(UroToday.com) The session started with an overview of Photocure from an organization's mission, vision, and values to optimize bladder cancer care. The Bladder Cancer Company has become evolved from many years of multiorgan and disease state enhanced detection and treatment of cancers using photodynamic therapy. Specific to bladder cancer, blue light cystoscopy (BLC) in the US has garnished increased use with prior evidence including level one to support decreased recurrence rates of non-muscle-invasive bladder cancer (NMIBC) when compared with conventional white light cystoscopy (WLC).
Current studies are underway evaluating the use and outcomes of blue light cystoscopy in a real-world setting. A total of 378 NMIBC patients within the Veterans Affairs system that underwent BLC with or without a previous history of WLC from January 1, 2018 to December 31, 2020 were assessed. We determined recurrence rates and time to recurrence prior to BLC (i.e. after previous WLC) and following the BLC. Of 378 patients with complete data; 43 (11%) were Black and 300 (79%) White. The Median follow-up was 40.7 months. There were 194 (51%) patients with either T1 HG or T1 without CIS; 52 (14%) had CIS with or without TaHG or T1; and 127 (34%) had TaLG only. A total of 239 (63%) patients received BCG at any point during the study. The median time to first recurrence following BLC was longer compared to prior WLC (40 (33-NE) vs. 26 (17-39) months). The risk of recurrence was significantly lower following BLC (Hazard Ratio (HR) 0.70; 95% Confidence Interval (CI) 0.54-0.90). There was no significant difference in recurrence (Hazard Ratio (HR) 0.83; 95% Confidence Interval (CI) 0.48-1.43), progression (HR 1.46; 95% CI 0.45-4.74), and overall survival (HR 0.69; 95% CI 0.29-1.65) following BLC by Black vs. White race.
This study from an equal access setting in the VA observed a significantly decreased risk of recurrence and prolonged time interval to recurrence following BLC compared to the pre-study WLC. There was no difference in any bladder cancer outcomes by race.
These findings support other prior BLC registry work also showing decreased recurrence among patients that underwent BLC. There was also discussion regarding direct anti-cancer association with BLC but also immune environment among NMIBC which can impact outcomes. Lastly, photodynamic treatment (PDT) was discussed along with ongoing work to understand toxicity and outcomes and which NMIBC populations should be tested.
In summary, BLC use results in decreased rates of recurrence and longer time intervals to recurrence with current research underway to understand biological and treatment implications.
Presented by: Stephen B. Williams, MD, MS, FACS, Division of Urology, University of Texas Medical Branch, Galveston, TX; Department of Surgery, University of Texas Medical Branch, Galveston, TX
Written by: Stephen B. Williams, MD, MS, FACS, Division of Urology, University of Texas Medical Branch, Galveston, TX; Department of Surgery, University of Texas Medical Branch, Galveston, TX during the International Bladder Cancer Network Annual Meeting, September 28-October 1, 2022, Barcelona, Spain