Adaptive Immune Resistance to Intravesical BCG in NMIBC: Implications for Ongoing and Future BCG Unresponsive Clinical Trials

Posted by Trinity J. Bivalacqua, MD, PhD | May 2020

Trinity J. Bivalacqua, MD, PhD, presented “Adaptive Immune Resistance to Intravesical BCG in NMIBC: Implications for Ongoing and Future BCG Unresponsive Clinical Trials” during the 40th Annual Ralph E. Hopkins Urology Seminar on February 5th, 2020 in Jackson Hole, Wyoming.

How to cite: Bivalacqua, Trinity J. “Adaptive Immune Resistance to Intravesical BCG in NMIBC: Implications for Ongoing and Future BCG Unresponsive Clinical Trials” February 5th, 2020. Accessed Apr 2024. https://grandroundsinurology.com/adaptive-immune-resistance-to-intravesical-bcg-in-nmibc-implications-for-ongoing-and-future-bcg-unresponsive-clinical-trials/

Adaptive Immune Resistance to Intravesical BCG in NMIBC: Implications for Ongoing and Future BCG Unresponsive Clinical Trials – Summary:

Trinity J. Bivalacqua, MD, PhD, Director of Urologic Oncology at Johns Hopkins Medicine, discusses potential solutions to the issues with bacillus Calmette-Guérin (BCG) as a treatment for high-risk non-muscle invasive bladder cancer (NMIBC). Intravesical BCG is more effective than chemotherapy for NMIBC, but approximately ⅓ of high-risk patients are BCG-unresponsive, and there is also a BCG shortage. Dr. Bivalacqua lists potential solutions to both these problems, including early cystectomy, increasing the availability of BCG by using alternative strains, and enhancing immunotherapy. He concludes by discussing research intended to characterize immune cell expression among patients with NMIBC treated with BCG which found that immune checkpoint inhibition with BCG may be beneficial in a subset of patients who experience tumor recurrence after BCG.

About The 40th Annual Ralph E. Hopkins Urology Seminar:

The Ralph E. Hopkins Urology Seminar is a multi-day meeting focused on training urologists in the latest in assessing, diagnosing, and treating urologic conditions in the clinical setting. Updates are provided on urologic cancers, stone disease, urologic reconstruction, female urology, infertility, emerging surgical techniques, and general urology. Dr. Bivalacqua presented this lecture during the 40th iteration of the meeting on February 5th, 2020 in Jackson Hole, Wyoming.

For further educational activities from this conference, visit our collection page.

About The Author

Trinity J. Bivalacqua, MD, PhD

Trinity J. Bivalacqua, MD, PhD, is the Director of Urologic Oncology and the R. Christian B. Evensen Associate Professor of Urology and Oncology at the James Buchanan Brady Urological Institute of Johns Hopkins Medicine in Baltimore, Maryland. He also has an active clinical practice. Dr. Bivalacqua received his undergraduate, graduate, and medical degrees from Tulane University in New Orleans. He went on to complete general surgery and urology training at Johns Hopkins Hospital. He also completed an American Urological Association Foundation Post-Doctoral Fellowship. Dr. Bivalacqua has a particular interest in prostate and bladder cancers, and focuses on organ-sparing therapies, minimally-invasive techniques, and orthotopic bladder substitution. He has received several research grants, including a Career Development Award from the National Institute of Health and an AUA “Rising Star” Award. At present, Dr. Bivalacqua’s research lab is largely focused on the development of preclinical models of urothelial carcinoma to test systemic and intravesical immunotherapies and nano-particular based chemotherapies. He is also interested in regenerative approaches to enhance autonomic nerve function and the development of engineered urinary tissue.

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