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Urologic Oncology With Christopher Wallis, MD, PhD, FRCSC

Urology

Dr. Wallis is a urologic oncologist at the University of Toronto and Mount Sinai Hospital/University Health Network. He completed his Society of Urologic Oncology-accredited fellowship training at Vanderbilt University Medical Center. His clinical work and research are focused on the care of patients with prostate, kidney, bladder, and testis cancer.

Updates in bladder cancer

Hello all,

Following an eventful spring with important data coming both from the AUA and the ASCO meetings, I wanted to take this opportunity to summarize some of the data I found most interesting. Over the next three emails, we’ll cover data ranging across the landscape of bladder cancer from BCG-unresponsive NMIBC through MIBC to metastatic disease.

In this first email, I want to highlight some exciting data (and a disappointment) in NMIBC as well as highlights from ASCO 2023 in the treatment of patients with MIBC. At the AUA, we saw the first data from SunRise-1 demonstrated the efficacy of TAR-200 as a novel treatment paradigm in bladder cancer. Many ongoing trials will assess its role across the disease trajectory. We saw some disappointing data regarding the promising combo of N-803 + BCG from the FDA but hopefully that’s only a temporary set back.

At ASCO, we saw two important phase III RCTs, SWOG S1011 and VESPER. Each of these has the potential to change my practice, perhaps yours as well.

Thanks for joining and hope these articles are of interest!

See you next time.
c

Articles
  • Mashup Score: 19
    Dr Daneschmand on Data From SunRISe-1 With TAR-200 and Cetrelimab in BCG-Unresponsive NMIBC - 2 year(s) ago

    Sia Daneshmand MD, professor of Urology, Keck School of Medicine, University of Southern California, discusses preliminary results from the phase 2 SunRISe-1 trial (NCT04640623) in patients with non–muscle invasive bladder cancer (NMIBC) unresponsive to Bacillus Calmette-Guérin (BCG).

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      walliscjd

      Exciting new data about TAR-200 as a novel approach for patients with BCG-unresponsive NMIBC

  • Mashup Score: 1
    FDA Declines N-803 Combo Approval in Non-Muscle Invasive Bladder Cancer - 2 year(s) ago

    The FDA requests additional data and a safety update regarding N-803 plus BCG as a treatment for patients with BCG-unresponsive non-muscle invasive bladder carcinoma.

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      walliscjd

      There's been lots of movement in BCG-unresponsive NMIBC recently. Some of the most promising looking data appeared to be N-803 with BCG. However, the BLA wasn't approved for reasons apart from the data. Hopefully, this will be addressed soon and give us a new option for our patients with BCG-unresponsive disease.

  • Mashup Score: 1
    S1011: No Extended Node Removal in Bladder Cancer | SWOG - 2 year(s) ago

    An extended lymphadenectomy – removal of additional lymph nodes beyond the extent of the standard procedure – in patients undergoing radical cystectomy (removal of bladder and nearby tissues) because of clinically localized muscle-invasive bladder cancer provides no patient benefit as measured by disease-free survival or overall survival times. It does, however, increase the risk of adverse…

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      walliscjd

      Truly herculean effort to conduct a surgical trial. SWOG S1011 shows no oncologic benefit to extended LND at the time of cystectomy but increased toxicity compared to a standard approach. As with many times in life, perhaps less is more.

  • Mashup Score: 8
    Christian Pfister on Bladder Cancer: New Overall Survival Data on Perioperative Chemotherapy - The ASCO Post - 2 year(s) ago

    2023 ASCO Annual Meeting Christian Pfister, MD, PhD, of Rouen University Hospital, discusses phase III results from the VESPER trial, which showed that dose-dense methotrexate, vinblastine, doxorubicin, and cisplatin provided a better overall survival rate at 5 years and improved disease-specific survival compared with gemcitabine as perioperative chemotherapy in patients with…

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      walliscjd

      At ASCO 2023, Dr Pfister presented OS data for the comparison of ddMVAC and gem-cis as perioperative systemic therapy in patients undergoing cystectomy for MIBC. This showed a survival benefit for ddMVAC, particularly when used in the neoadjuvant setting. Given wide spread use of GC, is this practice changing?

  • Mashup Score: 11
    Radical Cystectomy vs Trimodality Therapy for Muscle-Invasive Bladder Cancer - The ASCO Post - 2 year(s) ago

    By Matthew Stenger Posted: 5/23/2023 10:03:00 AM Last Updated: 5/23/2023 10:03:23 AM In a retrospective analysis reported in The Lancet Oncology, Zlotta et al found that trimodality therapy was associated with similar outcomes compared to radical cystectomy in patients with muscle-invasive bladder…

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      walliscjd

      Radical cystectomy has been the gold standard for years in localized MIBC. This recent data shows that, among properly selected patients, trimodal therapy with TURBT, radiation, and chemotherapy can provide equivalent cancer control.