Bladder Cancer

An expert on urothelial carcinoma gives an overview of disease risk factors, patient diagnosis, and testing practices.

Scott T. Tagawa, MD, MS, FACP, FASCO, presents the case of 72-year-old patient with metastatic urothelial carcinoma and offers his initial impressions.

The application is based on results from the phase 3 CheckMate-901 trial.

"If a patient begins treatment with platinum-based chemotherapy and maintenance immune checkpoint inhibition, second-line options may involve evaluating erdafitinib, ADCs, or participation in clinical trials," says Adanma Ayanambakkam, MD.

The FDA has accepted a resubmitted biologics license application for N-803 for use in combination with BCG for the treatment of patients with BCG-unresponsive non–muscle-invasive bladder cancer carcinoma in situ with or without Ta or T1 disease.

"Our data show no evidence of benefit from selenium and evidence of harm from vitamin E—a compound readily available over the counter," the authors write.

An approach combining chemotherapy and immunotherapy could help preserve quality of life.

"If additional research confirms our findings, this may lead to a new paradigm in the treatment of muscle-invasive bladder cancer," says Matthew Galsky, MD.

Treatment with adjuvant pembrolizumab reduced the risk of disease recurrence or death versus observation in patients with localized muscle-invasive urothelial carcinoma and locally advanced urothelial carcinoma.

“We wanted to look at, is there something to be said for delay in treatment or time to surgery?” says Randie White, MD.

"It is erdafitinib’s time to shine," says Arlene O. Siefker-Radtke, MD.

“At this point, we really have to consider the hard work and next steps of setting up multi-institutional databases and registries aimed at drilling down on patient and provider factors and medical decision-making around this diagnosis,” says James Ferguson III, MD, PhD.

The EV-302 trial is the confirmatory trial for the FDA’s accelerated approval of pembrolizumab plus enfortumab vedotin for the first-line treatment of patients with locally advanced or metastatic urothelial carcinoma.

“We found that over 40% of patients with muscle-invasive bladder cancer are not receiving cystectomy or trimodal therapy,” says James Ferguson III, MD, PhD.

“The ADVANCED-2 trial in NMIBC is an exciting opportunity to build on the favorable anti-tumor and safety data of TARA-002 presented earlier this year," says Gautam Jayram, MD.

Patients with MIBC were randomly assigned to receive APL-1202 in combination tislelizumab or to tislelizumab alone.

The first patient with NMIBC has been dosed with nadofaragene firadenovec-vncg as part of the Adstiladrin Early Experience Program.

BT8009 targets the tumor antigen Nectin-4, which has elevated expression levels in urothelial cancer.

The EU application for erdafitinib in urothelial carcinoma is supported by data from cohort 1 of the phase 3 THOR trial.

National MENtion It® campaign explores the impact stress has on men’s sexual and mental well-being.

Adding perioperative durvalumab to standard care for patients with resectable muscle-invasive urothelial carcinoma demonstrated promising event-free and overall survival rates in a phase 2 trial.

In the setting of refractory urothelial carcinoma, Jue Wang, MD, says it is essential to thoroughly understand a patient's molecular profile, comorbidities, and residual side effects from prior lines of therapy.

"We as a center prioritized using cisplatin and carboplatin for patients who are receiving curative intent chemotherapy," says Tian Zhang, MD.

The phase 3 THOR trial is the supporting trial for a supplemental New Drug Application for erdafitinib in urothelial carcinoma.

Erdafitinib previously received an accelerated approved for the treatment of adult patients with FGFR2/3-positive, previously-treated locally advanced or metastatic urothelial carcinoma.

“I think it's extremely exciting to be part of something that is possibly practice changing, potentially field changing,” says Sandip M. Prasad, MD, MPhil.

The Northwestern Medicine Department of Urology provides no-cost continuing medical education programs for urology professionals.

“I can tell you from a patient standpoint, I think we all agreed across the panel, there's going to be tremendous enthusiasm from patients about a nonsurgical option,” says Sandip M. Prasad, MD, MPhil.

“I think it's a very novel finding, and something completely new to urologic oncology, that a nonsurgical ablative option inside the body can actually make tumors go away,” says Sandip M. Prasad, MD, MPhil.

“For ATLAS, it was a different protocol. This was looking at giving the chemotherapy agent upfront,” says Sandip M. Prasad, MD, MPhil.