FOIU 2018: Evidence and Anecdotal Based Approach for High-Risk Bladder Cancer: Is Bladder Preservation an Option? A Tale of Two Cities
Tel Aviv, Israel (UroToday.com) Mitchell Benson, MD, gave a discussion on high-risk bladder cancer. The therapeutic options for muscle-invasive bladder cancer (MIBC) include radical transurethral resection, primary radiation therapy, chemo-radiation therapy, primary radiation therapy, radical cystectomy (RC), neoadjuvant chemotherapy + radical cystectomy, and primary chemotherapy.
FOIU 2018: Trimodal Therapy for Muscle Invasive Bladder Cancer
Tel-Aviv, Israel (UroToday.com) Adam Feldman, MD discussed the therapeutic option of bladder preservation therapy (BPT). This includes maximal TURB combined with chemoradiation, partial cystectomy, or TURBT +/- chemotherapy. The option of organ conservation by trimodal therapy (TMT) is common in other organs including larynx, anus, breast, esophagus, and limb.
FOIU 2018: Robotic Assisted Radical Cystectomy
Tel-Aviv, Israel (UroToday.com) Alejandro Rodriguez, MD gave a presentation on the usage of robotic radical cystectomy. Although open radical cystectomy is the standard of care for muscle-invasive bladder cancer (MIBC) and some non-MIBC (NMIBC), it is still a procedure that is associated with high morbidity. Recent publications demonstrate a complication rate of 31.5%, with 40.7% requiring blood transfusions. The average length of stay decreased from 10.6 days to 9.2 days, but readmission increased to 21.4% in 2015. 1
FOIU 2018: Should the Primary Be Treated in Patients with Metastatic Disease? - Upper Tract Urothelial Cancer
Tel-Aviv, Israel (UroToday.com) Seth Lerner, MD discussed the topic of treating the primary tumor in patients with metastatic upper tract urothelial carcinoma (MUTUC). The outline of his talk included the unique biology of UTUC disease, the incidence and patterns of metastasis of UTUC, the efficacy of systematic chemotherapy, the outcomes of post systemic treatment, and locoregional surgical consolidation.
FOIU 2018: Bladder Cancer – Oncologist’s View
Tel-Aviv, Israel (UroToday.com) Raya Leibowitz-Amit, MD discussed the topic of whether we should treat the primary tumor in patients with metastatic bladder cancer. First, Dr. Leibowitz presented the potential harm in treating the primary tumor. Detrimental oncologic sequalae (discovered in mice models) include:
FOIU 2018: Immune-Oncology In Genitourinary Malignancies - Have We All Been Too Enthusiastic Too Soon?
Tel Aviv, Israel (UroToday.com) Raya Leibowitz-Amit, MD, PhD, gave an interesting talk on the role of immunotherapy in genitourinary malignancies. The first immunotherapy trial in locally advanced or metastatic urothelial cancer, KEYNOTE 012, was presented in ESMO 2014 in Madrid and analyzed the activity of pembrolizumab. This was a non-randomized, multi-cohort, open-label, phase 1b basket trial. Only patients with ECOG 0/1 and PD-L1 staining of at least 1% in tumor or stroma cells could have been enrolled in this trial. Of the 115 pre-screened patients, 61 were PD-L1 positive, of whom 33 were enrolled, and only 27 were assessable. After a median follow-up of 13 months, 7/27 patients achieved an overall response. The response rate was 26% with a median response duration of 10 months.
FOIU 2018: Current Experience in Immunotherapy for Metastatic Bladder Cancer
Tel-Aviv, Israel (UroToday.com) Avishay Sella, MD gave a talk about the evolution of immunotherapy in bladder cancer. The immunologic systemic therapy for urothelial cancer has significantly progressed in recent years. Currently, there are 5 FDA approved medications for use in bladder cancer. These include: