How do you effectively treat your bladder cancer population with an insufficient supply of BCG? Dr. Amy Luckenbaugh, a urologic oncologist at Vanderbilt University Medical Center, joins host Dr. Ruchika Talwar to highlight challenges and solutions to managing bladder cancer amidst ongoing BCG shortages.

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This podcast is supported by an educational grant from UroGen Pharma.

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SYNPOSIS

Dr. Luckenbaugh and Dr. Talwar delve into the history and significance of BCG in bladder cancer treatment, exploring the reasons behind the shortages and discussing various coping strategies, including split dosing and alternative intravesical therapies like gemcitabine, docetaxel, and the new mitomycin hydrogel. The conversation also covers emerging treatments for high-risk patients, the role of radical cystectomy, and the importance of standardization and innovation in dealing with medication shortages. Dr. Luckenbaugh highlights the importance of patient quality of life, cost considerations, and the need for resilient pharmaceutical supply chains.

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TIMESTAMPS

00:00 - Introduction
01:56 - History and Importance of BCG in Bladder Cancer
03:21 - Challenges and Shortages of BCG
06:36 - Managing BCG Shortages in Clinical Practice
12:33 - New Alternatives and Treatments for Bladder Cancer
23:28 - The Role of Cystectomy in Bladder Cancer Treatment
26:12 - Future Directions and Final Thoughts

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RESOURCES

BCG Shortage AUA Recommendations:
https://www.auanet.org/about-us/bcg-shortage-info

Reduced-dose bacillus Calmette-Guérin (BCG) in an era of BCG shortage: real-world experience from a tertiary cancer centre:
https://pmc.ncbi.nlm.nih.gov/articles/PMC11951178/

Bladder Cancer Advocacy Network (BCAN):
https://bcan.org/

Primary Chemoablation of Recurrent Low-Grade Intermediate-Risk Nonmuscle-Invasive Bladder Cancer With UGN-102: A Single-Arm, Open-Label, Phase 3 Trial (ENVISION)
https://pubmed.ncbi.nlm.nih.gov/39446087/b

FDA Approves Intravesical Mitomycin in Non–Muscle-Invasive Bladder Cancer:
https://www.fda.gov/drugs/resources-information-approved-drugs/fda-approves-mitomycin-intravesical-solution-recurrent-low-grade-intermediate-risk-non-muscle

TAR-200 - SunRISe-3 Study:
https://www.jnjmedicalconnect.com/products/tar-200/medical-content/tar-200-sunrise-3-study

First results from TAR-200 - SunRISe-1 Study:
https://www.jnj.com/media-center/press-releases/johnson-johnsons-tar-200-monotherapy-achieves-high-disease-free-survival-of-more-than-80-percent-in-bcg-unresponsive-high-risk-papillary-nmibc

N-803 Plus BCG Treatment for BCG-Naïve or -Unresponsive Non-Muscle Invasive Bladder Cancer: A Plain Language Review:
https://pmc.ncbi.nlm.nih.gov/articles/PMC11524197/

With BCG in short supply and recurrence rates still high, the race is on for better intravesical options. In this episode of BackTable Tumor Board, Dr. Lindsey Herrel, urologic oncologist at the University of Michigan, joins Dr. Ruchika Talwar to explore the evolving landscape of intravesical therapy for intermediate risk bladder cancer.

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This podcast is supported by an educational grant from UroGen Pharma.

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SYNPOSIS

The doctors break down the nuances of defining this risk category and the clinical gray zones that complicate treatment decisions. Dr. Herrell shares her patient-centered approach to surveillance and therapy, and introduces promising new agents, including Anktiva, UGN-102, and the gemcitabine-releasing TAR-200 "pretzel" device. The discussion also highlights how advances in molecular profiling are reshaping care strategies.
This episode underscores the urgent need for clearer guidelines and continued innovation to improve outcomes and quality of life for patients with this nuanced disease subtype.

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TIMESTAMPS

00:00 - Introduction
02:03 - Defining Intermediate Risk Bladder Cancer
06:12 - Intravesical Therapy Options
08:47 - Quality of Life and Patient Counseling
10:18 - New Treatments on the Horizon
12:56 - Practical Tips for TURBT Recovery
17:03 - In-Office Procedure Management
21:38 - Managing Symptoms and Quality of Life
31:50 - A Note on Smoking Cessation
33:37 - Conclusion and Future Directions

Counseling patients with intermediate-risk non-muscle invasive bladder cancer can be complex, with a wide range of treatment options and care pathways. In this episode of BackTable, urologic oncologists Dr. Ruchika Talwar and Dr. Kelly Bree explore how to approach this challenge with clarity and compassion.

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This podcast is supported by an educational grant from UroGen Pharma.

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SYNPOSIS

They emphasize a shift toward patient-centered, less aggressive treatment strategies, highlighting the importance of quality of life in clinical decision-making. The discussion includes risk stratification, the use of intravesical gemcitabine, and ongoing clinical trials. Dr. Bree also offers actionable tips for optimizing patient preparation and recovery. This episode underscores the growing importance of listening to patient voices to shape future standards of care.

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TIMESTAMPS

00:00 - Introduction
02:09 - Risk Stratification and Treatment Approaches
06:12 - Intravesical Therapy Options
08:47 - Quality of Life and Patient Counseling
12:56 - Practical Tips for TURBT Recovery
17:03 - In-Office Procedure Management
21:23 - Resources and Support for Patients
24:13 - Final Thoughts

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RESOURCES

Society of Urologic Oncology
https://suonet.org/home.aspx

How do the experts balance organ preservation, oncologic control, and emerging therapies in both localized and metastatic cases of penile cancer? This episode of BackTable Tumor Board focuses on penile cancer diagnosis and treatment, featuring urologic oncologist Dr. Charles Peyton (UAB), radiation oncologist Dr. Juanita Crook (UBC), and medical oncologist Dr. Andrea Apolo (NCI).

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This podcast is supported by:
Ferring Pharmaceuticals

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SYNPOSIS

This session covers case studies ranging from localized to advanced penile cancer, diagnostic practices, imaging preferences (MRI vs. CT), and treatment options, including surgery, brachytherapy, chemoradiation, and neoadjuvant chemotherapy. The multidisciplinary team highlights the complexities of treating this rare cancer, underscores the importance of physical exams, and stresses the necessity of personalized treatment plans. They also delve into the challenges of managing metastatic stages, potential salvage therapies, and the importance of clinical trials in enhancing treatment efficacy. The doctors also emphasize the potential of immunotherapy and chemotherapy combinations for metastatic disease.

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TIMESTAMPS

00:00 - Introduction
02:23 - Imaging Preferences
03:29 - Biopsy vs Immediate Surgery
06:04 - Lymph Node Dissection vs Radiation
13:48 - Brachytherapy Techniques and Case Study
23:21 - Challenges in Advanced Penile Cancer
27:03 - Chemotherapy and Chemoradiation
30:15 - InPACT Trial
37:12 - Salvage Therapies and Exploring New Treatment Frontiers
44:25 - Support and Awareness for Penile Cancer
51:29 - Final Thoughts

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RESOURCES

Society of Urologic Oncology
https://suonet.org/home.aspx

With so many treatment modalities for upper tract urothelial carcinoma, how does new evidence inform optimal care? In this episode of BackTable Tumor Board, urologic oncologist Dr. Nirmish Singla (Johns Hopkins), medical oncologist Dr. Jeannie Hoffman-Censits (Johns Hopkins), and urologic oncologist Dr. Bogdana Schmidt discuss treatment and diagnosis of upper tract urothelial carcinoma (UTUC).

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This podcast is supported by:

⁠⁠Ferring Pharmaceuticals⁠

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SYNPOSIS

The discussion covers real-world UTUC cases, highlighting diagnostic challenges, treatment options, and evidence-based management strategies. They address scenarios ranging from localized to advanced UTUC, the role of systemic therapies, perioperative treatments, and the potential for novel approaches with immune checkpoint inhibitors. The episode underscores the evolving landscape of UTUC treatment and the importance of clinical trials and emerging biomarkers in improving patient outcomes.

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TIMESTAMPS

00:00 - Introduction
02:49 - Case Study 1: 66-Year-Old Male with UTUC
11:19 - Case Study 2: 73-Year-Old Male with High-Grade Urothelial Carcinoma
28:11 - Intravesical Chemotherapy Protocols
30:44 - Case Study 3: 57-Year-Old Male with Recurrent Urothelial Cancer
41:25 Clinical Trials and Emerging Treatments
45:40 Case Study: 55-Year-Old Female with Bulky Lymphadenopathy
56:45 Concluding Remarks and Future Directions

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RESOURCES

Society of Urologic Oncology
https://suonet.org/home.aspx

What if the key to better cancer outcomes lies not just in surgery or chemotherapy, but also in mindfulness, movement, and diet? In this episode of the BackTable Tumor Board, host Dr. Aditya Bagrodia interviews urologic oncologist Dr. Viraj Master, Professor of Urology at Emory University, about his role in developing the integrative oncology and survivorship service line at Winship Cancer Institute.

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This podcast is supported by:

⁠⁠Ferring Pharmaceuticals⁠

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SYNPOSIS

They discuss the evidence-based use of complementary therapies alongside conventional cancer treatments, touching on various integrative methods including diet, exercise, mindfulness, acupuncture, yoga, and supplements. Dr. Master emphasizes the importance of physicians being open to these practices and understanding their potential benefits for improving patient outcomes and quality of life, even in highly acute cases like muscle-invasive bladder cancer. The conversation covers the importance of honesty and understanding across patient journeys–from initial diagnosis to survivorship–highlighting the value of holistic approaches in cancer care.

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TIMESTAMPS

00:00 - Integrative Oncology: Definitions and Basics
06:28 - Exercise and Its Impact on Cancer Treatment
08:12 - Physician Perspectives on Complementary Medicine
20:58 - Acupuncture and Acupressure in Cancer Care
25:28 - Practical Implementation of Integrative Approaches
31:30 - Supplements and Immuno Nutrition
36:25 - Cannabis, CBD, and Ayurveda in Cancer Care
44:39 - Conclusion and Final Thoughts

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RESOURCES

Society of Urologic Oncology
https://suonet.org/home.aspx

How can pediatric and adult urologists team up to tackle complex cancer cases? In this episode of the BackTable Tumor Board, host Dr. Amanda Buchanan, Division Chief of Pediatric Urology at the University of Kentucky, is joined by her colleagues Dr. Patrick Hensley, an adult urologic oncologist, and Dave Rodeberg, Division Chief of Pediatric Surgery. Their discussion centers around the importance of professional collaboration in urologic oncology care in order to improve patient outcomes.

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This podcast is supported by:

⁠⁠Ferring Pharmaceuticals⁠

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SYNPOSIS

The urologists discuss topics such as the experiences and benefits of interdisciplinary collaboration in complex cases and the role of pediatric urologists in treating adolescent and young adult patients. They also provide insights into the Children's Oncology Group (COG) studies and their intersections with adult oncology research. The episode concludes with practical advice for other institutions aiming to improve collaborative efforts between pediatric and adult urology departments.

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TIMESTAMPS

00:00 - Importance of Collaboration in Urologic Oncology
05:38 - Challenges in Multidisciplinary Collaboration
08:30 - Pediatric Urologists’ Role in Testicular Cancer
11:05 - Clinical Trials and Research Collaborations
14:21 - Navigating COG and Adult Oncology Groups
19:03 - Collaborative Approach to Kidney Tumors
29:31 - Resident Education and Collaboration
35:22 - Final Thoughts

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RESOURCES

Society of Urologic Oncology:
https://suonet.org/home.aspx

Children’s Oncology Group
https://www.childrensoncologygroup.org/

How can urologists and radiologists work together to improve kidney cancer treatment? In this episode, BackTable Tumor Board brings together Dr. Jason Abel (Professor of Urology and Radiology at the University of Wisconsin), Dr. Louis Hinshaw (Section Chief of Abdominal Imaging Intervention at the University of Wisconsin), and Dr. Ruchika Talwar (Assistant Professor of Urologic Oncology at Vanderbilt) for a multidisciplinary conversation regarding the treatment of renal tumors.

