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Trimodality Therapy - Bladder Cancer

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Introduction to the Trimodality Therapy - Bladder Cancer Center of Excellence

Leslie Ballas | June 22, 2023

Muscle-invasive bladder cancer (MIBC) represents 1/3 of the approximately 81,000 newly diagnosed bladder cancer cases in the US each year.1 Cisplatin-based neoadjuvant chemotherapy (NAC) followed by radical cystectomy (RC) has been the traditional and most widely used management approach to MIBC.

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Leslie BallasLeslie Ballas, MD, Dr. Ballas is a Radiation Oncologist at Cedars Sinai Medical Center in Los Angeles, California who specializes in the treatment of genitourinary cancers. Dr. Ballas is both a clinician and clinical investigator studying bladder preservation with Trimodality Therapy (TMT), the use of adjuvant radiotherapy (RT) following cystectomy, and radiotherapy effects on bladder cancer patients.
Videos
Clinical Conversations by Experts
Physician-Scientist Commentaries
Peer-reviewed Abstract Supplemental Commentaries
Written by Bishoy M. Faltas
Englander Institute for Precision Medicine, Weill Cornell Medicine
Radical cystectomy and Trimodality therapy, which combines transurethral resection of the bladder tumor (TURBT) and concurrent chemoradiation, are effective treatments for muscle-invasive bladder cancer (MIBC). A recent study investigated the outcomes of patients with MIBC who were eligible for both treatment options.
Written by Alexandre Zlotta MD & Jason Efstathiou MD
Radical cystectomy is widely used in muscle-invasive bladder cancer management, but even with improvements in surgical technique, it remains a major operation with significant morbidity, perioperative mortality, and quality of life-altering changes. Bladder preservation has been evaluated as a treatment for muscle-invasive bladder cancer since the 1980s
Conference Coverage
Conference Highlights Written by Physician-Scientist
Presented by Jason A. Efstathiou, MD, DPhil
(UroToday.com) The 2022 ASTRO annual meeting featured a session on bladder and kidney preservation, including a presentation by Dr. Jason Efstathiou discussing a multi-institutional matched comparison of radical cystectomy to trimodality therapy for muscle invasive bladder cancer. 
Presented by Alexandre Zlotta
(UroToday.com) Prior randomized controlled trials comparing bladder preservation to radical cystectomy (RC) for muscle-invasive bladder cancer (MIBC) closed due to lack of accrual. None are foreseen in the near future. Thus, we aimed to compare trimodality therapy (TMT, maximal transurethral resection of bladder tumor followed by concurrent chemoradiation) to radical cystectomy (RC) in matched cohorts of patients with MIBC.
Presented by Sophia C. Kamran, MD
(UroToday.com) On the second day of the American Society for Clinical Oncology (ASCO) Genitourinary Cancer Symposium 2022, Dr. Sophia Kamran presented in a session highlighting novel therapies in bladder cancer and their toxicities, discussing the role of bladder-sparing trimodality therapy with a focus on toxicity and functional outcomes.
Presented by Alexandre R. Zlotta, MD, PhD
(UroToday.com) On the second day of the American Society for Clinical Oncology (ASCO) Genitourinary Cancer Symposium 2022 focusing on urothelial carcinoma, Dr. Zlotta presented a comparison of radical cystectomy and trimodality therapy in the treatment of patients with muscle-invasive bladder cancer (MIBC) in a session focused on a Potpourri of Hot Topics in Urothelial Carcinoma.
Presented by Richard Lee, MD, MBA, Urologist
(UroToday.com) In anticipation of the 2021 American Urological Association (AUA) Annual Meeting which is being held, in a delayed fashion, in September, the AUA hosted a “May Kick-Off Weekend” which highlighted a variety of important topics in both benign urology and urologic oncology. Saturday afternoon, Adam Feldman led a course entitled “Trimodality Therapy (TMT) for Management of Muscle Invasive Bladder Cancer” along with faculty Richard Lee and Jason Efstathiou.
Presented by Adam Feldman, MD, MPH, Urologist
(UroToday.com) In anticipation of the 2021 American Urological Association Annual Meeting which is being held, in a delayed fashion, in September, the AUA hosted a “May Kick-Off Weekend” which highlighted a variety of important topics in both benign urology and urologic oncology. Saturday afternoon, Adam Feldman led a course entitled “Trimodality Therapy for Management of Muscle Invasive Bladder Cancer” along with faculty Richard Lee and Jason Efstathiou.
Presented by Adam Feldman, MD, MPH, Urologist
(UroToday.com) In anticipation of the 2021 American Urological Association (AUA) Annual Meeting which is being held, in a delayed fashion, in September, the AUA hosted a “May Kick-Off Weekend” which highlighted a variety of important topics in both benign urology and urologic oncology. Saturday afternoon, Adam Feldman led a course entitled “Trimodality Therapy (TMT) for Management of Muscle Invasive Bladder Cancer” along with faculty Richard Lee and Jason Efstathiou.
Presented by Jason Efstathiou, MD, DPhil
(UroToday.com) In anticipation of the 2021 American Urological Association (AUA) Annual Meeting which is being held, in a delayed fashion, in September, the AUA hosted a “May Kick-Off Weekend” which highlighted a variety of important topics in both benign urology and urologic oncology. Saturday afternoon, Adam Feldman led a course entitled “Trimodality Therapy (TMT) for Management of Muscle Invasive Bladder Cancer” along with faculty Richard Lee and Jason Efstathiou.
Presented by Jason Efstathiou, MD, DPhil
(UroToday.com) In anticipation of the 2021 American Urological Association (AUA) Annual Meeting which is being held, in a delayed fashion, in September, the AUA hosted a “May Kick-Off Weekend” which highlighted a variety of important topics in both benign urology and urologic oncology. Saturday afternoon, Adam Feldman led a course entitled “Trimodality Therapy (TMT) for Management of Muscle Invasive Bladder Cancer” along with faculty Richard Lee and Jason Efstathiou.