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PEER-TO-PEER CLINICAL CONVERSATIONS |
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Treatment Options for BCG-Unresponsive Non-Muscle-Invasive Bladder Cancer
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Kelly Stratton, MD, FACS
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| Sam Chang and Kelly Stratton explore emerging intravesical therapies for BCG-unresponsive non-muscle invasive bladder cancer. Dr. Stratton highlights the significant unmet need for patients seeking bladder preservation alternatives to cystectomy.
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SunRISe-1 Cohort 4 Analysis: One-Year Disease-Free Survival in BCG-Unresponsive Papillary Bladder Cancer
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Siamak Daneshmand, MD
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| Siamak Daneshmand presents SunRISe-1 Cohort 4 one-year results for gemcitabine intravesical system (Gem-iDRS), INLEXZO™ (gemcitabine intravesical system; formerly TAR-200) in BCG-unresponsive papillary NMIBC.
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Individual Patient Data Analysis Explores Benefit of Adding Immunotherapy to BCG in Bladder Cancer
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Ashish Kamat, MD, MBBS
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| This Individual patient data analysis explores benefit of adding immunotherapy to BCG in bladder cancer. Dr. Kamat emphasizes BCG remains highly effective when used with adequate maintenance duration.
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| Impact of BCG Failure Pattern on Oncologic Outcomes of Intravesical Gemcitabine and Docetaxel in High-Risk NMIBC: A Multicenter European Study
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| Pietro Scilipoti, MD,
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| A multicenter European study presented at EAU 2026 found that intravesical gemcitabine + docetaxel was effective across BCG failure types in high-risk NMIBC, with low 12-month progression and cystectomy rates overall. Outcomes were most favorable in BCG-relapsing patients, while BCG-refractory disease carried the highest recurrence risk, suggesting failure pattern should factor into counseling and treatment selection.
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| Gemcitabine Intravesical System (TAR-200) Monotherapy in BCG-Unresponsive High-Risk NMIBC: Characterization of Recurrence, Progression, and Time to Radical Cystectomy
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| Katie Murray, DO, MS, FACS
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| Katie Murray reported that TAR-200 monotherapy in BCG-unresponsive high-risk NMIBC produced a high complete response rate of 82.4% and durable responses, with more than half of responders maintaining response for at least 12 months. With a median follow-up of 20.2 months, progression to T2 or higher occurred in 8.2% of patients, and only 21.2% underwent radical cystectomy, suggesting TAR-200 may delay or reduce the need for surgery.
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| Role of ctDNA Testing in BCG-Exposed Non-Muscle-Invasive Bladder Cancer: A Real-World Analysis
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| Can Aydogdu, MD
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| In a real-world analysis of 17 BCG-exposed NMIBC patients, ctDNA was positive in 47% overall and was more common in clinically advanced disease, including 75% of patients staged cT3 or higher. Among the six patients who underwent radical cystectomy, all four ctDNA-positive patients were pathologically upstaged, while both ctDNA-negative patients had pT0 pN0 disease, suggesting ctDNA may help identify occult higher-risk disease and guide earlier definitive treatment.
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| Case-Based Panel Discussion High-Risk NMIBC Post-BCG Failure: Spare the Bladder? How Do Cystectomy and Bladder Sparing Compare When We Ask Patients?
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| Kathryn Hacker Gessner, MD, PhD
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| Kathryn Gessner highlighted CISTO, the first prospective study directly comparing bladder-sparing therapy with radical cystectomy in recurrent high-grade NMIBC after BCG. The main finding was that 12-month physical functioning was similar between groups, but radical cystectomy was associated with better emotional well-being, lower anxiety/depression, less financial burden, and lower recurrence, while bladder-sparing therapy had better bowel and sexual outcomes.
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