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PEER-TO-PEER CLINICAL CONVERSATIONS |
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| Bladder-Sparing Treatment Options for Muscle-Invasive Bladder Cancer |
| Andrea Necchi, MD |
| In his presentation, Andrea Necchi focuses on finding bladder-sparing treatment options for muscle-invasive bladder cancer (MIBC). He discusses promising results from immunotherapy studies such as the Balar and IMMUNOPRESERVE trials, emphasizing the importance of standardizing research and defining bladder-intact disease-free survival as survival without the need for direct bladder therapy, including radiotherapy. |
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HCRN GU 16-257, a Phase 2 Trial of Gemcitabine, Cisplatin, Plus Nivolumab Shows Promise for Bladder-Sparing in Muscle- Invasive Bladder Cancer (MIBC)
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Matthew Galsky, MD
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| Matthew Galsky discusses the challenges of treating MIBC and the potential of neoadjuvant cisplatin-based chemotherapy in achieving pathologic complete response at the time of cystectomy. He presents data from the phase 2 trial HCRN GU 16-257, which evaluates the efficacy of gemcitabine, cisplatin, and nivolumab in sparing patients from radical cystectomy or definitive local therapy.
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| The Role of Bladder-Sparing Trimodality Therapy |
Sophia C. Kamran, MD
Sophia Kamran joins Sam Chang to discuss novel therapies in bladder cancer and their toxicities, discussing the role of bladder-sparing trimodality therapy with a focus on toxicity and functional outcomes. |
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| Bladder Preservation – A New Age of Sparing Bladders That Includes Immunotherapy? |
| Evan Yu, MD |
| Evan Yu discusses the emerging approach of bladder preservation in the treatment of muscle-invasive bladder cancer (MIBC), which includes the use of immunotherapy. It highlights the potential of combining immune checkpoint inhibitors with chemoradiation therapy to achieve bladder preservation and avoid radical cystectomy. The article emphasizes the need for further research and clinical trials to optimize the bladder-sparing approach and assess long-term outcomes. |
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| Biology and Performance of Pre- and Post-Pembrolizumab VI-RADS to Predict the Pathological Response in MIBC: Full Data Analysis from a Clinical Trials Pipeline |
| Andrea Necchi, MD
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| Andrea Necchi presents a full data analysis from a clinical trials pipeline regarding the biology and performance of pre- and post-pembrolizumab VI-RADS in predicting pathological response in MIBC. He highlights the potential of using pembrolizumab, an immune checkpoint inhibitor, in combination with VI-RADS as a predictive tool for assessing the response to treatment in MIBC patients. |
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| Bladder Only versus Bladder Plus Pelvic Lymph Node Chemoradiation for Muscle-Invasive Bladder Cancer |
| Sagar A. Patel, MD |
| Sagar Patel discusses a study comparing two treatment approaches for MIBC: bladder-only radiation therapy versus bladder plus pelvic lymph node chemoradiation. The study aims to determine the optimal radiation field for MIBC patients and assess the impact on treatment outcomes. Dr. Patel presents the findings from the study, highlighting the potential benefits of including pelvic lymph node radiation in improving locoregional control and disease-free survival in MIBC patients. |
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| Optimizing Urothelial Cancer Management From Organ-Confined to Metastatic Disease: A Multidisciplinary Approach – Radiation Oncologist Perspective
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| Neha Vapiwala, MD
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| Neha Vapiwala provides insights from a radiation oncologist's perspective on optimizing the management of urothelial cancer, from organ-confined to metastatic disease, using a multidisciplinary approach. She highlights the role of radiation therapy in various stages of urothelial cancer treatment, including bladder preservation, postoperative adjuvant radiation, and metastatic disease management.
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| Neoadjuvant Pembrolizumab for Cisplatin-Ineligible Muscle-Invasive Bladder Cancer Prior to Radical Cystectomy |
| Kyle Rose, MD |
| Kyle Rose discusses the use of neoadjuvant pembrolizumab, an immune checkpoint inhibitor, for patients with muscle-invasive bladder cancer (MIBC) who are ineligible for cisplatin-based chemotherapy. He focuses on the potential benefits of administering pembrolizumab before radical cystectomy to improve treatment outcomes in this specific patient population. Dr. Rose emphasizes the importance of exploring alternative treatment strategies for cisplatin-ineligible MIBC patients. |
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| INTACT (S/N1806): Phase III Randomized Trial of Concurrent Chemoradiotherapy with or without Atezolizumab in Localized Muscle-Invasive Bladder Cancer—Toxicity Update on First 213 Patients
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| Sameer G. Jhavar, MD, Ph.D.
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| Sameer Jhavar provides an update on the Intergroup NRG Oncology trial S1806, a phase III randomized trial evaluating the use of concurrent chemoradiotherapy with or without atezolizumab in localized muscle-invasive bladder cancer. This study highlights the importance of monitoring and managing treatment-related toxicities while assessing the efficacy of the combination therapy approach for localized bladder cancer.
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| The Value of Multiparametric Magnetic Resonance Imaging Sequences to Assist in the Decision Making of Muscle-Invasive Bladder Cancer - Beyond the Abstract
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| Marco Bandini, Ph.D., and Andrea Necchi, MD
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| Marco Bandini and Andrea Necchi explore the value of multiparametric magnetic resonance imaging (mpMRI) sequences in aiding the decision-making process for muscle-invasive bladder cancer (MIBC). They go beyond the abstract of a study to discuss the potential benefits of mpMRI in accurately staging and characterizing MIBC, as well as guiding treatment decisions. Drs. Bandini and Necchi highlight the role of mpMRI in improving patient outcomes and emphasize the need for further research and standardization of mpMRI protocols in the management of MIBC.
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