Seth P. Lerner, MD, moderated “Updates in Upper Tract Urothelial Cancer” during the International Bladder Cancer Update 2021 virtual conference in April 2021.
How to cite: Lerner, Seth P. “Updates in Upper Tract Urothelial Cancer” April 2021. Accessed Nov 2024. https://dev.grandroundsinurology.com/updates-in-upper-tract-urothelial-cancer/
Updates in Upper Tract Urothelial Cancer – Summary:
Seth P. Lerner, MD, Professor of Urology and holder of the Beth and Dave Swalm Chair in Urologic Oncology in the Scott Department of Urology at Baylor University, provides an update on recent trials and treatment options for upper tract urothelial cancer (UTUC). He begins with the OLYMPUS study, a phase III prospective study assessing treatment of low-grade disease with mitomycin gel, which found a complete response in 59% of patients. Dr. Lerner then outlines the rationale for neoadjuvant therapy, which is based, in part, on level 1 evidence for patients with muscle invasive bladder cancer, adding that it can help identify patients at increased risk for locally advanced or micrometastatic disease. Newer data shows a lower pathological stage in patients who were treated with neoadjuvant chemotherapy than patients treated without. He notes that the EAU recently updated its guidelines to strongly recommend adjuvant chemotherapy. Dr. Lerner reviews ECOG’s EA8141, a prospective phase II trial of neoadjuvant chemotherapy followed by surgery in high-risk UTUC, which found roughly a 14% overall pathological complete response rate after treatment. He then comments on Lynch Syndrome and the approval of Pembrolizumab for patients with unresectable or metastatic MSI high or MMR deficient solid tumors. This treatment should be considered in patients with a solitary kidney. Dr. Lerner concludes with a discussion of adjuvant therapy including an overview of the POUT trial.
About the International Bladder Cancer Update 2021 virtual conference:
The International Bladder Cancer Update (IBCU) is a CME conference focused on the diagnosis and treatment of bladder cancer. The conference offers medical professionals an opportunity to listen to updates from, and interact with, expert international faculty to improve knowledge and determine best treatment practices to improve patient outcomes. IBCU encompasses expert lectures, interactive discussions, a panel roundtable, debates, and case presentations. It is physician-led, multi-supported, and designed for urologists, urologic oncologists, and other healthcare professionals involved in the treatment of bladder cancer.
ABOUT THE AUTHOR
Seth P. Lerner, MD, is a Professor of Urology and holds the Beth and Dave Swalm Chair in Urologic Oncology in the Scott Department of Urology at Baylor College of Medicine. He is also Director of Urologic Oncology and the Multidisciplinary Bladder Cancer Program and Faculty Group Practice Medical Director for the Urology Clinic at Baylor. He earned his medical degree from Baylor College of Medicine, completed a surgical internship at Virginia Mason Hospital in Seattle, and returned to Baylor for his residency training. He completed a two-year fellowship at the University of Southern California in Urologic Oncology and Reconstructive Surgery under Peter Jones and Don Skinner before returning to join the full-time Baylor faculty in 1992. His clinical practice, education, and research activities are devoted to urologic oncology, particularly lower and upper tract urothelial cancer. Dr. Lerner is an author on over 190 peer-reviewed articles, and co-editor of the comprehensive Textbook of Bladder Cancer. He is the founding Co-Editor-in-Chief of the Bladder Cancer journal. He established and directs the multi-disciplinary Bladder Cancer Research Program at Baylor, and his research interests include the use of selective estrogen receptor modulators for the treatment of bladder cancer, gene therapy, integrated genomic analysis of bladder and upper urinary tract cancers, and outcomes of radical cystectomy and pelvic lymphadenectomy. He has 25 years of experience as a clinical investigator for both NCI and industry-funded clinical trials. He is the PI of the ongoing SWOG NCI Phase III trial comparing extended vs. standard pelvic lymphadenectomy at the time of radical cystectomy. He is Chair of the Local Bladder Cancer Committee of SWOG, founding and former Co-Chair of the NCI Bladder Cancer Task Force and current Co-Chair of the NCI CTEP Genitourinary Steering Committee, and he has co-chaired the Analysis Working Group of The Cancer Genome Atlas Project for muscle-invasive bladder cancer for the past decade. He is very active in the Bladder Cancer Advocacy Network (BCAN) as a member of the Board of Directors, and is Past Chair of the Bladder Cancer Think Tank and Co-Chair of the Management Committee of the Bladder Cancer Research Network. Dr. Lerner is an active member of the prestigious American Association of Genitourinary Surgeons and is listed routinely among “America’s Top Doctors” and “Best Doctors in America.”
