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PEER-TO-PEER CLINICAL CONVERSATIONS |
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Advancing Treatment for BCG-Unresponsive Bladder Cancer
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Eugene Pietzak, MD
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| Sam Chang hosts Eugene Pietzak to discuss treatment options for BCG-unresponsive bladder cancer and the challenges of evaluating their comparative effectiveness. Dr. Pietzak emphasizes that while multiple FDA-approved treatments are now available, including pembrolizumab, nadofaragene, and BCG with IL-15 superagonist, comparing their efficacy is complicated by variations in trial designs, surgeon techniques, pathology interpretations, and patient populations.
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| Addressing BCG Supply Shortages, Workflow, and Enhancing Bladder Cancer Treatment through Strategic Partnerships |
Patrick Soon-Shiong, MD
Ashish Kamat and Patrick Soon-Shiong delve into the current status and future prospects of Anktiva for bladder cancer. Dr. Soon-Shiong addresses concerns about the BCG shortage and the steps taken to ensure its availability through a partnership with the Serum Institute of India, which will provide both traditional and next-generation recombinant BCG. |
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| Real-World Treatments Following BCG Induction in Patients with NMIBC: A US Claims Analysis |
| Amanda Myers, MD |
| Zachary Klaassen and Amanda Myers discuss a US claims analysis examining real-world treatment patterns following BCG induction in non-muscle invasive bladder cancer patients. The study reveals significant underutilization of maintenance BCG therapy, with only a quarter of patients receiving adequate maintenance doses after induction. |
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| BCG Shortage: What’s on the Horizon to Replace?
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| Joshua Meeks, MD, PhD
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| Josh Meeks discusses the ongoing BCG shortage for treating urothelial carcinoma and potential replacements. He highlighted alternatives such as gemcitabine + docetaxel, immune checkpoint inhibitors, and innovative drug delivery systems like TAR-200, which could offer better outcomes for patients.
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| Patterns of Treatment of High-Risk BCG-Unresponsive NMIBC Patients Among Arab Urologists - Beyond the Abstract
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| Mohamad Abou Chakra, MD, Neal Shore, MD, FACS, & Michael O'Donnell, MD
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| A recent survey of 106 urologists across 22 Arab countries highlighted significant challenges in managing high-risk BCG-unresponsive NMIBC. Despite widespread BCG shortages, 50% of Arab urologists preferred radical cystectomy for BCG-unresponsive cases, compared to only 24% in the U.S.
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| BCG Shortage – An End in Sight?
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| Danica May, MD
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| Danica May addresses the ongoing BCG shortage and strategies to optimize its use. She emphasized prioritizing BCG for high-risk NMIBC, dose reduction, and alternative therapies like gemcitabine, docetaxel, and checkpoint inhibitors.
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| The Impact of BCG Shortage on Disease Recurrence for Patients with Non-Muscle Invasive Bladder Cancer: A SEER Patterns of Care Analysis |
| Madison Wahlen |
| Madison Wahlen presents a SEER-based study analyzing the impact of BCG shortages on recurrence-free survival in NMIBC. Among 581 patients, 21% were affected by BCG shortages. The study found no significant increase in recurrence risk for patients impacted by the shortage, whether they received reduced or no BCG. However, patients who did receive BCG had a 54% reduced recurrence risk, emphasizing the importance of BCG in NMIBC management and advocating for dose-adjusted alternatives when supply is limited. |
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| N-803 plus BCG Complete Response Rate in NMIBC CIS: BCG Refractory, Relapsed, Checkpoint Failure, and Chemotherapy Failure; Updated Results (QUILT 3.032)
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| Patrick Soon-Shiong, MD
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| Patrick Soon-Shiong presents updated findings from the QUILT 3.032 trial, evaluating N-803 (ANKTIVA®) plus BCG in patients with BCG-unresponsive NMIBC CIS. The combination therapy demonstrated a 70% overall complete response rate across subgroups, including 72% in BCG-relapsed patients.
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| Efficacy of Intravesical Nadofaragene Firadenovec-VNCG for Patients with BCG-Unresponsive NMIBC: 36-Month Follow-Up from a Phase 3 Trial |
| Yair Lotan, MD |
| Yair Lotan presents 36-month follow-up data from a phase 3 trial of nadofaragene firadenovec for BCG-unresponsive NMIBC, demonstrating durable efficacy and bladder preservation. In the CIS cohort, 53.4% achieved a complete response at 3 months, with 25.5% remaining high-grade recurrence-free at 36 months, while 72.9% of the Ta/T1 cohort were recurrence-free at 3 months, with 31.4% maintaining this status at 36 months. |
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| Topline Results from BOND-003: A Phase-3 Study of Intravesical Cretostimogene Grenadenorepvec for the Treatment of High-Risk BCG-Unresponsive NMIBC with CIS
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| Mark Tyson, II MD, MPH
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| Mark Tyson presents the phase 3 BOND-003 trial results, highlighting the efficacy of cretostimogene grenadenorepvec for high-risk BCG-unresponsive NMIBC with CIS. The therapy achieved a 74.5% overall complete response rate, with 64% maintaining response at 12 months and 57% at 24 months, while the median duration of response exceeded 27 months.
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