Jennifer M. Taylor, MD presented “Second-line Bladder Cancer Therapies When First Line Treatments Fail” during the 23rd Annual Innovations in Urologic Practice on September 14, 2018 in Santa Fe, New Mexico.

How to cite: Taylor, Jennifer M. “Second-line Bladder Cancer Therapies When First Line Treatments Fail” September 14, 2018. Accessed [date today]. https://dev.grandroundsinurology.com/second-line-bladder-cancer-therapies-when-first-line-treatments-fail/

 

Second-line Bladder Cancer Therapies When First Line Treatments Fail – Summary:

Jennifer M. Taylor, MD, MPH, discusses risk-stratification in non-muscle invasive bladder cancer (NMIBC), definitions of treatment failure in this setting, and indicated workup for suspected failure. She then reviews salvage intravesical therapy options under investigation in clinical trials for Bacillus Calmette–Guérin (BCG) unresponsive NMIBC.

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Abstract 

This discussion focuses on options for management of non-muscle invasive bladder cancer NMIBC after failing first-line BCG therapy. The American Urological Association (AUA) recently reclassified NMIBC into practical risk groups, as opposed to the focus on index patients in previous guidelines. There have been many definitions of therapy failure in NMIBC, such as BCG refractory, resistant, and relapsing. However, the harmonizing term BCG-unresponsive NMIBC emerged in 2015 to ensure consistent criteria for clinical trials and better interpretation of trial results. When a patient has suspected persistent or recurrent disease, it is essential to perform indicated workup to completely restage and confirm the disease.

A range of salvage intravesical therapies are available for confirmed BCG unresponsive NMBIC patients unfit or unwilling to undergo cystectomy. These therapeutic options include an FDA-approved drug and therapies under investigation, such as BCG plus interferon, valrubicin, gemcitabine, and a gemcitabine-docetaxel doublet. Overall, this is a very active area of research in clinical trials.

About Innovations in Urologic Practice

Innovations in Urologic Practice (IUP) is an annual CME-accredited conference devoted to updating urologists on the rapidly changing healthcare environment. Topics focus on innovative diagnostic and treatment strategies, controversies, new and currently developing technologies, and challenges in today’s urologic practice. Dr. Taylor presented this lecture during the 23rd IUP in 2018. Please visit this page in order to learn more about future IUP meetings.