdana Schmidt, assistant professor of Urologic Oncology at the University of Utah, and leading urologic oncologists Dr. Mark Tyson from Mayo Clinic Arizona and Dr. Suzanne Merrill from Colorado Urology.---This podcast is supported by:Ferring Pharmaceuticalshttps://www.ferring.com/home-classic/people-and-families/uro-uro-oncology/bladder-cancer/---SYNPOSISThe discussion delves into the newest treatment strategies and FDA-approved therapies for non-muscle invasive bladder cancer with an emphasis on BCG-refractory patients. They highlight their approaches to sequencing therapies, the real-world applicability of these treatments, and the impact of patient factors in clinical decision-making. The panel also explores emerging trials and innovative treatment mechanisms, emphasizing the importance of personalized care in oncology.---TIMESTAMPS00:00 - Introduction05:09 - Challenges and Strategies in Treatment10:55 - Bladder Sparing Therapies21:41 - Practical Tips for Therapy Administration30:39 - Challenges and Considerations in Reinduction37:05 - Clinical Trials and Future Directions44:11 - Counseling Patients on Treatment Options57:36 - Concluding Thoughts and Future Outlook---RESOURCESCORE-008 Clinical Trial https://www.sciencedirect.com/science/article/abs/pii/S1078143924010147Legend Clinical Trial:https://ascopubs.org/doi/10.1200/JCO.2025.43.5_suppl.802CISTO Studyhttps://pubmed.ncbi.nlm.nih.gov/37980511/
When a patient is diagnosed with non-muscle invasive bladder cancer (NMIBC), how do you tailor the conversation and treatment plan to their individual needs (and fears)? In part two of the 2025 NMIBC Creator Weekend™ series, host Dr. Vignesh Packiam is joined by Dr. Sima Porten from UCSF and Dr. Patrick Hensley from the University of Kentucky to discuss patient-centered diagnostic and therapeutic approaches for non-muscle invasive bladder cancer.---This podcast is supported by:Ferring Pharmaceuticalshttps://www.ferring.com/home-classic/people-and-families/uro-uro-oncology/bladder-cancer/---SYNPOSISThe conversation covers initial patient consultations, discussing diagnoses, personalized treatment options such as BCG, gemcitabine, clinical trials, and managing side effects. The experts emphasize the importance of clear communication, understanding patient preferences, and tailoring approaches to enhance the patient's quality of life. They also explore insights from recent studies like the CISTO trial and highlight novel research directions.---TIMESTAMPS00:00 - Introduction04:28 - Counseling Patients on Diagnostic Findings12:03 - Symptom Management and Patient Care19:30 - Post-Procedure Care and Counseling28:50 - Recovery After TURBT: Medications and Patient Care44:16 - The Impact of Radical Cystectomy on Quality of Life49:15 - Final Thoughts and Future Directions in Bladder Cancer Care---RESOURCESNIMBUS Studyhttps://pubmed.ncbi.nlm.nih.gov/32446864/
Brad McGregor joins us on the heels of his #ESMO25 discussion of these important data in the NMIBC landscape.
