Emerging Treatments for BCG Unresponsive Non-muscle Invasive Bladder Cancer

Posted by Amirali Salmasi, MD | Mar 2022

Amirali Salmasi, MD, presented “Emerging Treatments for BCG Unresponsive Non-muscle Invasive Bladder Cancer” during the 29th Annual Perspectives in Urology: Point-Counterpoint, on November 18, 2021, in Coronado Island, San Diego, California.

How to cite: Salmasi, Amirali. “Emerging Treatments for BCG Unresponsive Non-muscle Invasive Bladder Cancer.” November 18, 2021. Accessed Apr 2024. https://grandroundsinurology.com/emerging-treatments-for-bcg-unresponsive-non-muscle-invasive-bladder-cancer/

Emerging Treatments for BCG Unresponsive Non-muscle Invasive Bladder Cancer

Amirali Salmasi, MD, Assistant Professor of Urology at the University of California, San Diego, discusses available and emerging treatments for bacillus Calmette-Guérin (BCG)-unresponsive non-muscle invasive bladder cancer (NMIBC). He begins by giving a brief history of intravesical BCG and explaining how BCG works, before moving on to discuss treatments for BCG-unresponsive NMIBC. Dr. Salmasi observes that valrubicin was the best available treatment for a long time, but suggests that some of the many emerging treatments may prove superior. He then summarizes recent and ongoing research into various potential therapies for BCG-unresponsive NMIBC, including: sequential gemcitabine and docetaxel; intravesical cabazitaxel, gemcitabine, and cisplatin; chemohyperthermia treatment; CG0070, an oncolytic adenovirus; superagonist N-803; intravesical nadofaragene firadenovec gene therapy; and pembrolizumab. Dr. Salmasi concludes that, for the moment, the gold standard treatment for a patient with BCG-unresponsive bladder cancer remains radical cystectomy, but he argues that if someone is not eligible for or turns down cystectomy, pembrolizumab is now the go-to rather than valrubicin, although this may change depending on the results of some of these ongoing trials.

About the 29th Annual Perspectives in Urology: Point Counterpoint conference:
Presented by Program Chair and Grand Rounds in Urology Editor-in-Chief E. David Crawford, MD, this conference brought together leading experts in urology, medical oncology, and radiation oncology to discuss and debate the latest topics in genitourinary cancers, primarily prostate cancer and bladder cancer. This interactive conference offered topical lectures, pro/con debates, interesting-case presentations, interactive panel discussions, and interactive audience and faculty networking.

About The Author

Amirali Salmasi, MD

Amirali Salmasi, MD, is a urologist with expertise in the management of genitourinary cancers in men and women, including bladder, prostate, kidney, ureteral, testicular, adrenal, and penile cancers. He provides a personalized, multidisciplinary approach to deliver the best possible treatment options (active surveillance, focal therapy, surgery, radiation, systemic treatments, or clinical trials) for his patients. Dr. Salmasi performs advanced minimally invasive and complex open surgeries, such as robotic-assisted laparoscopic cystectomy, nerve-sparing prostatectomy, retro-peritoneal lymph node dissection, adrenalectomy, and partial nephrectomy. He is also interested in translational research and clinical trials in urologic oncology, and his hope is to bridge the gap between the bench and clinical research. He has published over 50 articles in peer-reviewed journals. Dr. Salmasi completed a urologic oncology fellowship at the University of California, Los Angeles, and a urology residency at Rutgers Robert Wood Johnson Medical School. As a first step towards a career in academic medicine and research, he also did a postdoctoral fellowship at Johns Hopkins School of Medicine. He earned his medical degree from Tehran University of Medical Sciences and holds a master's degree in clinical research (MSCR) from UCLA Clinical and Translational Science Institute. He is a member of the American Urological Association, the Society for Urologic Oncology and the American Society of Clinical Oncology.

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