Managing Patients with Non-Muscle Invasive Bladder Cancer: Old Disease, New Ideas

This symposium took place on 12th March 2016 as part of the European Association of Urology Congress 2016 in Munich, Germany

Chairperson: Per-Uno Malmström1
Speakers: Marko Babjuk,2 Carsten Ohlmann,3 Bernard Malavaud,4 Ashish Kamat5

1. Department of Urology, Akademiska Sjukhuset, Uppsala University Hospital, Uppsala, Sweden
2. Department of Urology, Hospital Motol and 2nd Faculty of Medicine, Charles University, Prague, Czech Republic
3. Saarland University Medical Center, Hamburg, Germany
4. Department of Onco-Urology, Institut Universitaire du Cancer, Toulouse, France
5. University of Texas MD Anderson Cancer Center, Houston, Texas, USA

Disclosure: Per-Uno Malmström has served on advisory boards and as a scientific advisor for Photocure AS. Marko Babjuk has recieved speaker’s fees/honoraria from Astellas and Medac. Carsten Ohlmann has recieved speaker’s fees/honoraria from Medac, has served on advisory boards for Medac, and was an invited lecturer for EAU. Bernard Malavaud is on an advisory board for Olympus. Ashish Kamat has served as a consultant or advisor for Abbott Molecular, Theralase, Telesta Therapeutics Inc. (formerly Bioniche), Sanofi, Oncogenix, Spectrum Pharmaceuticals, Merck, Heat Biologics, and Photocure, as a meeting participant or lecturer for Photocure, Sanofi, and Pacific Edge Ltd., and in a scientific study or trial for Merck, Heat Biologics, Photocure, and FKD.
Acknowledgements: Writing assistance was provided by Dr Tom Priddle, ApotheCom.
Support: Medical writing assistance was funded by MEDAC. The views and opinions expressed are those of the authors as expressed during the symposium and not necessarily those of MEDAC.
Citation: EMJ Urol. 2016;4[1]:36-43.

Meeting summary

Prof Per-Uno Malmström opened this symposium on non-muscle invasive bladder cancer (NMIBC) by describing the medical and economic burden caused by the increasing incidence of bladder cancer and the lack of new therapeutic options available to address the challenges of the management of NMIBC. Prof Marko Babjuk followed with a presentation that demonstrated that risk stratification using European Organisation for Research and Treatment of Cancer (EORTC) and Spanish Urological Club for Oncological Treatment (CUETO) risk scores remains a useful tool for determining the best individual treatment options for patients. The next presentation, given by Dr Carsten Ohlmann, described the use of mitomycin C (MMC) for low and intermediate-risk patients as per the European Association of Urology (EAU) guidelines. However, despite a favourable safety profile, single case reports of severe adverse events following treatment with MMC should not be dismissed. MMC should therefore be given with care, with an emphasis on performing high quality transurethral resection of the bladder (TURB). Prof Bernard Malavaud then presented details of newer diagnostic methods, such as photodynamic diagnosis (PDD) and narrow band imaging (NBI), which offer better optical tumour recognition for the surgeon than the old standard of white light cystoscopy. The uptake of PDD and NBI in the future will facilitate an increase in the quality of TURB. Finally, Prof Ashish Kamat explained that recurrence of bladder cancer after bacillus Calmette–Guérin (BCG) treatment (‘BCG failure’) needs to be more clearly defined and stratified. He stated that optimal recognition of timing with relation to BCG immunotherapy is critical to determine the next steps. For example, in the past, patients with late recurrence who may have benefitted from challenge with BCG may have been overlooked.

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