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- Thomas Powles, MD, and Charles Ryan, MD share in a discussion regarding the use of immunotherapy in the peri-operative setting for bladder cancer and the current state of immunotherapy for bladder cancer. Dr. Powles, while excited about the evolving role of immunotherapy, is less enthusiastic on the use of combination immune therapy based on recent findings. Monotherapy with either atezolizumab (A...
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- Wassim Kassouf and Alicia Morgans discuss the role of neoadjuvant chemotherapy in muscle-invasive bladder cancer (MIBC) including the accuracy of clinical staging and treatments. Biographies: Wassim Kassouf, MD, CM, FRCSC, is a Professor in the Division of Urology and Vice-Chair of the Department of Surgery at McGill University. Dr. Kassouf’s clinical practice focuses on bladder, prostate, and ren...
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- Sia Daneshmand discusses the history of fast-tracked and streamlined post-operative cystectomy care for patients and associated improved outcomes in his conversation with Ashish Kamat. He details the development of the ERAS protocol and the significant milestones that have been realized in this journey to improved patient outcomes after cystectomy. Biographies: Siamak Daneshmand, MD Dr. Sia Danesh...
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- Thomas Powles discusses the current state of immunotherapy in the treatment of muscle-invasive bladder cancer (MIBC) specifically in the second-line after cisplatin-based chemotherapy with Chuck Ryan. He discusses the recent learnings that immunotherapy offers a long-term durable response in 10 - 20% of the cisplatin-eligible patient population who are biomarker positive. They discuss ongoing clin...
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- Jean Hoffman-Censits joins Alicia Morgans and shares details on the Johns Hopkins women’s bladder cancer program. This program is created in recognition of the pathway that women frequently take in the diagnosis of their bladder cancer. We often see a delay in the diagnostic process of bladder cancer in women compared to men. This delay in diagnosis leads to what is thought to be stage migration....
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- Piyush Agarwal reflects on a debate at the EAU 2019 where he debated Seth Lerner, MD who is a preeminent urologist in bladder cancer. Dr. Lerner was favoring open surgery and Dr. Agarwal was favoring robotic surgery for the purpose of the debate as he conveys the positioning of the arguments with Charles Ryan. If you look at the robotic literature in urologic cancers, there is no evidence of any o...
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- Brant Inman discusses the role of the surgeon in the management of metastatic bladder cancer. Oftentimes surgical management is overlooked in favor of systemic therapies, including chemotherapy and immunotherapy. However, in certain cases, a surgical approach may provide a higher cure rate. Dr. Inman and Dr. Kamat discuss appropriate patient selection and scenarios for surgery and the role of neoa...
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- Stephen Williams and his team explored the question, what is the association of patient survival and intensity of treatment with total Medicare costs that are associated with radical cystectomy vs trimodal therapy for older adults with localized muscle-invasive bladder cancer in a time frame of longer than 180-days? He and Alicia Morgans discuss the study, its findings, and implications in patient...
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- Ashish Kamat, MD discusses the focus of the International Bladder Cancer Group, discussing the pathway to developing the definition of BCG-unresponsive. Today the unified definition of BCG-unresponsive disease essentially denotes those patients for whom any more BCG is futile. This has opened the door to many ongoing clinical trials. The discussion moves to review these trials, including Nadofarag...
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- Neal Shore discusses the current 2019 shortage of BCG with Ashish Kamat and Jonathan Rubenstein. Bacillus Calmette-Guérin (BCG) is used as first-line intravesical therapy following tumor resection of non–muscle-invasive bladder cancer. Bacille Calmette-Guérin (BCG) has been a standard of care for many patients with non-muscle invasive bladder cancer for decades.Merck & Co., Inc., has advised that...
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