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.
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How to cite: Gomella, Leonard G. “Intermediate-Risk NMIBC/BCG Naïve: Treatment of Choice.” December, 2024. Accessed Apr 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, is the Bernard W. Godwin, Jr. Professor of Prostate Cancer and chair of the department of urology at Sidney Kimmel Medical College of Thomas Jefferson University in Philadelphia, Pennsylvania, where he also serves as senior director for clinical affairs. Originally from New York, Dr. Gomella 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, he joined Thomas Jefferson University in 1988 and was appointed chair of the urology department in 2002. From 1998 until 2020 he was urology chair for the Radiation Therapy Oncology Group (RTOG) (now NRG Oncology) and from 2008 until 2019 he was clinical director of the Sidney Kimmel Cancer Center Network.
Dr. Gomella is involved in translational basic science and clinical research developing new diagnostic tests and treatments for prostate, bladder, and kidney cancer through the Sidney Kimmel Cancer Center where he has co-led the Biology of Prostate Cancer Program. Dr. Gomella's team was first to use molecular techniques (RT-PCR) in 1992 to detect circulating prostate cancer micrometastases, the first report of “liquid biopsy,” a discovery that led to a new field of investigation in this disease. Dr. Gomella is also recognized for developing the multidisciplinary clinic approach to prostate cancer and was an early contributor to urologic laparoscopy. He led the urology effort in the 2017 and 2019 Philadelphia Prostate Cancer International Consensus that provided the first multidisciplinary guidance on genetic testing for prostate cancer.
Dr. Gomella has given over 600 presentations nationally and internationally and written over 600 papers, chapters and monographs in urology. He has authored and edited 63 editions of 17 different books for medical students, residents, and practicing physicians, many of which have been translated into foreign languages. Dr. Gomella has consistently earned recognition for urologic oncology and prostate cancer, including a 2015 national recognition in Newsweek. In 2007, Men’s Health Magazine listed Dr. Gomella as one of the 20 top urologists in the US. Among other awards, in 2018 the Society of Urologic Oncology presented him with a “Distinguished Service Award.” In 2019, Dr. Gomella was named Enterprise Urology Vice President for Jefferson Health. Additionally, the American Urological Association (AUA) awarded him “Honorary Membership” status in 2023 in recognition for his contributions and leadership in urologic oncology. Dr. Gomella has been president of the Mid-Atlantic section of the AUA and elected to the American Association of Genitourinary Surgeons and the prestigious Clinical Society of Genitourinary Surgeons.
