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Highlights from the 2025 American Urological Association Annual Meeting |
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| The Computational Histology Artificial Intelligence (CHAI) Biomarker Enhances Risk Stratification of High-Grade Ta Non-Muscle Invasive Bladder Cancer in a Multicenter Cohort: Comparison to 2024 AUA Guidelines |
| Sam Chang, MD, MBA |
| Sam Chang presented a multicenter study showing that the Computational Histology Artificial Intelligence (CHAI) biomarker more accurately stratifies risk for high-grade Ta NMIBC patients than current AUA or EAU guidelines. In a cohort of 269 patients, CHAI biomarkers were significantly associated with both high-grade recurrence-free survival and progression to muscle-invasive disease, outperforming traditional risk models. |
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| The Role of the UroAmp MRD in Predicting Recurrence in High-Risk Non-Muscle Invasive Bladder Cancer Undergoing BCG |
| Henning Bahlburg, MD |
| Henning Bahlburg presented data showing that urine-based UroAmp MRD testing can predict recurrence in high-risk NMIBC patients undergoing BCG therapy. Patients who were MRD-positive had significantly worse recurrence-free survival, and MRD detection often preceded clinical recurrence by a median of 5.6 months. These findings suggest MRD testing could personalize treatment strategies and surveillance in NMIBC. |
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| Comparative Efficacy of BCG Induction with BCG Maintenance vs. Gemcitabine/Docetaxel Maintenance |
| Kaushik Kolanukuduru, MBBS |
| Kaushik Kolanukuduru presented a study comparing BCG induction with BCG maintenance versus BCG induction with Gemcitabine/Docetaxel maintenance in NMIBC patients. After propensity matching, recurrence-free and high-grade recurrence-free survival were similar between groups, with minimal progression events. These findings suggest Gem/Doce maintenance is an effective alternative to BCG maintenance, particularly useful in settings of BCG shortage. |
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| Comparing AUA Non-Muscle-Invasive Bladder Cancer Risk Stratification Outcomes: Sequential Gemcitabine and Docetaxel to BCG
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| Kaushik Kolanukuduru, MBBS
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| Kaushik Kolanukuduru presented a study comparing outcomes of NMIBC patients treated with BCG versus sequential gemcitabine/docetaxel (Gem/Doce) across AUA risk groups. While BCG-treated high-risk patients had significantly worse high-grade recurrence and progression rates compared to intermediate-risk patients, Gem/Doce-treated patients showed similar outcomes across risk groups. These results suggest that current AUA risk stratifications may not adequately apply to Gem/Doce-treated patients, highlighting the need for updated classification models.
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| Phase III, Single-Arm Study to Evaluate the Efficacy and Safety of Intravesical Paclitaxel-Hyaluronic Acid Conjugate in Patients with BCG-Unresponsive Carcinoma in Situ of the Bladder +/- Ta-T1 Papillary Disease (Orion-BC Study) |
| Max Kates, MD |
| Max Kates presented results from the Orion-BC phase III trial, evaluating intravesical paclitaxel-hyaluronic acid conjugate (Oncofid-P-B) in BCG-unresponsive CIS +/- papillary NMIBC patients. The therapy showed a favorable safety profile across 933 instillations in 66 patients, with no drug-related serious adverse events and only mild (Grade 1-2) drug-related side effects. These early results suggest Oncofid-P-B could become a promising bladder-preserving option for patients unwilling or unfit for radical cystectomy. |
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| PROGRxN-BCa, an Artificial Intelligence-Based Model to Predict Progression Risk in Non-Muscle Invasive Bladder Cancer and Improve Substratification of Intermediate-Risk Disease: An International Evaluation of 12659 Patients |
| Jethro Kwong, MD, MSc |
| Jethro Kwong presented PROGRxN-BCa, an AI-based model developed from an international cohort of 12,659 patients to predict progression risk in NMIBC. The model outperformed current guideline-endorsed tools by about 10% in accuracy, showed consistent performance regardless of treatment variations, and improved sub-stratification of intermediate-risk patients into distinct risk groups. This marks a major advancement in personalized NMIBC management. |
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| Predicting Recurrence and Progression in Contemporary Patients with NMIBC Undergoing Blue Light Cystoscopy-aided Transurethral Resection of Bladder Tumor |
| Agustin Perez-Londono, MD |
| Agustin Perez-Londono presented predictive models for recurrence and progression in non-muscle invasive bladder cancer patients undergoing blue light cystoscopy (BLC)-guided TURBT. Using a multi-institutional cohort of 1,109 patients, the study identified key clinicopathologic predictors and built models with strong discrimination metrics, aiming to guide personalized, risk-adapted NMIBC management. While promising, these models still require external validation. |
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| Detectable Pre-Cystectomy ctDNA Status for Patients with Non-Muscle Invasive Bladder Cancer Correlates with Adverse Radical Cystectomy Outcomes and Poor Prognosis |
| Reuben Ben-David, MD |
| Reuben Ben-David presented a study showing that detectable pre-cystectomy circulating tumor DNA (ctDNA) in NMIBC patients undergoing radical cystectomy was associated with higher rates of pathological upstaging, nodal involvement, and disease recurrence. Patients with detectable ctDNA had significantly worse recurrence-free survival compared to those without detectable ctDNA, suggesting ctDNA may be a valuable prognostic tool for this population. |
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| Performance of the EORTC and CUETO Risk Prediction Models in Contemporary Patients Undergoing Transurethral Resection of Bladder Tumor with Blue Light Cystoscopy |
| Agustin Perez-Londono, MD |
| Agustin Perez-Londono presented an analysis showing that the EORTC and CUETO risk models performed poorly in predicting recurrence-free and progression-free survival for NMIBC patients undergoing blue light-guided TURBT. The EORTC model generally underestimated outcomes, especially for higher-risk patients, while the CUETO model showed inconsistent results, highlighting the need for updated predictive tools tailored to modern treatment practices. |
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| Intravesical Gemcitabine and Docetaxel for High-Risk Non-Muscle Invasive Bladder Cancer Previously Treated with BCG: Results from the EuroGemDoce Group |
| Pietro Scilipoti, MD |
| Pietro Scilipoti presented results from the EuroGemDoce Group showing that intravesical gemcitabine and docetaxel (Gem/Doce) achieved encouraging 1-year disease-free, high-grade disease-free, and progression-free survival rates in high-risk NMIBC patients previously treated with BCG. The regimen was also well-tolerated, though Dr. Scilipoti emphasized the need for prospective and randomized trials to better define patient selection and treatment protocols. |
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