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- Ashish Kamat hosts a discussion with Benjamin Pradere, Fredrik Liedberg, and Marco Moschini about the extent of transurethral resection of bladder tumor (TURBT) needed in muscle-invasive bladder cancer. Dr. Pradere emphasizes TURBT as the first treatment step regardless of imaging findings, while Dr. Liedberg recommends considering patient preferences and treatment plans when determining TURBT app...
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- Ashish Kamat moderates an exchange between Shilpa Gupta and Felix Guerrero-Ramos about managing locally advanced bladder cancer with nodal involvement. Dr. Gupta advocates for systemic therapy as the primary approach, highlighting that EV-pembrolizumab is now standard of care with maintenance immunotherapy following complete response, while questioning the necessity of "life-altering surgery" in t...
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- Sam Chang hosts Neema Navai to discuss an article examining pT0 and pN0 as potential biomarkers in node-positive bladder cancer. Dr. Navai questions longstanding assumptions around nodal metastatic disease treatment, suggesting that traditional dogma deserves reconsideration. He highlights findings that patients achieving complete response in both bladder and lymph nodes after systemic therapy hav...
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- Zachary Klaassen and Neal Shore review first-line treatment for metastatic urothelial carcinoma using enfortumab vedotin plus pembrolizumab. Dr. Klaassen presents a 72-year-old veteran who initially underwent neoadjuvant chemotherapy and radical cystectomy for muscle-invasive bladder cancer but later developed lung and pelvic metastases. Dr. Shore discusses the EV-302 trial data showing efficacy o...
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- Ashish Kamat is joined by Marie-Pier St-Laurent to discuss the NEO-BLAST trial, a study investigating neoadjuvant therapy for muscle-invasive bladder cancer followed by active surveillance versus definitive treatment. Dr. St-Laurent outlines the approach to improve clinical restaging accuracy post-neoadjuvant therapy using multiple modalities including ctDNA, bladder MRI, TURBT, and template biops...
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- Ashish Kamat hosts Nimira Alimohamed to discuss the potential impact of circulating tumor DNA in muscle invasive bladder cancer management. Dr. Alimohamed reviews findings from multiple studies showing ctDNA's strong prognostic value, with detection after surgery correlating with recurrence and clearance during treatment often indicating better outcomes. She highlights several ongoing trials inclu...
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- Leslie Ballas is joined by Neil Desai to discuss combining radiotherapy with antibody drug conjugates (ADCs) in advanced urothelial carcinoma. Dr. Desai shares findings from a retrospective study examining whether these increasingly important treatments interact adversely with radiation. Results show no increased adverse events regardless of radiation timing or intensity. Of patients who discontin...
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- Ashish Kamat interviews Funda Meric-Bernstam about a TROPION-PanTumor01, a phase I expansion trial evaluating datopotamab deruxtecan (Dato-DXd) in urothelial cancer. Dr. Meric-Bernstam shares results from 40 heavily pretreated patients, all previously exposed to immunotherapy and most to platinum therapy and enfortumab vedotin. Despite this challenging population, Dato-DXd demonstrates a 25% objec...
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- Ashish Kamat speaks with Alina Basnet about research on young onset bladder cancer, defined as occurring in patients under age 50. Dr. Basnet shares findings from a comprehensive genomic profiling of clinically advanced bladder cancer patients, comparing 321 young onset cases against over 9,000 older patients. The analysis reveals that genomic alteration patterns, TMB, MSI status, and PD-L1 expres...
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- Sam Chang speaks with Amanda Nizam about research on real-world treatment-related toxicities in locally advanced and metastatic urothelial carcinoma. Dr. Nizam shares findings from a Flatiron database analysis of over 5,300 patients treated between 2016-2023, comparing six different treatment regimens including enfortumab vedotin plus pembrolizumab, single-agent immunotherapies, and platinum-based...
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