PT0 after NAC: Implications for Bladder Sparing and Prognosis

Posted by Leonard G. Gomella, MD, FACS | Jul 2019

Leonard G. Gomella, MD, presented “PT0 after NAC: Implications for Bladder Sparing and Prognosis” during the 3rd Annual International Bladder Cancer Update on January 23, 2019 in Beaver Creek, Colorado.

How to cite: Gomella, Leonard G. “PT0 after NAC: Implications for Bladder Sparing and Prognosis” January 23, 2019. Accessed Apr 2024. https://dev.grandroundsinurology.com/pt0-after-nac-implications-for-bladder-sparing-and-prognosis/

PT0 after NAC: Implications for Bladder Sparing and Prognosis

Leonard G. Gomella, MD, FACS, reviews treatment options for patients with bladder cancer, including new research that could lead to bladder sparing.

Summary:

Leonard G. Gomella, MD, FACS, reviews research about neoadjuvant chemotherapy and radical cystectomy for patients with muscle-invasive bladder cancer (MIBC). Traditional bladder preservation protocol combines a maximum transurethral resection of bladder tumor (TURBT) with induction chemotherapy and radiation.

Dr. Gomella explains that as bladder cancer advances, survival rates decrease in patients treated with radical cystectomy for urothelial carcinoma.

Further research into dose-dense methotrexate, vinblastine, adriamycin, and cisplatin (MVAC) regimens attempts to provide options for treating advanced bladder cancer. Then, Dr. Gomella explores the possibility of bladder preservation with potential new treatment options.

Dr. Gomella presents the rationale for NAC and addresses possible reasons for the underutilization of NAC. He also introduces the new dose-dense or accelerated bladder cancer protocols, focusing mainly on data collected by the Columbia study.

Additionally, he summarizes ongoing research about the newer concepts of immuno-oncology and molecular biomarkers, specifically the ABACUS and PURE-01 trials. Lastly, he gives future predictions on the role NAC will play in helping physicians manage MIBC in their patients.

About the International Bladder Cancer Update

The International Bladder Cancer Update (IBCU) is an annual one-day CME conference focused on bladder cancer treatment updates. IBCU takes place during its sister conference, the International Prostate Cancer Update (IPCU). The conference’s faculty consists of international experts, and the event caters to urologists, urologic oncologists, and other healthcare professionals. In addition to didactic lectures, IBCU features interactive discussions, a panel roundtable, debates, and case presentations. Dr. Gomella presented this lecture during the 3rd IBCU in 2019. Please visit this page in order to learn more about future IBCU meetings.

About The Author

Leonard G. Gomella, MD, FACS

Leonard Gomella, MD, FACS, is the Bernard W. Godwin, Jr., Professor of Prostate Cancer and Chairman of the Department of Urology at the Sidney Kimmel Medical College of Thomas Jefferson University. He joined the Jefferson faculty in 1988 and was appointed Chair in 2002. He serves as Senior Director for Clinical Affairs for the NCI-designated Sidney Kimmel Cancer Center, Clinical Director of the SKCC Network, and Urology Chair for NRG (RTOG). Dr. Gomella is involved in translational basic science and clinical research in the development of new diagnostic techniques and treatments for prostate and bladder cancer through the Sidney Kimmel Cancer Center as Co-Leader of the Biology of Prostate Cancer Program. In 1992, he led the team that first used molecular techniques to detect circulating tumor cells in prostate cancer. He has given over 500 presentations, written over 400 papers, and edited dozens of chapters and monographs in the field of urology. Dr. Gomella has authored and edited many editions of a number of books for medical students, residents, and practicing physicians, including the “Clinician’s Pocket Reference” (aka “The Scut Monkey Book”) and “Five Minute Urology Consult.” He is also Editor-in-Chief of the Canadian Journal of Urology. “Recovering from Prostate Cancer,” which Dr. Gomella wrote in 1993, was the first book released for the general public specifically on the topic of prostate cancer. “Best Doctors in America,” “Top Doctors for Cancer,” and Philadelphia Magazine’s “Top Doctors” have recognized him for many years for his contributions to urologic oncology and prostate cancer care. He also received national recognition in Newsweek in 2015. In 2007, Men’s Health listed Dr. Gomella as one of the 20 top urologists in the US. He has received numerous awards, including the American Cancer Society’s “Volunteer Achievement Award” and an “NCI Achievement Award.” He has been President of the Mid-Atlantic Section of the AUA and has been elected to the American Association of Genitourinary Surgeons and the prestigious Clinical Society of Genitourinary Surgeons. The University of Kentucky College of Medicine awarded him a “Distinguished Alumnus Award” in 2009. From 2015-2017, he was President of the Society of Urologic Oncology. In 2015, he received a “Distinguished Contribution Award” from the AUA and Jefferson honored him with the “Jefferson Achievement Award in Medicine.”

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