What would be your preferred treatment strategy for patients with NMIBC whose disease progresses after BCG plus durvalumab?
Will you continue with other intravesical therapies? Would there still be a future role for pembrolizumab for BCG-refractory disease in patients wishing to avoid radical cystectomy?
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For a patient with high-risk NMIBC who progresses after BCG plus durvalumab, what would be your generally preferred next step?
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2 Answers
Mednet MemberInvited Expert
Urology · University of Washington School of Medicine
Answered on
Pembrolizumab is little used in real-world practice in 2026. The response rates were lower than those of other more recently available therapies for BCG-unresponsive high-risk CIS, and the risk/benefit tradeoff is less favorable than other newly available treatments. Most urologists would treat pati...
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Mednet Member
Urology · Penn State Health
Answered on
Radical cystectomy remains my preferred treatment for patients whose disease progresses after BCG plus durvalumab. I also think the CISTO study is helpful when counseling these patients, as the prospective quality-of-life data are reassuring and help put some of the concerns around cystectomy into p...
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