AUA 2018: Adherence to Bladder Cancer Guidelines and Issues with Implementation

San Francisco, CA (UroToday.com) To start the bladder cancer session at the SUO session, Dr. de Vere White discussed adherence to guidelines and implementation. As he notes, the goals of treating non-invasive papillary carcinoma (Ta) disease is to stop recurrence, whereas for T1 is to stop progression and reduce mortality.  

AUA 2018: Three Articles Last Year that Changed Practice: Bladder Cancer

San Francisco, CA (UroToday.com) Badrinath R. Konety, MD concluded the Society of Urologic Oncology bladder cancer session discussing three impactful papers from the last year that in his opinion are practice changing. To do this, he screened 1726 articles from the top 5 generic journals (New England Journal of Medicine, Lancet, etc), as well as the top 20 oncology and urology/nephrology journals. 

AUA 2018: Where and How Does Cystoscopy Fall Short? Initial Results of a Prospective Cohort Study Evaluating Reliability of Endoscopic Evaluation in Predicting pT0 Disease at the Time of Radical Cystectomy

San Francisco, CA (UroToday.com) Daniel Parker, MD presented a prospective trial performed at the Fox Chase Cancer Center, led by Alexander Kutikov, MD.  Accurate preoperative prediction of pathologic T0 disease could spare a portion of patients from unnecessary cystectomy.  Previous studies have demonstrated an approximately 30% rate of pT0 following neoadjuvant chemotherapy and 12% after transurethral resection alone. 

AUA 2018: Automated and Dynamic Classification of Bladder Cancer using Deep Learning on Real-Time Confocal Laser Endomicroscopy Images

San Francisco, CA USA (UroToday.com) Dr. Timothy Chang, urology resident at Stanford University, presented on the use of artificial intelligence to classify bladder cancer by analyzing real-time confocal laser endomicroscopy (CLE) images. As an introduction, the author explained the function of CLE and its ability to provide real time microscopic tissue characterization. The goal of this study was to apply deep learning, which is a form of machine learning that involves object detection, to identify bladder cancer in tissues using these CLE images.

AUA 2018: Translational Research to Potentiate Immunotherapy in Urothelial Cancer

San Francisco, CA (UroToday.com) In this SBUR/SUO session, Chong-Xian Pan, MD, discussed an overview of immunotherapy for advanced urothelial cancers, focusing on strategies to improve therapy.  Multiple PD1/PD-L1 agents have been approved for use in the United States for metastatic urothelial cancers and have an approximate overall response rate of 20%.  The Keynote-045 trial stratified patients who had disease progression after platinum-based chemotherapy to dealer’s choice chemotherapy versus Pembrolizumab.  This study demonstrated an overall response to pembrolizumab of 21% compared to chemotherapy of 11%. 

AUA 2018: Refining Immunotherapy Combinations and Sequencing in Bladder Cancer

San Francisco, CA (UroToday.com) Joaquim Bellmunt, MD presented his thoughts on how we are able to refine immunotherapy combinations in patients with advanced urothelial carcinoma of the bladder as part of the basic science lectures at the combined meeting of the Society of Urologic Oncology (SUO) and Society for Basic Urologic Research (SBUR) at the American Urological Association’s 2018 meeting in San Francisco, CA. 

AUA 2018: Overview of Immunotherapy in GU Cancers 

San Francisco, CA (UroToday.com) Dr. Gulley discussed the role of immunotherapy in GU malignancies, focusing on prostate and bladder cancers.  Previously published data has demonstrated a wide range of overall response rates with PD1/PDL1 inhibition by cancer, with melanoma having a higher response rate, bladder and kidney cancers with a moderate response and prostate having a low response.  Dr. Gulley explained the cycle of the “5 E’s” of immunotherapy: engage, expand, excursion, establish ID, and enable. 
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