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Highlights from the 2023 Society of Urologic Oncology 24th Annual Meeting
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| Neoadjuvant Chemotherapy Followed by Surveillance if Complete Clinical Response
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| James McKiernan, MD
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| James McKiernan presents on the management of complete clinical response post-neoadjuvant systemic therapy for muscle-invasive bladder cancer. Emphasizing the challenges and risks associated with radical cystectomy, he highlighted data suggesting a focus on maximal transurethral resection, multiparametric MRI, and ctDNA for improved patient selection.
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| Trimodality Therapy/Radiotherapy after Complete Clinical Response
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| Adam Feldman, MD, MPH
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| Adam Feldman's presentation focuses on trimodality therapy/radiotherapy, he highlighted its consideration as an alternative to radical cystectomy, emphasizing its potential for similar oncologic outcomes and improved quality of life. Dr. Feldman discusses the challenges and compares outcomes, suggesting trimodality therapy may be a balanced approach for selected patients.
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| Radical Cystectomy SHOULD be Performed after Achieving cT0 after Neoadjuvant Chemotherapy |
| Anne K. Schuckman, MD
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| Anne Schuckman advocates for radical cystectomy after achieving cT0 following neoadjuvant chemotherapy in MIBC. While acknowledging potential arguments against cystectomy, such as comparable outcomes without surgery and improved quality of life, she emphasizes the significance of accurate staging and prognostication that cystectomy allows. Dr. Schuckman discusses challenges in identifying truly pT0 patients and the limitations of current staging methods.
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| Late Breaking Abstract: First Results from BOND-003, a Phase 3 Study of Intravesical Cretostimogene Grenadenorepvec Monotherapy for Patients with High-Risk BCG-Unresponsive NMIBC
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| Mark D. Tyson, MD, MPH
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| Mark Tyson presents the initial findings from the BOND-003 phase 3 study on intravesical Cretostimogene grenadenorepvec monotherapy for high-risk BCG-unresponsive non-muscle invasive bladder cancer (NMIBC). The study reported a notable 75.7% complete response rate at any time, demonstrating the potential of Cretostimogene in reshaping the treatment landscape for NMIBC.
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| UTUC: Chemoablation and Renal Preservation is the Future
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| Katie S. Murray, DO
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| Katie Murray discusses chemoablation and renal preservation as the future of upper tract urothelial carcinoma (UTUC) management. The presentation highlighted risk assessment, renal preservation techniques, and the role of chemoablation, emphasizing the importance of organ-sparing approaches for UTUC patients, with insights from recent guidelines and studies.
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| The Role of Biomarkers for UTUC Risk Stratification
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| Helen Y. Hougen, MD
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| Helen Hougen discusses the need for biomarkers in the risk stratification of upper tract urothelial carcinoma (UTUC). She highlights the limitations of current diagnostic methods, such as ureteroscopic biopsies, and emphasizes the potential of biomarkers, including urine cytology, multi-fluorescence in situ hybridization (FISH), Bladder EpiCheck test, and cell-free DNA, for accurate risk assessment, treatment selection, and prognosis in UTUC patients.
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| Updated Efficacy and Safety of Oral Erdafitinib in Patients With BCG-Unresponsive, High-Risk, Non–Muscle-Invasive Bladder Cancer With FGFR3/2 Alterations in THOR-2 Cohort 2
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| James Catto, MBChB, Ph.D., FRCS
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| James Catto presented updated safety and efficacy outcomes of THOR-2 Cohort 2, which assesses oral erdafitinib in patients with BCG-unresponsive NMIBC and FGFR3/2 alteration. In this exploratory cohort focusing on patients with BCG-unresponsive CIS, erdafitinib demonstrated promising and durable efficacy with a complete response rate of 94% at 8 weeks and 73% at 32 weeks.
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| Treatment of Low-grade, Intermediate-risk Non-Muscle Invasive Bladder Cancer with UGN-102 ± Transurethral Resection of Bladder Tumor (TURBT) compared to TURBT Monotherapy: The Phase 3 ATLAS Trial
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| Sandip M. Prasad, MD, MPHil
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| Sandip Prasad presents the results of the recently published phase 3 ATLAS trial comparing primary chemoablation with UGN 102 ± TURBT versus TURBT monotherapy in patients with low-grade, intermediate-risk non-muscle invasive bladder cancer. Primary, non-surgical chemoablation with UGN-102 for the management of low-grade, intermediate-risk NMIBC offers a potential therapeutic alternative to TURBT monotherapy and warrants further investigation.
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| Marker Lesion Study of Oral Erdafitinib in Patients With Intermediate-Risk Non-Muscle Invasive Bladder Cancer With FGFR3/2 Alterations in THOR-2: Updated Cohort 3 Results
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| Siamak Daneshmand, MD,
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| Siamak Daneshmand presents the updated results from THOR-2 Cohort 3, a marker lesion study of oral erdafitinib in patients with intermediate-risk, non-muscle invasive bladder cancer (NMIBC) and FGFR3/2 alterations. In this exploratory cohort, erdafitinib demonstrated promising anti-tumor activity with an 83% complete response rate.
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| Comparing White Light versus Blue Light Cystoscopy Recurrence Outcomes Among Non-Muscle Invasive Bladder Cancer Patients in an Equal Access Setting: A Propensity-scored Matched Analysis
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| Sanjay Das, MD
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| Sanjay Das presents the results of a retrospective cohort study comparing recurrence outcomes between blue light and white light cystoscopy in NMIBC patients within the Veterans Affairs health care system. The study included 674 matched patients, and the analysis revealed a significantly lower rate of recurrence in patients who underwent blue light cystoscopy compared to white light cystoscopy in this equal access setting.
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| Efficacy of Intravesical Nadofaragene Firadenovec-vcng for Patients with BCG-Unresponsive Carcinoma in Situ of the Bladder: 36-Month Follow-Up from a Phase 3 Trial
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| Stephen Boorjian, MD
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| Stephen Boorjian presented the 36-month follow-up results of a phase 3 trial evaluating the efficacy of intravesical nadofaragene firadenovec-vcng for patients with BCG-unresponsive carcinoma in situ of the bladder. The results showed sustained durability of the initial complete response in approximately 25% of patients through 36 months. Nadofaragene firadenovec demonstrated efficacy and represents a novel treatment option for BCG-unresponsive NMIBC.
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