|
|
|
A hallmark of EAU, the Rapid Fire Debates—developed and led by Ashish Kamat, MD, MBBS—bring together leading experts to tackle the most pressing controversies in bladder cancer. Through concise, opposing viewpoints, participating clinicians offer diverse, practice-relevant perspectives to inform real-world decision-making. UroToday provides written summaries from the meeting, capturing key takeaways and expert perspectives to inform real-world decision-making.
|
|
|
| Moderator and Case Presentation
|
| P. Gontero
|
|
|
|
|
| Urinary Markers versus Cystoscopy: Is It Time to Ditch the Scope?
|
| Jeremy Teoh, MBBS, FRCSEd (Urol), FCSHK, FHKAM (Surgery), and Laura S. Mertens, MD, PhD
|
| Jeremy Teoh argued urinary markers can replace cystoscopy for low/intermediate-risk NMIBC surveillance, especially post-en bloc TURBT in elderly/low-progression pts per pragmatic de-intensification. Laura Mertens countered markers lack sensitivity for low-grade recurrences, yield false-positive cascades, and fail safety/utility vs gold-standard cystoscopy, better as adjuncts.
|
|
|
|
|
|
| Moderator and Case Presentation
|
| A. Kamat
|
|
|
|
|
| High-Risk BCG-Naïve NMIBC: BCG + IO – Bold New Standard or Overreach?
|
| Neal D. Shore, MD, FACS, and Ekaterina Laukhtina, MD
|
| In this EAU 2026 debate, Neal Shore argued BCG+IO is a bold new standard for high-risk BCG-naïve NMIBC based on CREST/POTOMAC ph3 successes, preventing recurrence cascades to cystectomy despite toxicity, via shared decision-making. Ekaterina Laukhtina countered it's overreach: modest NNT=25 lacks PFS/OS gains, quadruples gr3+ AEs, complicates care/cost, favoring biomarkers/risk-adaptation over routine escalation.
|
|
|
|
|
|
| Moderator and Case Presentation
|
| A. Kamat, A. Stenzl, P. Mariappan
|
|
|
|
|
| TMT for MIBC: Radiation, Responsibility, and Recurrences -- Who Manages the Fallout, and How? Debater 1: Radiation Toxicity Is Real and Its Urologists Who Manage the Consequences
|
| Antoine van der Heijden, MD, PhD
|
| Antoine van der Heijden argued the need for urologists to manage TMT radiation fallout, via conservative care, advanced therapies, nephrostomies/diversion, stressing collaboration despite 30yr latency/QoL impact. In the case, urologists handled AKI/hydronephrosis, sepsis/incontinence/hematuria, painful scopes/shrunken bladder.
|
|
|
|
|
|
|
|
|
|
|
| TMT for MIBC: Radiation, Responsibility, and Recurrences -- Who Manages the Fallout, and How? Debater 2: Toxicity Happens but Is Manageable -- Radiation Oncologists Can and Should Take Responsibility
|
| Neha Vapiwala, MD, FASTRO
|
| Neha Vapiwala argued radiation oncologists should lead TMT toxicity management: refine selection, predict via biomarkers, pre/post-rehab, MDT clinics, personalized PROs/imaging surveillance to improve tolerability. In the case, emphasized collaboration despite RC risks > RT comorbidities.
|
|
|
|
|
|
| Moderator and Case Presentation
|
| B. Pradère
|
|
|
|
|
| Bladder Preservation Post-Neoadjuvant Chemotherapy: A Smart Strategy or Risky Business?
|
| Fernando Maluf, MD, PhD, and Bogdana Schmidt, MD, MPH
|
| Fernando Maluf argued bladder preservation post-NAC is smart for cCR pts, citing rising pCR, cCR predictive accuracy, ctDNA/utDNA/MRI for MRD clearance, and trials like REDEMPTED for chemoradiation salvage. Bogdana Schmidt countered it's risky: retrospective MSKCC 38% 15y bladder recurrence, RETAIN surveillance 36-68% local relapses despite selection, ctDNA misses intravesical disease, urging trials over routine omission of RC.
|
|
|
|
|
|
| Moderator and Case Presentation
|
| M. Galsky
|
|
|
|
|
| MIBC Systemic Therapy: Maximise Early or Strategize Post-Op?
|
| Thomas Powles, MBBS, MRCP, MD, and Patrizia Giannatempo, MD
|
| In this EAU 2026 debate, Thomas Powles argued for perioperative IO-based therapy in all cisplatin-eligible MIBC pre-RC patients, citing consistent pCR/EFS/OS gains across trials without surgical harm, over post-op delays missing therapeutic windows. Patrizia Giannatempo countered for NAC then risk-adapted adjuvant IO, using ctDNA dynamics and NIAGARA subgroups to avoid overtreating pCR/MRD-neg patients, prioritizing precision over universal escalation.
|
|
|
|
|
|
|
|
|
|
|
