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    How will immunotherapy change the future of bladder Ca care?

     


    Dr. Corman“Urologists have become more comfortable with the concept of immunotherapy for urologic cancers in the past decade. If you really think about it, urology’s experience with immunotherapy predates prostate cancer by more than 2 decades.

    First, we actually use immunotherapy for bladder cancer every day—BCG treatments. Even though we may not think of it as that, that’s exactly what BCG is. Going back even further in time, we’re also experienced with immunotherapy for advanced renal cell carcinoma, using interleukin-2. So the concept of immune therapy isn’t really foreign for urologists.

    Now there are some relatively new immune agents for advanced bladder cancer that is refractory to chemotherapy. Promising studies indicate that select patients may see benefits to immune stimulation. There are also bladder cancer vaccines that can take the form of a true vaccine.

    So urologists are becoming more accustomed to the idea of giving therapy before surgery or radiation to make those treatments more effective. We’re more accepting that chemotherapy before removing the bladder can make those surgical outcomes better.

    Agents recently FDA approved for immunotherapy for bladder cancer show that patients who had minimal recourse after failing chemotherapy now have additional options available. These add to our armamentarium, and urologists want to be involved in this. We know this disease, we treat this disease, and these are agents that can be given by urologists in the right setup.

    With our history of immunotherapy for prostate cancer, this is not asking people to reach far outside of their comfort zone.

    Currently, immunotherapy has its biggest bang in early disease to prevent progression, but so many options are available for early-stage patients, more resources may actually get dedicated to advanced bladder cancer because those patients have fewer options. A recent drug out of MD Anderson that was FDA approved saw 20% of the patients have a partial or complete response. For people who are end stage that’s pretty remarkable.”

     

    John Corman, MD

    Seattle


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    Karen Nash
    Karen Nash is a medical reporter and media consultant based in Monroeville, PA.

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