Sarah Psutka, MD, MSc, recaps SUO 2024 session on NMIBC management

In this video, Sarah P. Psutka, MD, MSc, recaps a session from the Society of Urologic Oncology 25^th Annual Meeting on the growing complexity of decision-making in non–muscle-invasive bladder cancer (NMIBC). Psutka is an associate professor of urology at the University of Washington and Fred Hutchinson Cancer Center.

Video Transcript:

The panel was a super interesting conversation around how complex the management of bladder cancer is in 2024. Dr. Kamat led the panel, and it was really a great experience to be a part of it. I think the key points are, for folks with non–muscle-invasive bladder cancer, decision-making, all of a sudden, has become much more complex, largely because one I would say, we understand the space more, and we understand the nuances and the heterogeneity within that space. There was a great conversation Dr. Porten gave on the nuances and the heterogeneity within intermediate-risk disease. So, we had a case on a patient who has intermediate-risk bladder cancer. I think Dr. Kamat's questions really did a nice job of drawing out the tensions and the trade-offs that patients face in terms of trying to weigh treatment burden, toxicity of therapy. We didn't really get into concepts such as financial toxicity in great detail, but that's obviously something that our patients have to navigate.

We talked about the pressures and the priorities to preserve the bladder, but at what point you actually call it, and say "No, at this point the correct move is actually to move towards radical cystectomy." How do you decide when that's the right time for the patient? Dr. Efstathiou and Dr. Hahn got into some of the complexities of integrating systemic therapy into the management of non-muscle-invasive disease that progresses and what's the role for radiation as part of our armamentarium in non-muscle-invasive disease. I would say the vast majority of the field strongly believes in the role for TMT in appropriately selected patients with muscle-invasive disease. But there is some interesting data that he highlighted supporting considering introducing radiation in the paradigm to manage, especially, I would say, what we call very high-risk non–muscle-invasive disease. So, it was interesting.

The whole day, the whole bladder cancer course, was just exceptional. If anybody didn't have a chance to participate or be there, I believe the videos will be online through the SUO. There was a wonderful breadth of discussion of some of the key questions that exist within management of bladder cancer right now. Dr. Jackie Brown gave a great talk on perioperative systemic therapy and all of the different strategies that are being investigated in that space. There was a lot of, really, I would say, nuanced conversation around this whole idea of how we're moving towards a world in which we might be considering not definitively taking out the bladder for localized disease. What are going to be the prerequisites that we have to achieve and achieve for our patients before we can safely consider that a viable strategy? And then, of course, all the great work that's being done in the changing paradigm for metastatic disease. So, it was a really excellent day.

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