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GU Cancers 2018 | Future therapy options for muscle-invasive bladder cancer

Treatment for muscle-invasive bladder cancer has evolved as medical knowledge has expanded. Jeanny Aragon-Ching, MD, FACP, from Inova Schar Cancer Institue, Falls Church, VA, explains how, previously, the single treatment for muscle-invasive bladder cancer was a radical cystectomy, where patients still did not have the best outcomes. She talks about the need to incorporate a multidisciplinary approach, including medical oncologists, surgeons and radiation oncologists, in order to reach the most suitable treatment choice. Dr Aragon-Ching stresses how finding the right biomarkers is necessary to deliver the best care. She highlights how immunotherapy treatments for muscle-invasive cancer are still experimental, yet are showing promising results. This interview was recorded at the Genitourinary Cancers Symposium 2018 in San Francisco, CA.

Transcript (edited for clarity)

I think this is a very exciting field now in muscle invasive bladder cancer. In the olden days, people used to treat this as a single modality treatment. Urologist typically would do a radical cystectomy however, we find that a lot of these patients unfortunately do not do well even in the hands of the best surgeons.

What is lacking is a multidisciplinary approach. I think that this the future wave of treatment for muscle invasive bladder cancer...

I think this is a very exciting field now in muscle invasive bladder cancer. In the olden days, people used to treat this as a single modality treatment. Urologist typically would do a radical cystectomy however, we find that a lot of these patients unfortunately do not do well even in the hands of the best surgeons.

What is lacking is a multidisciplinary approach. I think that this the future wave of treatment for muscle invasive bladder cancer. There is a lot of collaboration between medical oncologists, surgeons and radiation oncologists and the real thrust is is trying to find the right biomarker for the right patient. For instance in the general session I co-chaired, we emphasized on the use of molecular markers in order to stratify and predict patients who may do well or better with neoadjuvant chemotherapy or who would do better with combined chemoradiation. Certainly a lot of future studies also involve the use of immunotherapy. Immunotherapy, in the setting of muscle invasive bladder cancer, is still experimental but there are a lot of studies that are looking at it. It’s very promising and I think the future will hold immunotherapy in that multidisciplinary setting of muscle invasive bladder cancer.

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