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PEER-TO-PEER CLINICAL CONVERSATIONS |
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| International Validation of AI Tool for Stratifying Bladder Cancer Progression Risk |
Jethro Kwong, MD, MSc
Zachary Klaassen is joined by Jethro Kwong to discuss the development and validation of PROGRxN-BCa, an AI model for predicting progression in non-muscle invasive bladder cancer. |
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Biomarkers for Gemcitabine Docetaxel in Non-Muscle Invasive Bladder Cancer
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Vignesh Packiam, MD
Joep de Jong interviews Vignesh Packiam about gemcitabine-docetaxel (gemdoce) for non-muscle invasive bladder cancer and potential predictive biomarkers.
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| Immune Infiltration Gene Signatures Predict Response to Gemcitabine Docetaxel vs BCG in Bladder Cancer |
| Michael O’Donnell, MD |
| Ashish Kamat is joined by Michael O'Donnell to discuss gene expression signatures and immune infiltration in response to intravesical gemcitabine/docetaxel versus BCG in high-risk non-muscle-invasive bladder cancer. |
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| An Artificial Intelligence-Powered Predictive Biomarker for Response to Intravesical BCG versus Gemcitabine-Docetaxel for High-Grade Non-Muscle Invasive Bladder Cancer
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| Vignesh Packiam, MD
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| Vignesh Packiam presented a study evaluating a computational histology AI (CHAI) biomarker that predicts treatment response in high-grade, BCG-naïve NMIBC patients. The CHAI biomarker identified patients more likely to benefit from gemcitabine + docetaxel over BCG, with significantly improved high-grade recurrence-free survival in biomarker-positive patients, suggesting it could guide more personalized intravesical therapy selection.
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| Gene Expression Signatures of Immune Infiltration Portend Differential Response to Sequential Intravesical Gemcitabine and Docetaxel versus Bacillus Calmette-Guerin in High-Risk NMIBC |
| Joep de Jong, BSc |
| Joep de Jong presented a study showing that immune infiltration gene expression signatures may help predict which high-risk NMIBC patients respond better to gemcitabine + docetaxel versus BCG. In a matched cohort, patients with high immune scores had significantly better high-grade recurrence-free survival with Gem/Doce than BCG, while those with low immune scores showed no significant difference. |
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| Is There a Role for AI in Diagnosis and Risk Stratification for Bladder Cancer? |
| Hikmat Al-Ahmadie, MD, and Alexandre Zlotta, MD, PHD, FRCSC |
| At AUA 2025, a debate explored the role of AI in bladder cancer diagnosis and risk stratification, with Drs. Zlotta and Al-Ahmadie presenting evidence from clinical and pathological perspectives. Dr. Zlotta highlighted the PROGRxN-BCa AI model, which outperformed current risk tools in predicting progression in NMIBC across a large cohort, while Dr. Al-Ahmadie emphasized AI's growing utility in pathology without replacing time-tested histologic classification. |
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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 trained and validated on 12,659 patients to predict progression risk in NMIBC. The model significantly outperformed the EAU risk calculator—by about 10% across all subgroups—and proved especially valuable in better stratifying intermediate-risk patients into distinct progression risk tiers. This international validation supports its potential use in personalizing treatment intensity and guiding clinical trial eligibility. |
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| Should Primary, Solitary, and Small (3 cm) TaHG Tumors Be Classified as Intermediate- or High-Risk Disease? A Retrospective, International Cohort Study |
| Jethro Kwong, MD |
| Jethro Kwong presents a large international retrospective study evaluating whether primary, solitary, and small Ta high-grade (TaHG) bladder tumors without CIS should be considered intermediate- or high-risk. Among 5,774 patients, those with this specific tumor profile had a 5-year progression risk similar to intermediate-risk low-grade tumors and significantly lower than other high-grade groups, supporting reclassification as intermediate-risk. |
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| Gene Expression Signatures of Immune Infiltration Portend Differential Response to Gem/Doce Versus BCG in High-Risk Non-Muscle-Invasive Bladder Cancer |
| Ian McElree, MD |
| Ian McElree presented a study showing that gene expression signatures related to immune infiltration can help predict treatment response in HR-NMIBC. In a retrospective matched cohort of 143 patients, those with high immune scores had significantly better high-grade recurrence-free survival when treated with Gem/Doce compared to BCG. These findings suggest immune profiling could guide more personalized treatment decisions, especially as Gem/Doce gains traction amid BCG shortages. |
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