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PEER-TO-PEER CLINICAL CONVERSATIONS |
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Enhancing Bladder Cancer Diagnosis and Management with Advanced Visualization Techniques
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Stephen Williams, MD, MS, FACS
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| Stephen Williams discusses the evolving role of blue light cystoscopy in detecting non-muscle invasive bladder cancer. The conversation covers its pathophysiology, diagnostic, and surveillance applications, emphasizing selective utilization and benefits post-BCG therapy.
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Timing and Rationale for Repeat TURBT: Perspectives on Improving Bladder Cancer Outcomes
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Badrinath Konety, MD, FACS, MBA, and Jeremy Teoh, MBBS, FRCSEd (Urol), FCSHK, FHKAM (Surgery)
Ashish Kamat discusses the controversial topic of repeat transurethral resection for high-grade non-muscle-invasive bladder cancer with Badrinath (Badri) Konety and Jeremy Teoh.
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Adequate BCG Therapy for Very High-Risk Non-Muscle-Invasive Bladder Cancer: A Multicenter Analysis
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José Daniel Subiela Henriquez, MD, Ph.D.
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| José Daniel Subiela Henriquez presented findings from his multicenter study on BCG therapy for very high-risk non-muscle-invasive bladder cancer. Dr. Subiela's research evaluates the effectiveness of BCG in a group where the European Association of Urology (EAU) had recommended radical cystectomy due to high progression risks.
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SunRISe-5 Trial: Evaluating TAR-200 for Recurrent High-Risk Non-Muscle Invasive Bladder Cancer
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Sima Porten, MD, MPH
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| Sima Porten provides an overview of the SunRISe-5 trial, a Phase III study evaluating TAR-200, a novel drug delivery system for patients with recurrent high-risk non-muscle invasive bladder cancer who have not responded to BCG treatment.
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| Comparing White Light versus Blue Light Cystoscopy Recurrence Outcomes Among Non-Muscle Invasive Bladder Cancer Patients in an Equal Access Setting: A Propensity-scored Matched Analysis |
| Sanjay Das, MD |
| Sanjay Das presented a study comparing recurrence outcomes between blue light and white light cystoscopy in non-muscle invasive bladder cancer (NMIBC) patients within the Veterans Affairs (VA) healthcare system. The study found that blue light cystoscopy was associated with a significantly lower recurrence rate compared to white light cystoscopy, suggesting its potential benefit in reducing cancer recurrence in NMIBC patients. |
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| Replacing ReTUR with Cystoscopy in High-Grade T1 NMIBC Patients: Confirmatory Results from the HuNIRe Trial
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| Alessio Finocchiaro, MD
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| Alessio Finocchiaro presented findings from the HuNIRe trial, which investigated replacing re-staging TURBT with cystoscopy in high-grade T1 non-muscle invasive bladder cancer patients. The study confirmed that avoiding immediate re-staging TURBT and instead using cystoscopy and urine cytology for follow-up did not worsen cancer outcomes, with similar recurrence-free and progression-free survival rates observed in both groups. These results suggest that selective re-staging TURBT based on cystoscopy and cytology findings may be a safe alternative in these patients.
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| Optimal TURBT: Do Skilled Urologists Really Need to Perform reTUR for all HG Patients? |
| Jeremy Teoh, MBBS, FRCSEd, FCSHK, FHKAM, and Badrinath Konety, MD |
| At the 2024 AUA Annual Meeting, a debate was held on whether skilled urologists need to perform repeat TURBT for all high-grade non-muscle invasive bladder cancer (NMIBC) patients. Dr. Jeremy Teoh argued against routine re-TURBT, highlighting advancements like en bloc resection and imaging techniques that might make a second surgery unnecessary. Conversely, Dr. Badrinath Konety supported re-TURBT for all high-grade cases, emphasizing its role in ensuring complete tumor removal, accurate staging, and improved patient outcomes, including better selection for BCG treatment and decision-making regarding cystectomy. |
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| Reasons for Refusal of or Ineligibility for Radical Cystectomy in Patients with BCG–unresponsive High-Risk NMIBC from the SunRISe-1 Study
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| Joseph M. Jacob, MD
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| Radical cystectomy is the recommended treatment option for patients with BCG-unresponsive high risk NMIBC. However, radical cystectomy is associated with significant risk of morbidity, mortality, and impact on quality of life, thus some patients may refuse/be ineligible for radical cystectomy. In a systemic review of 160 real-world studies, <20% of patients with high risk NMIBC recurrent after BCG underwent radical cystectomy.
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| Cretostimogene Grenadenorepvec: At the CORE and Forming BONDs in High-Risk NMIBC and PIVOTing into Intermediate-Risk NMIBC
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| Zachary Klaassen, MD, MSc
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| The NMIBC disease space is an exciting space, with many new advances moving forward in BCG-unresponsive NMIBC. However, intermediate-risk NMIBC remains an important and treatment-orphaned disease space, with very few novel treatment options. PIVOT-006 is designed specifically for potentially adding options to the intermediate-risk NMIBC treatment armamentarium. With excellent support from the SUO-CTC and the trial sponsor CG Oncology, there is optimism that this trial will accrue efficiently and we eagerly await the results of this registration trial.
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