Gautam Jayram, MD, on key trends in bladder, kidney cancer

In this video, Gautam Jayram, MD, recaps his presentation, “Five things urologists need to know now about bladder and kidney cancer in 2025,” which was presented at the 2024 LUGPA Annual Meeting in Chicago, Illinois. Jayram is a urologic oncologist and director of the Advanced Therapeutics Center in Nashville, Tennessee.

Video Transcript:

So much is happening. I tried to slow down and put focus on some things that were most important. We really talked a little bit about what's happening in intermediate-risk disease, being a lot of the attention has been in high-risk disease, but intermediate-risk disease, I think, is a more practical and a more popular disease state for a community urologist, because these are patients with lower grade disease. They come back fairly often. We're not really that threatened by them in terms of dying from their cancer, but it still is a big nuisance disease, and it's still a big quality of life issue. So, ultimately, there's so much happening with new drugs and new therapies coming in intermediate-risk disease, there's going to be a lot of questions of, well, do we really need to treat all of these patients now with all of this stuff? Because I haven't been treating any patients with this stuff. We tried to lay out a couple reasons why and who you should treat with intermediate-risk disease and what potentially those treatments could look like in the future.

We then talked a little bit about BCG unresponsive disease, which is a really hot topic. A lot of trials and a lot of data coming there. We outlined the 4 therapies that if we had to choose today for BCG-unresponsive carcinoma in situ, we outlined the 4 treatments that are available to urologists, the pros and cons of all of them.

I then talked a little bit about muscle-invasive disease, which is again aggressive disease, which usually requires major treatments. There have been a lot of advances in terms of new trials and new therapies that are coming out that potentially can change how we look at these patients—utilizing ctDNA as a marker for how to treat patients, how to prognosticate how patients do on treatment.

Then we moved to kidney cancer, and I think 2 really important things that urologists need to know is that adjuvant treatment for high-risk renal cell carcinoma is now here to stay. It's cemented by overall survival data that we haven't had with any of the other treatments. Patients who have a nephrectomy for high-risk renal cell [carcinoma] should get consideration of immunotherapy either if the urologist is giving it or a medical oncologist. But the bottom line is, they should be getting that.

And then the PET scan that is now emerging for clear cell kidney cancer, which is called girentuximab or CAIX, is really exciting. It's kind of paralleling what we're seeing with PSMA in terms of its expression, its uptake, and its really high sensitivity and specificity for kidney cancer. That's something we really need in this space, because our imaging for kidney cancer is okay, but it leaves a lot of questions, and it causes a lot of follow-up: procedures and visits to be done. I think a tool like this could really change how we're thinking about kidney cancer.

This transcript was AI generated and edited by human editors for clarity.