On the Horizon: A Global Multidisciplinary Perspective on Delivering Emerging Therapies for Patients with BCG-Naïve High-Risk NMIBC
Abstract Patients with high-risk non-muscle invasive bladder cancer (NMIBC) are generally treated with transurethral resection of the bladder tumor followed by intravesical bacillus Calmette-Guérin (BCG), the current standard of care. However, recurrence or progression is common and may result in pa...
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| Format: | Article |
| Language: | English |
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Adis, Springer Healthcare
2025-04-01
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| Series: | Oncology and Therapy |
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| Online Access: | https://doi.org/10.1007/s40487-025-00334-6 |
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| author | Bernadett E. Szabados Félix Guerrero-Ramos Enrique Grande Petros Grivas Viktor Grünwald Marta Carpintero Miguel Syed A. Hussain Girish S. Kulkarni Ana Lisa Wilson Neal D. Shore Srikala S. Sridhar Mary Hoyt Samantha Strumeier Jennifer Sutton Julia Brinkmann Rosemary E. Teresi Tilman Todenhöfer |
| author_facet | Bernadett E. Szabados Félix Guerrero-Ramos Enrique Grande Petros Grivas Viktor Grünwald Marta Carpintero Miguel Syed A. Hussain Girish S. Kulkarni Ana Lisa Wilson Neal D. Shore Srikala S. Sridhar Mary Hoyt Samantha Strumeier Jennifer Sutton Julia Brinkmann Rosemary E. Teresi Tilman Todenhöfer |
| author_sort | Bernadett E. Szabados |
| collection | DOAJ |
| description | Abstract Patients with high-risk non-muscle invasive bladder cancer (NMIBC) are generally treated with transurethral resection of the bladder tumor followed by intravesical bacillus Calmette-Guérin (BCG), the current standard of care. However, recurrence or progression is common and may result in patients requiring radical cystectomy. Additionally, BCG continues to be in short supply worldwide. Therefore, there is an unmet need for new therapies that provide durable disease control and maintain quality of life. In the BCG-naïve high-risk NMIBC setting, potential new treatment options are emerging, with several regimens combining intravesical therapy with systemic PD-1 or PD-L1–directed immune checkpoint inhibitors (ICIs) currently under investigation in several Phase 3 trials. In routine clinical practice, NMIBC has traditionally been managed almost entirely by urologists. However, the introduction of systemic ICIs would likely require medical oncology expertise to help assess patients’ fitness for these therapies and potentially for treatment administration and immune-related adverse event management. While multidisciplinary workflows are common practice for advanced bladder cancer, they would represent a paradigm shift in NMIBC. Based on current experience of managing patients with NMIBC across different countries and healthcare systems from our perspective as urologists, medical oncologists, and nurses, we discuss best practices for the potential integration of emerging therapies such as ICIs into the treatment of BCG-naïve high-risk NMIBC. We emphasize the need for multidisciplinary care, either through formalized multidisciplinary teams or cross-discipline collaborative workflows adapted to local needs, to ensure efficient coordination and sharing of responsibilities. Specialized nurses have the potential to play key roles across multiple aspects of patient care. We also highlight the crucial importance of effective communication across teams, increases in resourcing, and education for healthcare professionals, patients, and caregivers to enable eligible patients with high-risk NMIBC to benefit optimally from the introduction of these potential new treatment options. Supplementary file2 (MP4 407382 kb) |
| format | Article |
| id | doaj-art-dccdbde53afe4daeb5a91552f93ffd84 |
| institution | Kabale University |
| issn | 2366-1070 2366-1089 |
| language | English |
| publishDate | 2025-04-01 |
| publisher | Adis, Springer Healthcare |
| record_format | Article |
| series | Oncology and Therapy |
