Bladder cancer is the sixth most common cancer in the United States and ninth most common worldwide. While the FDA approved the Bacillus Calmette-Guérin (BCG) cancer vaccine in 1990 for the treatment of superficial, non-invasive bladder cancer, oncologists today are excited about a new class of immunotherapies called immune checkpoint inhibitors. New immunotherapies have significantly reduced the risk of recurrence for bladder cancer while also increasing the percentage of patients who see a complete response post-surgery. Dr. Matthew Galsky, of The Tisch Cancer Institute, discusses the potential to further improve outcomes for patients with this disease and answers questions from the audience. We will discuss how oncologists predict patient response to immunotherapies, common mutations in bladder cancer, length of treatment, and other topics. Don’t forget to submit your questions to Dr. Galsky.

Vidit Sharma, MD, MS, Mayo Clinic, Rochester, MN, discusses the financial impact of bladder cancer and the impact of cost on the quality of life of a patient. The cost of bladder tends to be disease-related, including disease stage, complications and surveillance, whereas toxicity may be related to the patients personal circumstances including income, employment and age. This interview took place at the ASCO GU Cancers Symposium 2023 in San Francisco, CA.

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Strategies to address the impact of bladder cancer treatments on sexuality with University of Arizona Comprehensive Cancer Center in Tucson medical oncologist Alejandro Recio-Boiles, MD.

Co-Chairs, Petros Grivas, MD, PhD, and Neal D. Shore, MD, FACS, discuss bladder cancer in this CME/MOC activity titled “Personalizing Bladder Cancer Care in the Modern Therapeutic Era: One Size No Longer Fits All.” For the full presentation, downloadable Practice Aids, slides, and complete CME/MOC information, and to apply for credit, please visit us at PeerView.com/YEM865. CME/MOC credit will be available until December 29, 2023.

Our UROONC BCa chief editor Dr. Benjamin Pradere had a great discussion with Prof. Paolo Gontero on the new treatment of non-muscle-invasive bladder cancer. They talked about what's new in the field of immunotherapy in NMIBC, the different approaches of FDA and EMA on new drugs and more.

Drs. Eila Skinner and Yair Lotan discuss the recurrence of non-muscle invasive bladder cancer.

Sophia Kamran, MD, Massachusetts General Hospital, Boston, MA, discusses bladder-sparing trimodality therapy (TMT) as an effective treatment for muscle-invasive bladder cancer (MIBC). Dr Kamran highlights combining immunotherapy (IO) with TMT, specifically with radiation therapy whereby data has demonstrated synergy which may improve clinical outcomes such as survival data. Multiple trials, including the Phase III SWOG/NRG 1806 (NCT03775265) study investigating the addition of atezolizumab to the standard of care (SOC) TMT therapy, will provide an abundance of data to aid in the understanding of how IO will improve upon outcomes for MIBC. Hypofractionated radiation therapy may provide the means to shorten the duration of treatment with radiation, however, early data indicates increased toxicities when combined with IO. Additional information is required to decipher which patients demonstrate these increased toxicities. Adaptive radiation therapy may provide the solution to supplying hypofractioanted radiation therapy in combination with IO. This interview took place at the American Society of Clinical Oncology (ASCO) Genitourinary Cancers Symposium 2022 in San Francisco, CA.

Sia Daneshmand, MD, Associate Professor of Urology and Director of Clinical Research at the University of Southern California, describes the current landscape of muscle invasive bladder cancer treatment, highlighting developments in radical cystectomy and chemotherapy. He observes that while radical cystectomy has long been the gold standard, efforts are being made to preserve reproductive organs in female patients who have low-stage disease. Dr. Daneshmand also notes the significant number of neoadjuvant chemotherapy phase II trials currently underway. While studies examining adjuvant chemotherapy have shown promise, the limitations of these trials necessitate further research. Similarly, research comparing super-extended lymph node dissection (LND) with extended LND have yielded insignificant p-values, but absolute numbers demonstrate a positive upward survival trend over 5 years. Dr. Daneshmand concludes that additional clinical trials will reveal the optimal combination and sequencing of treatment options.

We stand and advocate to embrace equity for women affected by bladder cancer around the world.

Although bladder cancer is often considered a disease of men of older age, bladder cancer also affects women. Around 1 in 4 cases of bladder cancer will be diagnosed in women with over 130,000 women diagnosed with bladder cancer every year.

Krysta (Canada) was diagnosed in 2022 at the age of 37 and shares her bladder cancer journey with us.

Raising awareness and moving the conversation forward to address the bias women face will allow female bladder cancer patients to receive better care and create a positive change for all!