Next Generation Developments in Bladder Cancer
2018 Consensus Statements
- We need to develop a consensus on standard testing for immunotherapy and molecular therapy testing to facilitate eligibility for immuno-oncology and molecular therapy.
- Identifying predictive PD-1/PD-L1 expression markers for patients with metastatic and possibly non-metastatic disease is necessary.
- We should incorporate molecular diagnostics into the risk stratification of bladder cancer.
- Improving the diagnostic accuracy, evaluation, and risk stratification of noninvasive bladder cancers by better determining tissue, radiographic, and molecular predictors of disease risk needs to be emphasized.
- We should more clearly risk-stratify T1 tumors to assist clinicians in clinical management and to identify those patients eligible for future clinical trials.
- In patients with T2-4 urothelial carcinoma (UCC), the risk/benefit of T0 after transurethral resection (TUR) prior to and following neoadjuvant chemotherapy (NAC) should be further explored.
- The beneficial impact of systemic immunotherapy or combination therapy for high-risk noninvasive bladder cancers needs to be studied.
- Transurethral resection of bladder tumor (TURBT) will be done in the same way.
- No consensus urine marker will exist yet.
- Molecular profiling of invasive and non-invasive tumors will be more commonplace and will help determine therapeutic choices.
- Bladder sparing multimodality will become more commonly chosen for invasive disease.