Session 1:
Next Generation Developments in Bladder Cancer

2018 Consensus Statements

  1. We need to develop a consensus on standard testing for immunotherapy and molecular therapy testing to facilitate eligibility for immuno-oncology and molecular therapy.
  2. Identifying predictive PD-1/PD-L1 expression markers for patients with metastatic and possibly non-metastatic disease is necessary.
  3. We should incorporate molecular diagnostics into the risk stratification of bladder cancer.
  4. Improving the diagnostic accuracy, evaluation, and risk stratification of noninvasive bladder cancers by better determining tissue, radiographic, and molecular predictors of disease risk needs to be emphasized.
  5. We should more clearly risk-stratify T1 tumors to assist clinicians in clinical management and to identify those patients eligible for future clinical trials.
  6. In patients with T2-4 urothelial carcinoma (UCC), the risk/benefit of T0 after transurethral resection (TUR) prior to and following neoadjuvant chemotherapy (NAC) should be further explored.
  7. The beneficial impact of systemic immunotherapy or combination therapy for high-risk noninvasive bladder cancers needs to be studied.

5-Year Predictions:

  1. Transurethral resection of bladder tumor (TURBT) will be done in the same way.
  2. No consensus urine marker will exist yet.
  3. Molecular profiling of invasive and non-invasive tumors will be more commonplace and will help determine therapeutic choices.
  4. Bladder sparing multimodality will become more commonly chosen for invasive disease.

Session Moderators

Sam S. Chang, MD, MBA

Vanderbilt University
Nashville, TN

Michael S. Cookson, MD

University of Oklahoma
Oklahoma City, OK

ABOUT THE AUTHOR

Sam S. Chang, MD, MBA

Dr. Chang is the Patricia and Rodes Hart Endowed Professor of Urologic Surgery and Oncology and the Oncology Fellowship Director and Vice Chair of Urologic Surgery at Vanderbilt University Medical Center in Nashville, Tennessee. He is a graduate of Princeton University and Vanderbilt University Medical School (where he earned a full 4-year Justin Potter Scholarship) and he completed his Uro-Oncology Fellowship as Chief Fellow at Memorial Sloan-Kettering Cancer Center. He also completed his MBA at Vanderbilt’s Owen School of Business.

Since his return to Nashville, Dr. Chang has focused on urologic oncology and education and has led efforts in the integration of evidence-based medicine in clinical pathways, enhanced national guidelines formulation, and improved urologic cancer staging. He has orchestrated the initiation and expansion of multiple cancer-related treatment protocols at Vanderbilt and elsewhere.

Dr. Chang has served as the Chairman of the SUO Panel on Hormone Refractory Prostate Cancer, the Chair of the American Joint Committee on Cancer GU Staging Task Force, the Chair of the AUA/SUO Guidelines on Noninvasive Bladder Cancer, the Facilitator and Vice-Chair of the Renal Malignancy Follow-Up AUA Guidelines Panel, the Chair of the AUA/ASCO/ASTRO/SUO Guidelines Panel on Non-Metastatic Invasive Bladder Cancer, and the Chairman of the AUA Prostate Cancer Core Curriculum Committee. He is a former member of the NCCN Kidney Cancer Panel. In addition, he was an AUA-EAU Academic Exchange Fellow.

Dr. Chang has authored more than 250 original publications, multiple book chapters and edited several textbooks. For his academic efforts, he received the SUO’s first-ever Distinguished Service Award, a CaP CURE Young Investigator Award, and has been named multiple times as a Journal of Urology’s Best Reviewer.

Dr. Chang was named as the 2011 recipient of the American Urologic Association Gold Cystoscope Award and completed a term as a nominated Fellow of the Nashville Health Care Council in 2016.