| spelling | doaj-art-dccdbde53afe4daeb5a91552f93ffd842025-08-20T03:25:16ZengAdis, Springer HealthcareOncology and Therapy2366-10702366-10892025-04-0113227529110.1007/s40487-025-00334-6On the Horizon: A Global Multidisciplinary Perspective on Delivering Emerging Therapies for Patients with BCG-Naïve High-Risk NMIBCBernadett E. Szabados0Félix Guerrero-Ramos1Enrique Grande2Petros Grivas3Viktor Grünwald4Marta Carpintero Miguel5Syed A. Hussain6Girish S. Kulkarni7Ana Lisa Wilson8Neal D. Shore9Srikala S. Sridhar10Mary Hoyt11Samantha Strumeier12Jennifer Sutton13Julia Brinkmann14Rosemary E. Teresi15Tilman Todenhöfer16Centre for Experimental Cancer Medicine, Barts Cancer Institute, Queen Mary University of LondonDepartment of Urology, University HospitalMedical Oncology Department, MD Anderson Cancer Center MadridFred Hutchinson Cancer Center, University of WashingtonDepartment for Medical Oncology, Department of Urology, University Hospital EssenDepartment of Urology, University HospitalSchool of Medicine and Population Health, University of SheffieldPrincess Margaret Cancer Centre, University of TorontoPrincess Margaret Cancer Centre, University of TorontoAUC Urology SpecialistsPrincess Margaret Cancer Centre, University of TorontoCarolina Urologic Research CenterBarts Health NHS TrustCarolina Urologic Research CenterPfizer Pharma GmbHPfizer IncStudienpraxis UrologieAbstract Patients with high-risk non-muscle invasive bladder cancer (NMIBC) are generally treated with transurethral resection of the bladder tumor followed by intravesical bacillus Calmette-Guérin (BCG), the current standard of care. However, recurrence or progression is common and may result in patients requiring radical cystectomy. Additionally, BCG continues to be in short supply worldwide. Therefore, there is an unmet need for new therapies that provide durable disease control and maintain quality of life. In the BCG-naïve high-risk NMIBC setting, potential new treatment options are emerging, with several regimens combining intravesical therapy with systemic PD-1 or PD-L1–directed immune checkpoint inhibitors (ICIs) currently under investigation in several Phase 3 trials. In routine clinical practice, NMIBC has traditionally been managed almost entirely by urologists. However, the introduction of systemic ICIs would likely require medical oncology expertise to help assess patients’ fitness for these therapies and potentially for treatment administration and immune-related adverse event management. While multidisciplinary workflows are common practice for advanced bladder cancer, they would represent a paradigm shift in NMIBC. Based on current experience of managing patients with NMIBC across different countries and healthcare systems from our perspective as urologists, medical oncologists, and nurses, we discuss best practices for the potential integration of emerging therapies such as ICIs into the treatment of BCG-naïve high-risk NMIBC. We emphasize the need for multidisciplinary care, either through formalized multidisciplinary teams or cross-discipline collaborative workflows adapted to local needs, to ensure efficient coordination and sharing of responsibilities. Specialized nurses have the potential to play key roles across multiple aspects of patient care. We also highlight the crucial importance of effective communication across teams, increases in resourcing, and education for healthcare professionals, patients, and caregivers to enable eligible patients with high-risk NMIBC to benefit optimally from the introduction of these potential new treatment options. Supplementary file2 (MP4 407382 kb)https://doi.org/10.1007/s40487-025-00334-6BCG-naïveImmune checkpoint inhibitorMedical oncologistMultidisciplinaryNon-muscle invasive bladder cancerNurse |
| spellingShingle | Bernadett E. Szabados Félix Guerrero-Ramos Enrique Grande Petros Grivas Viktor Grünwald Marta Carpintero Miguel Syed A. Hussain Girish S. Kulkarni Ana Lisa Wilson Neal D. Shore Srikala S. Sridhar Mary Hoyt Samantha Strumeier Jennifer Sutton Julia Brinkmann Rosemary E. Teresi Tilman Todenhöfer On the Horizon: A Global Multidisciplinary Perspective on Delivering Emerging Therapies for Patients with BCG-Naïve High-Risk NMIBC Oncology and Therapy BCG-naïve Immune checkpoint inhibitor Medical oncologist Multidisciplinary Non-muscle invasive bladder cancer Nurse |
| title | On the Horizon: A Global Multidisciplinary Perspective on Delivering Emerging Therapies for Patients with BCG-Naïve High-Risk NMIBC |
| title_full | On the Horizon: A Global Multidisciplinary Perspective on Delivering Emerging Therapies for Patients with BCG-Naïve High-Risk NMIBC |
| title_fullStr | On the Horizon: A Global Multidisciplinary Perspective on Delivering Emerging Therapies for Patients with BCG-Naïve High-Risk NMIBC |
| title_full_unstemmed | On the Horizon: A Global Multidisciplinary Perspective on Delivering Emerging Therapies for Patients with BCG-Naïve High-Risk NMIBC |
| title_short | On the Horizon: A Global Multidisciplinary Perspective on Delivering Emerging Therapies for Patients with BCG-Naïve High-Risk NMIBC |
| title_sort | on the horizon a global multidisciplinary perspective on delivering emerging therapies for patients with bcg naive high risk nmibc |
| topic | BCG-naïve Immune checkpoint inhibitor Medical oncologist Multidisciplinary Non-muscle invasive bladder cancer Nurse |
| url | https://doi.org/10.1007/s40487-025-00334-6 |
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