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PEER-TO-PEER CLINICAL CONVERSATIONS |
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Challenges and Management Strategies for BCG-Unresponsive Bladder Cancer
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Patrick Hensley, MD, and Frances Martin, MD
Frances Martin and Patrick Hensley discuss BCG-unresponsive NMIBC challenges with Sam Chang. Strict BCG unresponsive definition requires adequate BCG, but only 37% of patients receive this regimen during shortages.
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Blue Light Cystoscopy Detects Hidden Bladder Cancer After Induction Therapy
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Vignesh Packiam, MD
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| Sam Chang speaks with Vignesh Packiam about enhanced surveillance protocols for high-risk non-muscle invasive bladder cancer following induction therapy.
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Treatment Options for BCG-Unresponsive Nonmuscle-Invasive Bladder Cancer
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Kelly Stratton, MD, FACS
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| Sam Chang and Kelly Stratton explore emerging intravesical therapies for BCG-unresponsive non-muscle invasive bladder cancer. Dr. Stratton highlights the significant unmet need for patients seeking bladder preservation alternatives to cystectomy.
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| Optimizing Oncological Outcomes in High-Grade Nonmuscle-Invasive Bladder Cancer: The Impact of a Surgeon-Led Treatment Pathway - Beyond the Abstract
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| Pietro Scilipoti, Giuseppe Rosiello, Alfonso Santangelo et al.
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| Centralizing high-grade NMIBC care in a surgeon-led, guideline-driven pathway from first diagnosis was associated with better outcomes, including higher complete resection rates at re-TURBT and markedly improved 5‑year disease-free, progression-free, and cancer-specific survival, with most patients preserving their bladder.
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| Quality of Care Measures Among Patients with Recurrent, Papillary-Only BCG Experienced High-Risk Nonmuscle-Invasive Bladder Cancer
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| Ali Khaki, MD
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| This SEER–Medicare analysis shows that many Medicare-insured, BCG‑experienced patients with recurrent papillary-only high‑risk NMIBC do not receive guideline‑concordant care, including timely cystoscopy, repeat TURBT, and intravesical BCG. Less than half underwent surveillance cystoscopy every three months or repeat TURBT within six weeks, and nearly 40% did not receive BCG within 90 days of diagnosis, underscoring substantial real-world quality gaps and the need for more consistent implementation of established QoC measures.
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| Worldwide Clinical Practices in the Management of BCG-Unresponsive Nonmuscle-Invasive Bladder Cancer
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| Mohamad Abou Chakra, MD
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| This survey-based review shows striking global variation in how clinicians manage BCG‑unresponsive NMIBC, with intravesical chemotherapy favored in the US and China, radical cystectomy more common in Arab countries and some European settings, and high rates of watchful waiting and re‑resection in parts of Europe and Japan.
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| Optimal Sequencing: My Patient Has BCG Unresponsive NMIBC and Declines Radical Cystectomy
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| Wes Kassouf, MD, and Michael O’Donnell, MD
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| Wes Kassouf and Michael O’Donnell explored optimal second‑line therapy for BCG‑unresponsive CIS in patients declining cystectomy, contrasting gemcitabine + docetaxel intravesical chemotherapy with newer options like N‑803 + BCG and nadofaragene firadenovec. Data presented highlighted durable control and bladder preservation with gemcitabine + docetaxel but also strong biologic and prospective-trial support for N‑803 + BCG.
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