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Highlights from the 2024 Society of Urologic Oncology Annual Meeting |
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| Adjuvant Systemic Therapy in Urothelial Carcinoma: Where Are We At Today? |
| Jean Hoffman-Censits, MD |
| Jean Hoffman-Censits reviewed advancements in adjuvant systemic therapy for urothelial carcinoma, highlighting the use of immune checkpoint inhibitors. Nivolumab, approved for high-risk patients post-surgery, has shown significant improvements in disease-free survival and overall survival, as demonstrated in the CheckMate 274 trial. Similarly, the AMBASSADOR trial showed benefits of pembrolizumab, while ctDNA testing emerged as a tool to refine patient selection for adjuvant atezolizumab based on the IMvigor010 trial. |
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| Adjuvant Radiation Following Cystectomy: Underutilized Therapy?
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| Omar Mian, MD, PhD
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| Omar Mian discussed the potential of adjuvant radiotherapy post-radical cystectomy for high-risk muscle-invasive bladder cancer patients. While systemic therapies like chemotherapy and immunotherapy improve survival, they do not adequately address locoregional failure. Studies, including the Ghent and BART trials, demonstrated that modern radiotherapy techniques reduce recurrence risk and are generally well-tolerated, even in high-risk settings. Future research is needed to explore combinations of radiotherapy with emerging systemic therapies.
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| Management of the Bladder in Metastatic Patients Following Complete Response to Systemic Therapy: Is There a Role for Consolidative Local Therapy? |
| Fady Ghali, MD |
| Fady Ghali explored the role of consolidative local therapy for metastatic bladder cancer patients who achieve a complete response to systemic therapy. While systemic therapies improve survival, high relapse rates at initial disease sites and poor outcomes following relapse provide a rationale for local therapy. Retrospective studies and historical data suggest that consolidative therapy may benefit select patients, especially those with lymph node-only metastases, but further clinical trials are needed to validate these approaches. |
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| Implementing Smoking Cessation in the Urologic Oncology Setting
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| Richard Matulewicz, MD, MSCI, MS
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| Richard Matulewicz highlighted the importance of smoking cessation as a critical component of urologic oncology care, emphasizing its role in preventing and managing cancers such as bladder, kidney, and prostate cancer. Smoking cessation improves survival rates, reduces treatment costs, and is recognized as the "fourth pillar" of cancer care alongside surgery, systemic therapy, and radiation. Despite evidence-based practices for cessation being established, they are underutilized.
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| E-cigarette Use and the Risk of Bladder Cancer
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| Marc Bjurlin, DO, MSc, FACOS
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| Marc Bjurlin discussed the potential link between e-cigarette use and bladder cancer, noting the presence of carcinogens in the urine of e-cigarette users, including nitrosamines and aromatic amines, which are known to cause DNA damage. Metabolomic studies revealed elevated cancer-related biomarkers and flavoring agents unique to e-cigarettes, while epigenetic analysis showed shifts in DNA methylation patterns that may promote cancer development.
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