PT0 after NAC: Implications for Bladder Sparing and Prognosis

Leonard G. Gomella, MD, FACS

Leonard G. Gomella, MD, presented “PT0 after NAC: Implications for Bladder Sparing and Prognosis” during the 3rd Annual International Bladder Cancer Update on January 23, 2019 in Beaver Creek, Colorado.

How to cite: Gomella, Leonard G. “PT0 after NAC: Implications for Bladder Sparing and Prognosis” January 23, 2019. Accessed Dec 2025. https://grandroundsinurology.com/pt0-after-nac-implications-for-bladder-sparing-and-prognosis/

PT0 after NAC: Implications for Bladder Sparing and Prognosis

Leonard G. Gomella, MD, FACS, reviews treatment options for patients with bladder cancer, including new research that could lead to bladder sparing.

Summary:

Leonard G. Gomella, MD, FACS, reviews research about neoadjuvant chemotherapy and radical cystectomy for patients with muscle-invasive bladder cancer (MIBC). Traditional bladder preservation protocol combines a maximum transurethral resection of bladder tumor (TURBT) with induction chemotherapy and radiation.

Dr. Gomella explains that as bladder cancer advances, survival rates decrease in patients treated with radical cystectomy for urothelial carcinoma.

Further research into dose-dense methotrexate, vinblastine, adriamycin, and cisplatin (MVAC) regimens attempts to provide options for treating advanced bladder cancer. Then, Dr. Gomella explores the possibility of bladder preservation with potential new treatment options.

Dr. Gomella presents the rationale for NAC and addresses possible reasons for the underutilization of NAC. He also introduces the new dose-dense or accelerated bladder cancer protocols, focusing mainly on data collected by the Columbia study.

Additionally, he summarizes ongoing research about the newer concepts of immuno-oncology and molecular biomarkers, specifically the ABACUS and PURE-01 trials. Lastly, he gives future predictions on the role NAC will play in helping physicians manage MIBC in their patients.

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. Gomella 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

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.

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