Looking Ahead: The Next Big Thing in Bladder Cancer

A roundtable discussion, moderated by Thomas Powles, MBBS, MRCP, MD, covered the latest updates in bladder cancer treatment and research, including recent data from ESMO 2023. Dr. Powles was joined by Shilpa Gupta, MD; Sia Daneshmand, MD; and Petros Grivas, MD.

In the final segment of the roundtable series, the panel shares predictions for the future of bladder cancer, including the importance of ctDNA and the potential for radical cystectomy to “become a thing of the past.”

Watch more segments in this series.

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Dr. Powles: We’ve reached our time. We’ve got to a point in urothelial cancer where we’re catching up with some of the other tumor types. We’ve been stuck with platinum-based chemotherapy and squirting stuff into the bladder and getting people to roll around for 40 years. That was true, 40 years.

Dr. Grivas: Most old form of immunotherapy was intravesical and still is intravesical BCG.

Dr. Powles: We’re now in a position where we’ve transformed the frontline, and we may transform non-muscle invasive disease as well. We also talked a little bit about muscle-invasive disease and some of the trials going on there. Everything’s changing. It’s a fantastic time I think for patients for a change in urothelial cancer because that has been such a battle until recently. These transformations, I hope they’re going to improve the lives of our patients.

Dr. Gupta: Radical cystectomy may become a thing of the past.

Dr. Daneshmand: Hopefully for the patients.

Dr. Powles: We hope so, Sia.

Dr. Grivas: We’re going that direction in the future with proper biomarkers where you asked before, Tom, we still struggling, and I know you and me talked about it. We’re struggling to identify potentially predictive biomarkers. Going back to your previous question, how you select, how do you know this response?

Dr. Powles: ctDNA. I think we’re going to get ctDNA is going to be the next big thing. Change frontline therapy, change muscle-invasive and adjuvant therapy based around ctDNA. We’re going to have to stop talking. We’re going over. Thank you very much.