Intermediate-Risk NMIBC/BCG Naïve: Treatment of Choice

Leonard G. Gomella, MD, FACS

Leonard G. Gomella, MD, FACS, presented “Intermediate-Risk NMIBC/BCG Naïve: Treatment of Choice” during the 7th International Bladder Cancer Update on December 6, 2024, in Dallas, Texas.

This content is available free to the GRU Community. Login or create an account to view it.

Create an Account

How to cite: Gomella, Leonard G. “Intermediate-Risk NMIBC/BCG Naïve: Treatment of Choice.” December, 2024. Accessed Nov 2025. https://grandroundsinurology.com/intermediate-risk-nmibc-bcg-naive-treatment-of-choice/

Intermediate-Risk NMIBC/BCG Naïve: Treatment of Choice – Summary

Leonard G. Gomella, MD, FACS, explores bladder cancer treatment, particularly in the context of intermediate-risk, BCG-naïve disease.

In this 23-minute presentation, Dr. Gomella reviews the significant advancements in bladder cancer treatment options. He highlights the AUA and NCCN guidelines for intermediate-risk disease, emphasizing the role of BCG as a primary treatment. The BCG shortage has driven the use of alternative intravesical therapies such as gemcitabine, mitomycin, and gemcitabine-docetaxel, which are increasingly recognized as viable options.

Experts attending IBCU join the conversation, addressing challenges in clinical trial design, including ethical concerns over trial access to BCG when it is otherwise unavailable. The discussion also examines the growing role of biomarker-driven treatment selection and the heterogeneity of intermediate-risk disease, which necessitates refined patient stratification.

Future directions include ongoing trials evaluating new agents, novel drug delivery mechanisms, and potential radiation therapy approaches. The Bridge trial and other ongoing studies may further define the role of gemcitabine-docetaxel as a primary alternative to BCG, shaping the future standard of care for bladder cancer.

About the 7th International Bladder Cancer Update:

The International Bladder Cancer Update (IBCU) is a CME conference focused on the diagnosis and treatment of bladder cancer. The conference offers medical professionals an opportunity to listen to updates from, and interact with, expert international faculty to improve knowledge and determine best treatment practices to improve patient outcomes. IBCU encompasses expert lectures, interactive discussions, a panel roundtable, debates, and case presentations. It is physician-led, multi-supported, and designed for urologists, urologic oncologists, and other healthcare professionals involved in the treatment of bladder cancer.

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

ABOUT THE AUTHOR

Leonard G. Gomella, MD, FACS

Bernard W. Godwin, Jr. Professor in Prostate Cancer at Thomas Jefferson University | + posts

Leonard G. Gomella, MD, FACS, completed medical school and general surgery and urology training at the University of Kentucky in Lexington. After a urologic oncology fellowship in the surgery branch of the National Cancer Institute, National Institutes of Health in Bethesda, Maryland. Dr. Gomella is currently the Bernard W. Godwin, Jr. Professor of Prostate Cancer, Chairman of the Department of Urology, Senior Director of Clinical Affairs for the Sidney Kimmel Comprehensive Cancer Center, and the Enterprise VP of Urology at the Jefferson Health System, at Thomas Jefferson University in Philadelphia, Pennsylvania.

About The Author

Leonard G. Gomella, MD, FACS

Leonard G. Gomella, MD, FACS, completed medical school and general surgery and urology training at the University of Kentucky in Lexington. After a urologic oncology fellowship in the surgery branch of the National Cancer Institute, National Institutes of Health in Bethesda, Maryland. Dr. Gomella is currently the Bernard W. Godwin, Jr. Professor of Prostate Cancer, Chairman of the Department of Urology, Senior Director of Clinical Affairs for the Sidney Kimmel Comprehensive Cancer Center, and the Enterprise VP of Urology at the Jefferson Health System, at Thomas Jefferson University in Philadelphia, Pennsylvania. Dr. Gomella is involved in both basic science and clinical research in the development of new diagnostic techniques and treatments for prostate, bladder and kidney cancer through Jefferson’s Sidney Kimmel Comprehensive Cancer Center. Dr. Gomella's team was first to use RT-PCR to detect micrometastasis in patients with prostate cancer, a discovery that led to a new field of investigation in this disease. Dr. Gomella is also recognized as an early contributor to urologic laparoscopy, initiating the program at Jefferson in 1990. Dr. Gomella has given almost 500 presentations at local, national and international meetings and written over 300 papers, chapters and monographs in the field of Urology. Dr. Gomella has authored and edited 54 editions of 17 different books for medical students, residents, and practicing physicians, many of which have been translated into foreign languages. He is the editor-in-chief of the 5 Minute Urology Consult, and laparoscopy section editor for Glenn’s Urologic Surgery. Recovering from Prostate Cancer, the first book for the public dedicated to this topic, was authored by Dr. Gomella. In the field of medicine, Dr. Gomella is known for the Clinician's Pocket Reference, now in its 11th edition, a widely used reference for medical students and health care providers.

Share This

Chat with usLiveChat