Jennifer M. Taylor, MD, MPH, presented “Immunotherapy for NMIBC: Emerging and Expanding Indications” virtually during the Innovations in Urologic Practice 2020 virtual conference in September 2020.
How to cite: Taylor, Jennifer M. “Immunotherapy for NMIBC: Emerging and Expanding Indications” September 26th, 2020. Accessed Dec 2024. https://dev.grandroundsinurology.com/immunotherapy-for-nmibc-emerging-and-expanding-indications/
Immunotherapy for NMIBC: Emerging and Expanding Indications – Summary:
Jennifer M. Taylor, MD, MPH, Assistant Professor of Urology at Baylor College of Medicine in Houston, Texas, reviews new indications for immunotherapy for non-muscle invasive bladder cancer (NMIBC). She discusses the most common immunotherapy option, presents active clinical trials, and evaluates new treatment options. AUA guidance has previously stated that immunotherapy should be reserved for highest-risk NMIBC, and that for lower-risk cancer, patients and clinicians should weigh the benefit ratio when considering whether immunotherapy is an appropriate treatment choice given the possibility of adverse events. However, a shortage of the most common intravesical immunotherapy, bacillus Calmette-Guerin (BCG), in combination with increased numbers of BCG-unresponsive patients, have altered the treatment landscape. Dr. Taylor reviews the 2018 definition of BCG-unresponsive NMIBC and identifies several ways to determine whether a patient is BCG-unresponsive. Finally, she discusses the approval of pembrolizumab as a newly-available treatment for BCG-unresponsive NMIBC. In the study that led to the approval, 41% of patients had a complete response and no patients progressed to muscle invasive bladder cancer or metastasis. These favorable results are notable given that the gold-standard alternative is radical cystectomy. Additionally, pembrolizumab is well-tolerated and while adverse immune-related events are serious, they are rare and can be managed. Other treatments are also currently under investigation.
About the Innovations in Urologic Practice 2020 virtual conference:
Presented by co-chairs Mohit Khera, MD, MBA, MPH, and Michael Coburn, MD, FACS, the Innovations in Urologic Practice conference provides a detailed review and commentary on multiple genitourinary and urologic diseases. Among the featured oncological topics are bladder cancer and immunotherapies, as well as upper tract cancer management, prostate cancer, including state-of-the-art imaging, focal therapy, and MRI. Experts also discuss new tools and techniques for nephrectomy and treating advanced renal cell carcinoma. In terms of general urological approaches, the conference also includes pelvic reconstruction and trauma, men’s health topics like male infertility and sexual dysfunction, and ways to diagnose and treat infections in the urology patient. Dr. Taylor presented this talk virtually at this year’s conference.
ABOUT THE AUTHOR
Dr. Taylor is an Assistant Professor of Urology at Baylor College of Medicine in Houston, Texas. She serves as the Associate Residency Program Director and Director of Preclinical and Clinical Urology Courses for medical students. She is a member of the Dan L. Duncan Comprehensive Cancer Center at Baylor and the Cancer Committee at the Michael E. DeBakey VA Medical Center. She currently practices urologic oncology at Baylor College of Medicine and the Michael E. DeBakey VA Medical Center. Dr. Taylor received her undergraduate education from Barnard College in New York City. She went on to earn her MD from the University of Texas Medical School in Houston, and completed a fellowship in urologic oncology at Memorial Sloan Kettering Cancer Center in New York City. She also earned an MPH from the Harvard TH Chan School of Public Health in Boston. Dr. Taylor is involved in clinical research in multiple GU malignancies, with a focus on bladder cancer, as well as research in medical education. Dr. Taylor is involved in the national medical community and is a member of the American Urological Association, the Society of Urologic Oncology, the Society of Women in Urology, and the American College of Surgeons.
