Jason Hafron, MD, on the importance of patient selection in the new era of bladder cancer treatment

In this video, Jason Hafron, MD, discusses the recent growth of new agents in bladder cancer and the importance of understanding when and in whom to use these therapies. Hafron is the chief medical officer and medical director of clinical research of Michigan Institute of Urology.

Video Transcript:

Could you discuss the recent growth in the bladder cancer space?

Bladder cancer is exploding. I mean, bladder cancer is exciting, but it's changing, and we're just at the start of this. We are going to see a tsunami of new treatments, new indications. It's very exciting. It's also going to require a lot of education and understanding of how to apply these therapies. With that being said, we've seen 2 recent approvals in the CIS refractory space, in patients who are cystectomy ineligible who received adequate BCG. We have 2 great intravesical agents that have been recently being approved and are being used in a lot of our LUGPA practices.

You mentioned that one of the challenges might be knowing when to use these agents, or maybe how to sequence them. Could you expand on that?

These agents are very expensive, and these agents have been studied in very specific patient populations. What we as urologists have to learn about is exactly what these indications are. I think the key is that these are for CIS refractory disease, plus or minus papillary disease. That's the pathological requirement. Then they've also had to [have] received adequate BCG therapy. They've had to receive at least 5 out of 6 induction therapies and 2 out of 3 maintenance therapies for 2 out of 6 inductions. There is definitely some nomenclature and some wonkiness to this to figure out who qualifies for these treatments. But it's very important that we understand this, because these were the patients that were studied, and in the real world, this is what the payers are going to be asking for. Overall, all of this, the pathology, as well as the BCG requirements, these are patients that refuse cystectomy or are medically ineligible to get a cystectomy. It's a little wordy. It's a little tedious to find these patients, but it's really critical. Otherwise, you're not going to get reimbursed for these therapies.

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