Bladder Cancer

In a recent survey, individuals in remission reported a more positive experience with bladder cancer compared with their counterparts who currently have active disease.

While universal screening for Lynch syndrome is currently only recommended for patients with colorectal and endometrial cancers, a new study recently published in The American Journal of Surgical Pathology suggests this for patients with upper tract urothelial carcinoma, too.

Can providers decrease opioid prescriptions after surgery, while still managing care adequately?

Immunotherapy has been a buzzworthy topic in the field of bladder cancer over the last couple of years. However, according to a Food and Drug Administration (FDA) safety warning, patients with metastatic disease may need to have their treatment altered.

Immunotherapy pioneers James P. Allison and Dr. Tasuku Honjo have won the 2018 Nobel Prize in Physiology or Medicine for their research that eventually led to the use of immune checkpoint inhibitors to treat cancer.

Researchers determined that the use of methotrexate, vinblastine, doxorubicin and cisplatin before cystectomy may induce better outcomes for patients with advanced bladder cancer.

A new test that identifies which bladder cancer tumors will become invasive could help reduce health care costs and over-treatment in patients.

Stromal cells – known to provide structure to one’s organs – found in bladder cancer may explain why some patients do not respond to Opdivo (nivolumab) treatment.

Some patients eligible for bladder surgery due to cancer may safely opt to preserve the organ.

After chemotherapy, immunotherapy has become the standard treatment for bladder cancer. Will it ever play a bigger role?

While there is currently no definitive way to predict who will respond and who will not, researchers at Brighton and Sussex Medical School in the United Kingdom are working on a blood test that could identify about half of those who may not.

CURE spoke with Matthew Mossanen, M.D., from the Division of Urology at Brigham and Women’s Hospital, about what Bacillus Calmette-Guérin (BCG) is and what patients should know about this treatment option.

The Food and Drug Administration (FDA) updated the prescribing information for two immunotherapy agents – Keytruda (pembrolizumab) and Tecentriq (atezolizumab) – approved to treat patients with locally advanced or metastatic bladder cancer who are not eligible for cisplatin-based therapy.

With five immunotherapy drugs approved in the bladder cancer space, the next question researchers find themselves asking is whether these drugs would work better alone or as part of a combination for patients with metastatic disease.

Creating a medical family tree is helpful. If cancer is common, noting which branches include it can help inform decisions.

Women are more likely to die from bladder cancer earlier on after diagnosis, according to recent study findings published in the European Journal of Cancer. However, after that time frame the risk of death is higher for men.

Many questions still remain in the treatment of localized bladder cancer, like which patients are best suited to receive neoadjuvant (pre-surgery) chemotherapy – a procedure that could be beneficial to many, but comes with increased toxicity.

Because little is known about the effect of patients' sex on the efficacy of immune checkpoint inhibitors as cancer treatments, the researchers performed a systematic review and meta-analysis to determine the heterogeneity of immune checkpoint inhibitor efficacy between men and women.

Immunotherapy is being tested in the second-line setting for metastatic bladder cancer. Pending trial results, the role of chemotherapy for this patient population may change.

Phase 2 study results showed that patients with metastatic or unresectable, FGFR-positive bladder cancer may have a third-line option for treatment.

The FDA has incorporated PD-L1 status into the labels for Keytruda (pembrolizumab) and Tecentriq (atezolizumab) for existing frontline approvals for platinum-ineligible patients with urothelial carcinoma, based on lower overall survival (OS) rates with the PD-1/PD-L1 inhibitors compared with platinum-based chemotherapy for patients with PD-L1–low expressing platinum-eligible urothelial carcinoma.

Oncolytic, or engineered, viruses that infect and kill cancer cells are showing promise.

Enfortumab vedotin may be a potential novel therapy for patients with locally advanced or metastatic urothelial cancer, according to updated phase 1 study findings presented during the 2018 American Society of Clinical Oncology (ASCO) Annual Meeting.

PD-1 and PD-L1 inhibitors are generally well-tolerated, so most patients face little or no issues with the drugs. However, there are still some things to look out for.

Patients with non-muscle invasive bladder cancer experience high levels of distress, according to one study.

Immunotherapy is making landmark change in the treatment of patients with genitourinary (GU) cancers, with bladder cancer being the pioneer in the field, having five FDA-approved checkpoint inhibitors. But kidney cancer is not far behind, with a breakthrough therapy designation granted for a Keytruda (pembrolizumab) combination this past January.

The combination use of Cyramza (ramucirumab) plus docetaxel showed improvements in objective response rate (ORR) and a positive trend in overall survival (OS) among patients with advanced bladder cancer, according to additional results from the phase 3 RANGE trial.

In particular, patients whose tumors have certain genetic mutations may respond especially well to this combination approach.

While there are a few common and well-known checkpoints for bladder cancer, there are also many more than PD-1, PD-L1 and CTLA-4.

Chemotherapy can aid in making a tumor “hot” – meaning that it attracts tumor-infiltrating lymphocytes (TILs), which are linked to killing tumor cells – priming it to respond better to immunotherapy treatment.