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Overview of BCG-Unresponsive Bladder Cancer Treatments Landscape

Opinion
Video

Discussion on current and future treatments for BCG-unresponsive HR NMIBC presented at ESMO 2023.

This is a video synopsis/summary of a panel discussion involving Sia Daneshmand, MD.

Daneshmand discusses treatment options for BCG-unresponsive non–muscle invasive bladder cancer. Though radical cystectomy cures most patients, it has high morbidity/mortality risks, especially in elderly patients. Alternatives are needed.

If a clinical trial is unavailable or unwanted, options include doublet chemotherapy with gemcitabine plus docetaxel chemotherapy or pembrolizumab immunotherapy. Retrospective data shows 50% 2-year recurrence-free survival with gemcitabine/docetaxel. Pembrolizumab has 25% to 40% response rates.

Valrubicin, the first FDA-approved drug in this setting, has a poor 10% to 15% 1-year recurrence-free survival. More recent options include nadofaragene firadenovec. the first intravesical gene therapy (once every 3 months) with 25% to 40% 1-year recurrence-free survival.

Daneshmand notes clinical trials remain the preferred option, but new FDA-approved treatments provide alternatives for BCG-unresponsive patients. He is excited about the increasing options for this patient population.

Video synopsis is AI-generated and reviewed by AJMCÒ editorial staff.

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