Bladder cancer care and research is moving quickly, offering patients the potential for longer lives and better quality of life. Bladder cancer expert Dr. Ashish Kamat discusses recent advancements in treatment, including therapies that may help more patients preserve their bladder, access effective treatment, and achieve better outcomes.
Dr. Ashish Kamat is a Urologic Oncologist and the Director of the Bladder Cancer Support Program at University of Texas MD Anderson Cancer Center in Houston, Texas. Dr. Kamat also serves as the founding President of the International Bladder Cancer Group (IBCG). Learn more about Dr. Kamat.
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Transcript
Katherine Banwell:
To start, can you share some of the recent highlights and research and advances in research?
Dr. Ashish Kamat:
There are several different ways to look at it, but I think the biggest sort of push has been, as a field, there have been a lot of advances in research that allow patients to, A, live longer, which is obviously always the goal, but B, live longer with improved quality of life. And by that, what I mean is that the advances are moving towards not just survival, which, as I said, is always key, but allowing patients as much as possible to preserve their bladder, and, of course, everything else kind of dovetails into those two broad categories.
Katherine Banwell:
I know the ASCO meeting took place in June. What were the highlights from that meeting?
Dr. Ashish Kamat:
So, let me sort of reset the timeline because ASCO obviously is critical, but there have been so many developments that have been coming out over the last 12 months that it was not disappointing because I don’t want to use that word, but ASCO didn’t really have any new groundbreaking things to present; it was more updates on these trickle-down advances that happened over the months. And I think that’s important because it used to be that we would have to go to one major meeting just once every 12 months and only there hear about the advances. That’s the old paradigm.
I think nowadays, there’s just so much momentum, so much going on that these reports come out at AUA, they come out at GU, ASCO, EUA, ESMO, and, of course ASCO. So, with that in mind, just because it wasn’t only released at ASCO, some of the key things were, of course, the use of systemic therapy in patients with muscle-invasive disease in a way that is agnostic to their renal function.
And by that, what I mean is the EV-pembro paradigm. Because it used to be that patients with muscle-invasive bladder cancer, as with the metastatic phase, had to get cisplatin-based (Platinol) chemotherapy, and that depended heavily on their neurologic function, their kidney function, and a lot of bladder cancer patients tend to be older with diabetes, other issues that cause renal dysfunction.
What’s really remarkable about this new paradigm is that it’s completely agnostic of their kidney function, which allows almost every patient to potentially get this life-saving therapy, and it’s very, very effective.
So, not only do we have a treatment now that has raised the bar with better efficacy, but it’s also more equitable; more patients can actually access it. So, I think that was the major advance that was really at the ASCO meeting. The other one, which really wasn’t highlighted at ASCO specifically, but like I said, it’s been coming out over the last six months, is the improvement in therapies for patients with muscle-invasive and non-muscle-invasive disease.
So, we have muscle-invasive disease once the tumor is in the muscle of the bladder, and then we have non-muscle-invasive disease, which can still be invasive; it’s just not invasive in the muscle of the bladder. And that’s when patients are struggling with multiple lines of therapy, multiple attempts to try to prevent them from getting to that muscle-invasive phase, and we’ve had a lot of advances in that as well.
Katherine Banwell:
What would you like to leave the audience with? Are you optimistic about the future of bladder cancer care and treatment?
Dr. Ashish Kamat:
Absolutely. I’m extremely optimistic. This is a great time to be in the bladder cancer field both as a researcher, a caregiver, and obviously, you never want to have a diagnosis. But if you have a diagnosis, it’s also a great time to be in bladder cancer because things have improved and changed so much, just in the last 12 months, that it’s remarkable. It’s not night and day because we want to get to a point where nobody ever dies from their bladder cancer, but we’ve gotten to a point that is fairly close to allowing patients to have long life and good quality of life even with a diagnosis of bladder cancer.