Bladder Cancer   

Questions discussed in this category



If any clinical benefit (ie. CR, PR or SD) would you consider switch maintenance avelumab, surveillance until progression, or an alternate regimen?

Molecular profiling revealed no targetable alterations, however tumor mutational burden was >10 mut/Mb.

The recommended concurrent chemotherapy regimens (cisplatin/paclitaxel and cisplatin/FU) in NCCN are based on BID fractionation of radiation as in RTO...

How would non-regional adenopathy change management? What about poor surgical candidacy?

Would radical prostatectomy and PLND suffice or would a cystectomy be warranted (even in the absence of bladder involvement) as well? 

If no direct invasion into prostate from bladder or urethra, is there any role for systemic therapy?

Given long term data from Keynote 052 for pembrolizumab presented at ASCO 2021. What factors impact your treatment decisions? For cis-ineligible PD-...

What would your treatment approach be- surgery or chemoRT? What is your preferred chemo regimen? Is there a % threshold other than 100% (e.g. 95%) th...

Specifically, for cT2N0M0 small cell bladder cancer without response to neoadjuvant cisplatin and etoposide on imaging, would you proceed with cystect...

Is there a role for neoadjuvant cisplatin-based chemotherapy? Do patients with sarcomatoid histology respond to checkpoint inhibitors?

No actionable mutation on NGS testing. What approved therapy do you prefer? Are there specific investigational agents currently in clinical trial...

Do you prefer surgery vs radiation? For surgical patients, do you offer neoadjuvant chemotherapy? If so what regimen? 

Would you forego neoadjuvant chemotherapy? Are you using growth factor support differently? Any changes to immunotherapy? Other considerations?

Would you treat with chemoimmunotherapy based on IMvigor130 data presented at ESMO Congress 2019?

e.g. lymph node metastasis, presence of tumor involving the peritoneal surfaces and/or the abdominal wall. If so, which regimen would you offer?

Patient has small cell carcinoma of the bladder with extensive hepatic metastases. Would you extrapolate the approach from IMpower133?

There are now five PD-1/PDL-1 inhibitors approved for metastatic bladder CA, one (Atezolizumab) as first-line therapy in cisplatin-ineligible patients...

What systemic therapy do you use? Do you incorporate any multi-modality therapies?

The current treatment for bladder adenoCA is surgery. However in non-surgical candidates, RT is an option. Would you consider adding chemo ? Also woul...

Would you offer it for positive margins? NCCN says to consider adjuvant radiation for pT3-T4 or pN0-2. Is there sufficient evidence for adjuvant radia...

If so, is there a role for IMRT?  I was taught to use the RTOG style ports with whole pelvis 4 field box and then boost field to entire bladder ...

For a patient with a history of non-muscle invasive disease in the bladder, presenting with a prostatic urethra only recurrence, do you approach this ...

In the IMvigor 210 trial, increased PD-L1 expression in patients’ tumors was associated with response to atezolizumab, but some patients whose t...

Since the benefit of neoadjuvant chemotherapy is well-defined in muscle-invasive bladder cancer, is it reasonable to consider this in upper-tract tumo...

I've heard justification for treating the whole bladder to 60-64 Gy based on the UK MRC study (James et al. NEJM 2012 and Huddart et al. IJROBP 2013) ...

Realistically, there will always be some (hopefully small) inconsistency with bladder filling, and thus some small bowel could easily receive &ge...

Assuming a patient who could tolerate either, which is preferred? Does this depend on the choice for concurrent chemotherapy (5FU+mitomycin vs ci...

Specifically, for high grade T1 bladder cancer, is there evidence that definitive radiation yields similar control rates compared to cystectomy?

In the definitive setting, and would that change if cystecomy was planned if there was a complete response after CRT?  (similar to TCC paradigm).


Papers discussed in this category


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Lancet Oncol, 2021 May 26

N Engl J Med, 2020 Sep 18

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Cancer, 2020 Nov 20

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Clinical genitourinary cancer, 2016-02

Cancer, 2019-05-01

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