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Highlights from the 2024 International Bladder Cancer Network Annual Meeting
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| Augmented Cystoscopy with Deep Learning |
| Joseph Liao, MD |
| Joseph Liao presented on augmented cystoscopy with deep learning, focusing on how artificial intelligence (AI) can improve bladder cancer detection and treatment workflows. He emphasized the limitations of traditional cystoscopy and TURBT, including missed tumors and operator dependency, and discussed how AI tools, such as CystoNet, can enhance tumor detection with high sensitivity and specificity. |
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| The Value of mpMRI to Assist in Decision Making in Muscle Invasive Bladder Cancer |
| Andrea Necchi, MD |
| Andrea Necchi discussed the use of multi-parametric MRI (mpMRI) in decision-making for muscle-invasive bladder cancer. He emphasized the incremental value of mpMRI and the VI-RADS scoring system in improving staging, assessing response to neoadjuvant therapy, and predicting tumor relapse. Findings from the PURE-01 trial showed mpMRI's ability to predict complete response with high accuracy, potentially allowing bladder-sparing strategies. |
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| AI in Bladder Cancer: The Good, the Bad, and the Ugly
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| Jethro Kwong, MSc
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| Jethro Kwong discusses the pros and cons of AI in bladder cancer. The Good: AI shows promise in improving tumor detection, pathological assessments, and predicting treatment outcomes, with models like PROGRxN-BCa outperforming existing risk calculators. The Bad: Challenges persist, including dataset limitations, variable outcome definitions, and poor methodological quality, as highlighted by the APPRAISE-AI tool. The Ugly: AI tools in bladder cancer are not yet endorsed by major guidelines and significant work is required before widespread clinical adoption.
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| TAR-200 Plus Cetrelimab or Cetrelimab Alone as Neoadjuvant Therapy in Patients With Muscle-Invasive Bladder Cancer Who Are Ineligible for or Refuse Neoadjuvant Platinum-Based Chemotherapy: Interim Analysis of SunRISe-4 |
| Andrea Necchi, MD |
| Andrea Necchi presents interim findings from the SunRISe-4 trial, which assessed TAR-200 combined with cetrelimab or cetrelimab alone as neoadjuvant therapy for patients with muscle-invasive bladder cancer ineligible for or refusing chemotherapy. Results showed that the combination of TAR-200 + cetrelimab achieved a pathologic complete response rate of 42%, compared to 23% for cetrelimab alone. |
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| TAR-200 in Combination with Cetrelimab, TAR-200 Alone, or Cetrelimab Alone in Patients with BCG Unresponsive High-Risk NMIBC: Results from SunRISe-1
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| Michiel van der Heijden, MD, PhD
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| Michiel van der Heijden presents findings from the SunRISe-1 trial, evaluating TAR-200 combined with cetrelimab, TAR-200 alone, or cetrelimab alone in patients with BCG-unresponsive high-risk NMIBC. The results showed that TAR-200 monotherapy had the highest complete response rate of 84%, with 82% of patients remaining in response after a median follow-up of 9.2 months.
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| Using Urinary Genomic Disease Burden to Assess Cretostimogene Grenadenorepvec: Preliminary Analysis from the BOND-003 Trial
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| Colin Dinney, MD
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| Colin Dinney presents the results from the BOND-003 trial, which assessed cretostimogene grenadenorepvec, an oncolytic adenovirus therapy, in patients with BCG-unresponsive high-risk NMIBC. Using the UroAmp genomic platform, researchers quantified urinary genomic disease burden to evaluate patient responses. The study showed a complete response rate of 76%, with reductions in genomic disease burden linked to improved outcomes.
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| EG-70 (Detalimogene Voraplasmid), a Novel, Non-Viral, Intravesical Gene Therapy for BCG-Unresponsive NMIBC with CIS: Preclinical Characterization and Translation into the Clinic |
| James Sullivan, PhD |
| James Sullivan presents preclinical and early clinical findings for EG-70, a novel non-viral gene therapy for BCG-unresponsive high-risk non-muscle invasive bladder cancer. Preclinical studies have shown that EG-70 stimulates both innate and adaptive immune responses, reshaping the tumor microenvironment and reducing tumor burden in murine models. |
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| Benefit of Whole-Pelvis Radiation for Patients with Muscle Invasive Bladder Cancer: An Inverse Probability Treatment Weighted Analysis |
| Gautier Marcq, MD, MSc |
| Gautier Marcq presents a study on the benefit of whole-pelvis radiation for patients with muscle-invasive bladder cancer. The analysis compared bladder-only radiation therapy to whole-pelvis radiation therapy in 599 patients. While whole-pelvis radiation did not improve complete response rates, it was associated with better cancer-specific survival and overall survival. |
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| AI-Enabled Bladder Cancer Grading: Externally Validating Quantitative Nuclear Features and Demonstrating Their Potential to Better Predict Time to Recurrence |
| David Berman, MD, PhD |
| David Berman discusses the use of artificial intelligence (AI) for bladder cancer grading, highlighting the external validation of quantitative nuclear features to predict recurrence more accurately than traditional methods. These findings suggest that AI can improve the precision of bladder cancer grading and recurrence prediction, potentially leading to better patient management. |
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| A Randomized Phase II Trial Comparing Single Dose Perioperative Instillation of Intravesical Gemcitabine Versus Mitomycin-C Following Complete Resection of Non-Muscle Invasive Bladder Cancer: Evaluation of Efficacy and Tolerance |
| Brusabhanu Nayak, MD |
| Brusabhanu Nayak presents the results from a randomized phase II trial comparing single-dose perioperative instillation of intravesical gemcitabine versus mitomycin-C following TURBT for non-muscle invasive bladder cancer (NMIBC). The trial shows that recurrence rates were comparable between gemcitabine and mitomycin-C after one year, with no significant difference in time to recurrence. |
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| Influence of Immortal Time Bias and Conditional Survival on the Comparison of Radical Cystectomy Versus Trimodality Therapy for Muscle Invasive Bladder Cancer |
| Amy Chan, MD |
| Amy Chan presents findings on the influence of immortal time bias and conditional survival in comparing radical cystectomy and trimodality therapy for muscle-invasive bladder cancer. In a multi-institutional study of 722 patients, results indicated no significant differences in metastasis-free survival, disease-free survival, or cancer-specific survival between the two treatments, although overall survival favored trimodality therapy. |
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| Validation of Artificial Intelligence-Powered Pathology Assay and Comparison to EAU 2021 Guidelines on Prediction of Muscle Invasive Progression Post BCG in an International 12 Center Cohort |
| Vignesh Packiam, MD |
| Vignesh Packiam presented findings on an artificial intelligence-powered pathology assay for predicting muscle-invasive progression in high-risk non-muscle invasive bladder cancer (NMIBC) post-BCG therapy. In a cohort of 944 cases from 12 academic centers, the AI assay outperformed the EAU 2021 risk guidelines, identifying high-risk patients with significantly inferior progression-free survival rates. |
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