Perspectives in Urology Point Counterpoint 2018

Checkpoint Inhibitors for NMIBC

Daniel P. Petrylak, MD, provides an overview of immunotherapy treatment options for non-muscle invasive bladder cancer (NMIBC) including BCG, intravesical therapies, and checkpoint inhibitors. He also discusses clinical trials investigating alternative immunotherapy options for NMIBC other than BCG.

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Adjuvant Therapy in High Risk Renal Cell Carcinoma

Alan H. Bryce, MD, surveys data from three phase III trials on adjuvant therapies for high-risk renal cell carcinoma. He discusses the controversies following the conclusions of the completed trials and emphasizes the need for research in further adjuvant therapies beyond those that target the VEGF pathway.

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Can MR Imaging Help Triage Bladder Cancer Patients?

John C. Chang, MD, PhD, examines the potential of MRI for staging bladder cancer, emphasizing MRI’s facility in differentiating between muscle invasive and non-muscle invasive bladder cancer (NMIBC). He also acknowledges that MRI scanning can lead to overstaging, and that CT can be effective for detecting higher stages of bladder cancer.

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AR-V7 Predicts Response in CRPC

Raoul S. Concepcion, MD, FACS, emphasizes the need for more effective biomarkers when determining adequate treatment for patients with castrate-resistant prostate cancer (CRPC). Concurrently, he compares the findings of studies exploring various options, including the AR-V7 splice variant.

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MR Guided Biopsy

John C. Chang, MD, PhD, compares advantages and disadvantages of MRI-guided biopsy and transrectal ultrasound-guided (TRUS) biopsy. He emphasizes MRI-guided biopsy’s detection rates and its effectiveness in patients undergoing repeat biopsies, while acknowledging its relative inefficiency and limitations in low grade cancers.

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