Amirali Salmasi, MD, MSCR, presented “Role of Systemic Therapies in NMIBC” at the 7th International Bladder Cancer Update on December 6, 2024, in Dallas, Texas.

How to cite: Salmasi, Amirali. Role of Systemic Therapies in NMIBC” December 2024. Accessed Mar 2025. https://grandroundsinurology.com/role-of-systemic-therapies-in-nmibc/

Role of Systemic Therapies in NMIBC – Summary

Amirali Salmasi, MD, MSCR, explores the rationale for systemic immunotherapy in non-muscle invasive bladder cancer, emphasizing its potential role in BCG-unresponsive disease. 

In this 18-minute presentation, Dr. Salmasi shares that trials investigating pembrolizumab in this setting show a complete response rate of 41% at three months and a durable response of 19% at 12 months. Studies combining BCG with systemic immunotherapy suggest only marginal improvements, raising questions about its necessity for non-invasive tumors. 

The experts on the forum enhance the discussion, highlighting the importance of patient selection, particularly in high-grade T1 disease, where systemic treatment may offer greater benefit. Concerns arise regarding the sequencing of therapies and the risk of silent progression in patients delaying cystectomy. Experts debate the reliability of phase two trial data in predicting phase three outcomes, cautioning against premature shifts in the standard of care. The talk concludes with a call for randomized trials to clarify optimal treatment strategies and improve prognostic markers for systemic immunotherapy in 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

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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.