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PEER-TO-PEER CLINICAL CONVERSATIONS |
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Guidelines for High-Risk Non-Muscle Invasive Bladder Cancer Treatment Options
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Neal Shore, MD, FACS
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| Sam Chang hosts Neal Shore to discuss the evolving guidelines for high-risk, non-muscle invasive bladder cancer. Dr. Shore emphasizes the importance of shared decision-making, noting that while no head-to-head comparisons exist, both agents show promising efficacy with manageable tolerability profiles.
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Response-Guided Strategy Investigates Omission of Repeat TUR in High-Risk NMIBC
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Roberto Contieri, MD
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| Roberto Contieri presents the HuNIRe trial, a prospective observational multicenter testing a response-guided strategy to selectively omit second TURBT.
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CISTO Study: Patient Preferences Drive Bladder Cancer Treatment Choice, Shaping Quality of Life Outcomes
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Angela Smith, MD, MS
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| Angela Smith presents CISTO trial patient preference analysis with Sam Chang. The pragmatic study enrolled patients with recurrent high-grade NMIBC choosing bladder-sparing therapy or radical cystectomy.
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| Patient Time Toxicity from Management Options for NMIBC
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| Veerain Gupta, MD
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| Veerain Gupta’s SES AUA 2026 study found that among Medicare beneficiaries with NMIBC, time toxicity was lowest with TURBT alone and highest with radical cystectomy, with intravesical therapies falling in between. In short, cystectomy imposed the greatest patient time burden, intravesical chemotherapy more than BCG, and these data may help patients and clinicians weigh treatment tradeoffs during shared decision-making.
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| Optimizing Surgical Management of Non-Muscle Invasive Bladder Cancer
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| Jeremy Teoh, MBBS, FRCSEd (Urol), FCSHK, FHKAM (Surgery)
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| Jeremy Teoh’s ASCO GU 2026 presentation emphasized that TURBT remains the foundation of NMIBC management, but en bloc resection can improve surgical quality and lower 1-year recurrence, especially when paired with BCG in higher-risk disease. The EB-StaR trial showed recurrence reduction with ERBT versus standard resection, and emerging robotic platforms may further improve specimen quality and staging accuracy.
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| Quality Care Measures Among Patients with High-Risk Non-Muscle Invasive Bladder Cancer with Papillary Carcinoma or CIS Receiving Front-Line BCG or Other Intravesical Therapies
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| Mukul Singhal, PhD
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| Real-world data from AUA 2026 highlight persistent gaps in quality-of-care measures for patients with high-risk NMIBC receiving frontline bladder-sparing therapy. Dr. Mukul Singhal’s analysis of SEER-Medicare data underscores opportunities to improve timely treatment delivery, surveillance cystoscopy, repeat TURBT, and overall care adherence.
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| Gemcitabine Intravesical System (TAR-200) Monotherapy in BCG-Unresponsive High-Risk NMIBC: Characterization of Recurrence, Progression, and Time to Radical Cystectomy
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| Katie Murray, DO, MS, FACS
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| TAR-200 monotherapy in BCG-unresponsive high-risk NMIBC produced a high complete response rate, durable responses, and a relatively low rate of progression to muscle-invasive disease. In the SunRISe-1 cohort, recurrence or persistence still occurred in about half of patients, but progression to T2 or higher was uncommon and the 12- and 24-month cystectomy-free rates were 86.6% and 75.5%, supporting TAR-200 as a bladder-sparing option.
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| Physician Experiences with the Gemcitabine Intravesical System in High-Risk NMIBC: A Qualitative Study of SunRISe Trial Investigators
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| Timothy Lyon, MD
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| Timothy Lyon’s SES AUA 2026 study found that SunRISe trial investigators and allied staff viewed TAR-200 insertion/removal as quick, straightforward, and feasible in many clinical settings. They also felt it was generally better tolerated and less time-consuming than BCG or intravesical chemotherapy, with many expecting future use to shift partly to advanced practice providers.
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