Opinion
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Author(s):
"There's just a lot of active trials being studied, and hopefully, in the next 5 or 10 years, we'll see another handful of agents get approved and really start to make some headway in [NMIBC]," says Alexander I. Sankin, MD.
In this video, Alexander I. Sankin, MD, and Ahmed A. Aboumohamed, MD, discuss recent advances in urologic cancer treatment. Sankin is an associate professor of urologic oncology at Montefiore Medical Center/Albert Einstein School of Medicine, Bronx, New York, and Aboumohamed is a professor of urologic oncology at Montefiore Medical Center/Albert Einstein School of Medicine.
Sankin: For the last few decades really, there have not been many advances, especially in non–muscle invasive bladder cancer. BCG was the standard of care, which is an immunotherapy given into the bladder to prevent recurrence and progression. Beyond that, there were a couple of different chemotherapy options, but nothing really worked better than BCG. The question is, what do you do for patients who fail BCG, who don't want to have their bladder out? There have been a couple of FDA approvals. In the last handful of years, there was the approval of a checkpoint inhibitor called Keytruda [pembrolizumab] for this disease, as well as an intravesical immunotherapy called Adstiladrin [nadofaragene firadenovec]. That's certainly coming to market now and patients are starting to get those. But more importantly, there are a lot of different clinical trials in the pipeline looking at these immunotherapies, in combination with chemotherapy or in combination with other immunotherapies. Antibody drug conjugates are very interesting right now, and they're being studied in this field as well. So really, there's just a lot of active trials being studied, and hopefully, in the next 5 or 10 years, we'll see another handful of agents get approved and really start to make some headway in this disease.
Aboumohamed: There are a lot of talks and research and publications coming out almost every week or every month about a potential association for certain microbiome generations, whether it's gut or urinary microbiome, and its potential impact on the risk of prostate cancer and risk of having aggressive prostate cancer and also whether it may correlate to treatment responses for prostate cancer. We're joining nationwide institutions in assessing this on a much deeper level. So far, it's all predominantly focusing on improving our understanding of the relationship and whether there is an association that we can then work on in the future, to try to improve outcomes, predict risk, and better manage those patients.
This transcription was edited for clarity.