How are leading urologic oncologists using advanced biomarkers and artificial intelligence to refine the diagnosis and management of non-muscle invasive bladder cancer (NMIBC)? In the opening episode of our 2025 NMIBC Creator Weekend™ series, host Dr. Bogdana Schmidt engages in an insightful, in-studio discussion with Dr. Anne Schuckman and Dr. Piyush Agarwal about contemporary strategies and challenges in the diagnosis of non-muscle invasive bladder cancer.---This podcast is supported by an educational grant from Ferring Pharmaceuticals.---SYNPOSISThe doctors emphasize the importance of having an experienced cytopathologist and discuss the use of different biomarkers and imaging modalities in bladder cancer diagnosis. The conversation delves into risk stratification, patient management strategies, and the evolving role of technology and artificial intelligence in enhancing diagnostic accuracy. The experts also share their perspectives on future advancements and their potential impact on clinical practice.---TIMESTAMPS00:00 - Introduction04:05 - Surveillance and Follow-Up Strategies10:10 - Biomarkers in Bladder Cancer18:02 - Blue Light Cystoscopy and Patient Comfort30:56 - Risk Assessment and Counseling42:56 - Future of Bladder Cancer Diagnostics47:00 - Concluding Thoughts---RESOURCESCxBladder Studyhttps://www.sciencedirect.com/science/article/pii/S1078143923000091Lars Dyrsakjot Study on Tumor Markershttps://pmc.ncbi.nlm.nih.gov/articles/PMC7690647/The Bridge Trialhttps://pmc.ncbi.nlm.nih.gov/articles/PMC10515442/
In today's episode, we had the pleasure of speaking with Joseph Jacob, MD, MCR, about the FDA approval of the gemcitabine intravesical system (formerly TAR-200; Inlexzo) for the treatment of patients with BCG-unresponsive non–muscle-invasive bladder cancer. Dr Jacob is an associate professor of urology and the director of Urologic Oncology in the Department of Urology at State University of New York Upstate Medical University in Syracuse. In our exclusive interview, Dr Jacob discussed the significance of this approval, key efficacy findings from the pivotal phase 2b SunRISe-1 trial (NCT04640623), and the TAR-200 administration procedure, which he describes as straightforward for practitioners and convenient for patients.
The Latest Breakthroughs in LG-IR-NMIBC (2025) CME Available: auau.auanet.org/node/43689 After participating in this CME activity, participants will be able to: 1. Apply updated clinical evidence and treatment protocols for low-grade, intermediate-risk non-muscle invasive bladder cancer (NMIBC) in appropriate patient cases to reduce recurrence rates and improve clinical outcomes. 2. Improve clinical decision-making related to risk stratification and surveillance strategies for low-grade, intermediate-risk NMIBC based on pathophysiology, epidemiology, and progression patterns. 3. Support evidence-based, patient-centered treatment selection options for low-grade, intermediate-risk NMIBC by comparing traditional intravesical therapies with emerging treatments. 4. Interpret the efficacy and safety profiles of new therapies to appropriately integrate new therapeutic options into clinical practice (upon regulatory approval). 5. Utilize new medications in the evolving treatment landscape following an evaluation of key clinical trial data from recent studies. 6. Assess the impact of treatment options on patient-reported outcomes, including quality of life and treatment burden, to guide shared decision-making and optimize care delivery. ACKNOWLEDGEMENTS Support provided by an independent educational grant from: UroGen Pharma, Inc.
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.
Counseling patients with intermediate-risk non-muscle invasive bladder cancer can be complex, with a wide range of treatment options and care pathways. In this episode of BackTable Urology, urologic oncologists Dr. Ruchika Talwar and Dr. Kelly Bree explore how to approach this challenge with clarity and compassion. --- This podcast is supported by an educational grant from UroGen Pharma. --- SYNPOSIS They emphasize a shift toward patient-centered, less aggressive treatment strategies, highlighting the importance of quality of life in clinical decision-making. The discussion includes risk stratification, the use of intravesical gemcitabine, and ongoing clinical trials. Dr. Bree also offers actionable tips for optimizing patient preparation and recovery. This episode underscores the growing importance of listening to patient voices to shape future standards of care. --- TIMESTAMPS 00:00 - Introduction and Overview02:09 - Risk Stratification and Treatment Approaches06:12 - Intravesical Therapy Options08:47 - Quality of Life and Patient Counseling12:56 - Practical Tips for TURBT Recovery17:03 - In-Office Procedures and Patient Management21:23 - Resources and Support for Patients24:13 - Future Directions and Final Thoughts --- RESOURCES Society of Urologic Oncologyhttps://suonet.org/home.aspx
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.
Mark Tyson from Mayo Clinic joins the podcast to discuss this replicating adenovirus and a high CR rate in BCG-unresponsive NMIBC
Mark Tyson from Mayo Clinic joins the podcast to discuss this replicating adenovirus and a high CR rate in BCG-unresponsive NMIBC
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