AUA 2018: Switching of Bacillus Calmette-Guerin Strain at Second BCG Therapy May Reduce BCG-Related Side Effects in Patients with BCG-Relapsing Tumors
San Francisco, CA (UroToday.com) Currently, two strains of Bacillus Calmette-Guerin (BCG) (Tokyo-172 and Connaught) are used for the treatment of patients with high-risk non-muscle invasive bladder cancer. Recent studies have proposed that BCG resistance may be related to the type of strain used. Some have advocated that resistance may be secondary to clonal selection from the specific strain used, arguing that treatment with a different strain may rescue patients who have had an initial response to BCG (BCG relapsing). Dr. Niwa, from Keio University in Tokyo Japan, presents a retrospectives study which evaluates the clinical efficacy and safety of switching of BCG strain at the second BCG therapy in patients with BCG-relapsing non-muscle-invasive bladder tumor, defined as recurrence after achieving a disease-free status for 6 months.
AUA 2018: PSA 1.5 is the new 4.0
San Francisco, CA (UroToday.com) E. David Crawford gave a talk regarding the state of prostate cancer diagnostics and specifically focused on the role of PSA cutoff for evaluation. First, most people, including in the auditorium, are unsatisfied with the current state of prostate cancer detection. In his interactions with practicing urologists and family practice/internal medicine physicians, most are concerned – for different reasons. Common areas of concern: screening parameters, informed decisions, risks and benefits of PCa screening. However, both fields feel there is value to PCa screening.
AUA 2018: Does Tumor Size at the Time of Cytoreductive Nephrectomy Influence Survival?
San Francisco, CA USA (UroToday.com) Renzo DiNatale, MD, from Memorial Sloan Kettering Cancer Center presented his groups multi-institutional research focusing on the management of metastatic renal cell carcinoma. Although the cancer has metastasized, patients often undergo a cytoreductive nephrectomy (CN) to improve their quality of life and survival outcomes. However, urologists struggle to select the appropriate patient for the procedure as there are no clear-cut guidelines.
AUA 2018: Renal Cell Carcinoma and Brain Metastasis: A SEER Analysis
San Francisco, CA USA (UroToday.com) Dr. Daugherty from SUNY Upstate Medical University presented his groups research focusing on metastatic renal cell carcinoma (RCC). He explained that management decisions are often driven by the site and number of metastases. Brain metastases are considered a poor prognostic factor which typically excludes patients from undergoing cytoreductive nephrectomy (CN). Using the SEER database, his team sought to investigate the outcomes of patients that had brain metastases and underwent CN.
AUA 2018: Patient Centered Outcomes of Intravesical BCG Plus Interferon
San Francisco, CA (UroToday.com) The ongoing Phase 2 BCG/IFN national trial is a trial evaluating the efficacy and primarily the safety of BCG and concurrent IFN (interferon) for the treatment of BCG-naïve and BCG-refractory NMIBC (non-muscle invasive bladder cancer). In detail, patients were treated with full dose BCG for BCG naive (BCG-N), 1/3 dose BCG for prior BCG failures (BCG-F), and 1/10 dose BCG for patients deemed BCG intolerant (BCG-I)) plus IFN for 6 weekly treatments.
AUA 2018: Endoscopic Stone Measurement During Ureteroscopy
San Francisco, CA USA (UroToday.com) Gregory Joice, a clinical urologist from Johns Hopkins University, used this podium session to educate the audience on his team’s findings on intraoperative stone measurement during ureteroscopy (URS). He began his presentation by discussing the problematic nature of size determination of a visualized object due to the nature of direct vision via endoscopic cameras. Dr. Joice reasoned that intraoperative stone fragment measurements are important to determine whether further stone fragmentation is necessary, whether stones could be successfully removed through a ureteral access sheath, or whether stones could be removed without ureteral injury (in the absence of a sheath). In this study, the researchers set out to accurately calculate stone size from real-time ureteroscopic images using a novel software application.
AUA 2018: Accurate Prediction of Progression to Muscle Invasive Disease in Patients with T1G3 Bladder Cancer: A Clinical Decision-Making Tool
San Francisco, CA (UroToday.com) NMIBC represents approximately 70% of all bladder cancer diagnoses. While low-grade disease has high rates of recurrence and low rates of progression, patients with CIS and high-grade (HG) disease have high rates of progression to muscle-invasive bladder cancer. Early definitive therapy and more aggressive interventions may help alter the natural history of the disease and provide curative options for these patients.