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 May 2021. 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. 


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.