BCANTT 2020: High-Risk Non-Muscle Invasive BCG Unresponsive Bladder Cancer: Immune Response to BCG

(UroToday.com) Max Kates, MD, Johns Hopkins Greenberg Bladder Cancer Institute, presented mechanisms of bacillus calmette-guerin (BCG) in bladder cancer. T cell expansion is a driving force in immune cell recruitment. The immune checkpoint and BCG response has showed PDL1 expression is relatively high among patients with carcinoma in situ (CIS). Colonization of PDL1 and CD8 among BCG responders has been shown with a void of CD4+ cells. CD4 T cells recognize the antigen which then stimulates CD8 cells to kill tumor cells. However, cancers can silent CD8 cells to avoid tumor death. What is the role of PD1/PDL1 monotherapy and combination therapy in BCG unresponsive disease? Dr. Kates has observed certain post/pre gene expression among paired BCG unresponsive samples differ which may have evidence of adaptive resistance mediated through PD-L1 checkpoint.

Presented by: Max Kates, MD, Director, Bladder Cancer Program, Assistant Professor of Urology, Johns Hopkins Greenberg Bladder Cancer Institute 

Written by: Stephen B. Williams, MD, Medical Director for High-Value Care; Chief of Urology, Professor, Director of Urologic Oncology, Director Urologic Research, The University of Texas Medical Branch at Galveston, TX at the 2020 Virtual Bladder Cancer Advocacy Network Think Tank 2020