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PEER-TO-PEER CLINICAL CONVERSATIONS
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Immune Microenvironment Changes and Response to Cretostimogene in Bladder Cancer
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Taylor Goodstein, MD
Taylor Goodstein presents multiplex immunofluorescence findings from six cretostimogene-treated patients, identifying distinct T-cell expansion patterns between responders and non-responders. Responders preferentially expanded effector T-cells while reducing TCF1-positive stem-like or exhausted progenitor T-cells; non-responders showed the opposite pattern.
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BOND-003 Cohort P Examines Gene Therapy for Papillary-Only BCG-Unresponsive Bladder Cancer
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Vikram Narayan, MD
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| Vikram Narayan presents top-line results from BOND-003 Cohort P, a single-arm multinational study of cretostimogene grenadenorepvec patients with BCG-unresponsive papillary-only non-muscle invasive bladder cancer.
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Pilot Study Results for NDV-01 Intravesical Therapy in BCG-Unresponsive Bladder Cancer
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Boris Chertin, MD
Boris Chertin discusses NDV-01. NDV-01 delivers gemcitabine and docetaxel embedded in lipophilic polymers, forming a sustained-release gel depot inside the bladder after instillation of two syringes requiring approximately five minutes.
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| Durable 24-Month Outcomes from BOND-003 Cohort C: Phase 3 Study of Intravesical Cretostimogene Grenadenorepvec for High-Risk BCG-unresponsive Nonmuscle-Invasive Bladder Cancer with CIS
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| Shreyas Joshi, MD, MPH
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| In BOND-003 Cohort C, a phase 3 study of 112 patients with high-risk BCG-unresponsive NMIBC with CIS, intravesical cretostimogene grenadenorepvec achieved a complete response rate of 75.5% at any time, with landmark 12- and 24-month CR rates of 46.4% and 41.8%, and median duration of response of 27.9 months. At 24 months, 96.4% were free from ≥T2 progression and 83.6% avoided radical cystectomy; among 18 patients who underwent cystectomy, 15 were T0 or NMIBC at surgery, indicating many could have been bladder-spared.
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| Trial Design Drives Outcomes: Harmonizing Efficacy Across BCG-Unresponsive Bladder Carcinoma in Situ Trials
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| Daniele Robesti, MD
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| This analysis of five phase III single-arm trials in BCG-unresponsive CIS showed that key design differences—biopsy requirements, timing of complete response (CR) assessment, and retreatment/rechallenge policies—substantially inflate or distort reported efficacy, making cross-trial comparisons unreliable.
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| Bacillus Calmette-Guérin-Exposed Nonmuscle-Invasive Bladder Cancer: Survival Benchmarks, Bladder-Sparing Strategies, and Implications for Trial Design - Beyond the Abstract
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| Renzo Di Natale, MD, MSc, and Roger Li, MD
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| This Moffitt study of 470 BCG-treated high-grade NMIBC patients found that 52% were BCG-exposed (BCG-E) and 48% BCG-unresponsive (BCG-UR), with similar risks of subsequent high-grade recurrence and progression to muscle-invasive/metastatic disease, and no significant differences in recurrence-free, progression-free, metastasis-free, or overall survival between BCG-E and BCG-UR groups.
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| Quality of Care Measures Among Patients with Recurrent, Papillary-Only Bacillus Calmette–Guérin Experienced High-Risk Non–Muscle-Invasive Bladder Cancer
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| Ali Khaki, MD
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| This SEER-Medicare study of 262 BCG-experienced patients with recurrent, papillary-only high-risk NMIBC found significant gaps in quality-of-care measures, with less than half of patients receiving guideline-recommended surveillance and treatment within recommended timeframes. Notably, only 46.9% underwent regular cystoscopic surveillance every three months, and substantial proportions did not receive BCG within 90 days, failed repeat TURBT within six weeks after diagnosis, or lacked cystoscopy within 120 days after TURBT.
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| Genomic Signatures Predictive of High Grade Recurrence in NMIBC Following BCG Treatment
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| Vincent D'Andrea, MD
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| In a Memorial Sloan Kettering cohort of 503 NMIBC patients treated with BCG, those with high-grade recurrence within 12 months had significantly worse 10-year overall survival (HR 2.25) and were enriched for CDKN2A/p16/INK4A, CDKN2A/p14/ARF, CDKN2B, and KMT2A alterations, suggesting these mutations drive aggressive disease. Conversely, patients with recurrence after 12 months or no recurrence showed enrichment for PIK3CA and BRCA1 alterations, which may be protective modifiers of disease course.
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