Sanjay G. Patel, MD, presented “BCG Unresponsive Disease” during the 3rd Annual International Bladder Cancer Update on January 23, 2019 in Beaver Creek, Colorado.
How to cite: Patel, Sanjay G. “BCG Unresponsive Disease” January 23, 2019. Accessed Jul 2024. https://grandroundsinurology.com/bcg-unresponsive-disease/
BCG Unresponsive Disease- Summary:
Sanjay G. Patel, MD, discusses various definitions of bacillus Calmette-Guérin (BCG)-unresponsive non-muscle invasive bladder cancer (NMIBC). He also outlines treatment options available for these patients and the clinical trials evaluating each approach.
Abstract:
The mainstay treatment for high-risk NMIBC relies on BCG intravesical therapy. Despite the efficacy of intravesical BCG induction and maintenance therapy, long-term, disease-free, and progression-free survival may be difficult to achieve. A subset of patients will fail BCG therapy. If left unidentified and untreated, BCG failure can be lethal.
Current European Association of Urology and American Urological Association Guidelines suggest these patients should undergo radical cystectomy with urinary diversion given the high risk for disease progression. Unfortunately, in those patients who are medically unfit or refuse cystectomy, there are no generally accepted treatment options.
This presentation will review the various definitions of BCG-unresponsive disease, including intolerant, resistant, relapsing, and refractory. The discussion will also outline treatment options available for these patients, namely valrubicin, gemcitabine, docetaxel, paclitaxel, thermochemotherapy, BCG with interferon, and other investigational agents, as well as the clinical trials evaluating each option.
About the International Bladder Cancer Update
The International Bladder Cancer Update (IBCU) is an annual one-day CME conference focused on bladder cancer treatment updates. IBCU takes place during its sister conference, the International Prostate Cancer Update (IPCU). The conference’s faculty consists of international experts, and the event caters to urologists, urologic oncologists, and other healthcare professionals. In addition to didactic lectures, IBCU features interactive discussions, a panel roundtable, debates, and case presentations. Dr. Patel presented this lecture during the 3rd IBCU in 2019. Please visit this page in order to learn more about future IBCU meetings.
ABOUT THE AUTHOR
Sanjay G. Patel, MD, completed his undergraduate training in Biomedical Engineering at
Vanderbilt University. He proceeded to complete medical school at Vanderbilt University in
Nashville, Tennessee, and urologic surgery training at Vanderbilt University Medical Center. After
completing a Society of Urologic Oncology Fellowship at the University of Chicago, he joined the
faculty as an Assistant Professor in the Department of Urology at the University of Oklahoma in Oklahoma City.
Dr. Patel treats all urologic cancers (adrenal, kidney, ureter, bladder, urethra, and testicular
cancer) utilizing open, laparoscopic, and robotic surgery techniques. He has a particular interest
in the use of minimally invasive robotic approaches to treat urologic malignancies and has
extensive robotic surgery experience. He oversees the Bladder Instillation Clinic, where patients’ bladders
are directly treated with immunotherapy and chemotherapy to treat superficial bladder cancer. He is also developing techniques to perform intracorporeal robotic urinary diversions,
where he is using minimally invasive robotic techniques to create bladders out of the
intestinal tract.
Dr. Patel works with the Department of Engineering at the University of Oklahoma to develop novel diagnostic and therapeutic technologies to treat urologic disease. He also has an interest in genetic and molecular profiling of cancers, and how that kind of profiling can be used to guide treatment of urologic cancer.
