Bladder Cancer Academy 2017: Bladder Cancer Biomarkers: New and Old
Schaumburg, IL (UroToday.com) Dr. Cookson gave a great talk on bladder cancer biomarkers. He began his talk with a summary of current clinical practice. This included cystoscopy with biopsy (the gold standard), imaging with CT urogram, and urine based testing, which today include cytology, FISH, NMP-22, BTA. STAT and TRAK, ImmunoCyt and lastly, the new CxBladder. Cystoscopy and urine cytology have been recommended in all guidelines for quite some time, but some urinary biomarkers are now being recommended to be incorporated as well.
Bladder Cancer Academy 2017: Bladder-Sparing Strategies
Schaumburg, IL (UroToday.com) Dr. Bivalacqua gave an informative presentation on bladder perseveration approaches. Bladder preservation can be utilized to date in 2 states of disease. These include non-muscle invasive bladder cancer (NMIBC) disease which is unresponsive to BCG and intravesical chemotherapy, and muscle invasive bladder cancer (MIBC) – trimodal therapy (TMT) including maximal TURBT and chemoradiation.
Bladder Cancer Academy 2017: Neoadjuvant and Adjuvant Chemotherapy Bladder Cancer
Schaumburg, IL (Urotoday.com) Dr. Galsky gave an interesting presentation on the usage of chemotherapy in radical cystectomy (RC) patients. Perioperative chemotherapy in the context of RC is needed to eliminate any chance of micrometastatic disease not shown on standard imaging. Grossman et al. was the first to show an added benefit for neoadjuvant chemotherapy (NAC) in the setting of RC with a 5% overall survival benefit of 5%.1 In a meta-analysis of several studies on NAC, a hazards ratio (HR) of 0.86 (95% CI 0.81-0.98), p=0.003, was demonstrated in favour of NAC.2
Bladder Cancer Academy 2017: Genitourinary Oncology: A Peek Over the Horizon
Schaumburg, IL (UroToday.com) Dr. Theodorescu, gave a talk concluding the bladder cancer academy meeting, adding some important points that were not mentioned during the day. There are 3 different biomarker classes: predisposition, prognostic (assessing disease aggressiveness), and predictive (assessing therapy response).
Bladder Cancer Academy 2017: Immunotherapy of Advanced Bladder Cancer: The Next Frontier
Schaumburg, IL (UroToday.com) Dr. Balar gave an update on immunotherapy in advanced bladder cancer. Urothelial carcinoma (UC) is a chemotherapy sensitive disease with cisplatin and methotrexate having the highest response rate as single agents (20-30%). They are the basis for the combination treatments. A small proportion of patients (5-10%) can be cured with cisplatin based chemotherapy.
Bladder Cancer Academy 2017: Immunotherapy of Renal Cell Carcinoma
Schaumburg, IL (UroToday.com) Dr. Hammers gave a presentation on immunotherapy in renal cell carcinoma (RCC). RCC does not have a very high nor low somatic mutation frequency, being placed right in the middle of all cancers. High dose IL-2 was the first immunotherapy used in RCC in the past, achieving a complete response (CR) in about 5% of patients.
Bladder Cancer Academy 2017: Intravesical Therapy: When Bacillus Calmette-Guerin Fails
Schaumburg, IL (UroToday.com) Dr. Hahn gave an update on intravesical therapies in bladder cancer. A myriad of studies exist on Bacillus Calmette-Guerin (BCG) therapy and the recurrence rates in non-muscle invasive bladder cancer (NMIBC) patients. These trials have shown a 3 month complete response (CR) ranging from 18-79% and a 1 year recurrence free survival (RFS) ranging from 10-75%.