How do you counsel patients with high-risk NMIBC about the risk of systemic immune-related adverse events when adding durvalumab to BCG?

What elements are part of your approach to counseling on IRAE risk when adding durvalumab to BCG in high risk NMIBC?

• I apply the same irAE counseling framework I use for checkpoint inhibitors in other settings
• I lead with the DFS benefit and frame irAEs as a manageable trade-off
• I present irAE risks as a central factor in shared decision-making, particularly given immature OS data
• I tailor discussion of irAE risks more based on patient-specific risk factors (age, frailty, medical history)
• irAE counseling is a shared conversation between urology and medical oncology
• irAE counseling is handled primarily by medical oncology
• irAE counseling is handled primarily by urology
• Not applicable - I am not yet incorporating durvalumab in my treatment of high risk NMIBC
• Other