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This podcast is supported by:

⁠⁠Ferring Pharmaceuticals⁠

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SYNPOSIS

Their discussion covers the history and benefits of collaboration between urology and interventional radiology (IR), advances in image-guided procedural technologies, and the importance of teamwork in improving patient outcomes. The episode also considers the encouraging, but limited data in IR treatments such as microwave ablation and discusses the lasting role for surgery. Finally, Dr. Abel and Dr. Hinshaw share their experiences in establishing a successful interdisciplinary kidney cancer program. Ultimately, they conclude that the future of renal tumor treatment lies not in silos, but in collaboration.

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TIMESTAMPS

00:00 - Multidisciplinary Collaboration in Renal Tumor Treatment
05:59 - Advancements in Ablation Techniques: From Cryoablation to Microwave
10:13 - Ablation vs. Surgery: Patient Selection and Clinical Decision Making
14:00 - Technical Considerations and Complications in Ablation Procedures
24:19 - Patient Experience and Recovery Post-Ablation
36:17 - Importance of Teamwork in Modern Medicine

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RESOURCES

Society of Urologic Oncology
https://suonet.org/home.aspx

What does it take to deliver truly personalized, multidisciplinary care in testicular cancer? Get an inside look in this episode of BackTable Tumor Board, where renowned testicular cancer experts Dr. Nabil Adra and Dr. Richard Matulewicz join host Dr. Aditya Bagrodia for a virtual tumor board session on the nuanced management of germ cell tumors.

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This podcast is supported by:

⁠Ferring Pharmaceuticals

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SYNPOSIS

The expert panel uses specific patient cases to review their decision-making processes on the use of surgery, chemotherapy, and radiation. They highlight the importance of a multidisciplinary approach, particularly for advanced disease and challenging surgical scenarios. The episode reviews patient-specific factors, standard treatment protocols, post-treatment surveillance, and the latest research. This episode also highlights the benefits of personalized cancer care.

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TIMESTAMPS

00:00 - Case Presentation: 23-Year-Old Male with Testicular Mass
09:53 - Surveillance vs. Adjuvant Therapy Debate
13:53 - Recurrence, Comprehensive Staging, and Next Steps
23:09 - Case Study: 44-Year-Old with Mixed Non-Seminoma Germ Cell Tumor
27:47 - Surveillance and Surgery Recommendations
28:11 - Case Study: 17-Year-Old with Developmental Delay and Cancer
30:10 - Chemotherapy, Surgical Timing, and Prognosis
44:58 - Case Study: 21-Year-Old with Scrotal Swelling
47:12 - Surgical Considerations and Multidisciplinary Approach

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RESOURCES

Society of Urologic Oncology
https://suonet.org/home.aspx

There are now multiple phase 3 studies on combination transarterial chemoembolization (TACE) and immunotherapy showing a significant benefit over TACE alone. How do these findings change the hepatocellular carcinoma (HCC) treatment algorithm? In this multidisciplinary episode of the BackTable Podcast, Dr. Richard Finn (Medical Oncologist at UCLA) and Dr. Julius Chapiro (Interventional Radiologist at Yale University) join host Dr. Chris Beck to discuss immunotherapy, TACE, emerging trends in HCC treatment, and the future of the field.
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This podcast is supported by an educational grant from Guerbet.
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SYNPOSIS
The doctors highlight the importance of high quality clinical data and the pivotal studies shaping current best practices. They explore the role of the different players on the multidisciplinary team and compare the oncologic and radiologic perspectives. Additionally, they discuss the synergy between TACE and immunotherapy, the criteria for selecting appropriate treatments, and the ongoing need for research and collaboration.
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TIMESTAMPS
00:00 - Introduction
03:35 - HCC from an Oncologic Perspective
05:33 - Radiological Perspective on Liver Cancer
06:50 - Referral Patterns and Organizing a Multidisciplinary Approach
18:01 - Explaining TACE and Variations in the Procedure
27:27 - Choosing the Right Procedure for HCC
36:13 - Making a Decision on Medical Treatment Candidacy
42:23 - Importance of Data Driven HCC Treatment, Practical Insights, and Studies to Know
55:30 - Planning an Approach for a TACE Procedure
01:02:26 - Final Thoughts and Future Prospects in Liver Cancer Treatment
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RESOURCES
Barcelona Staging System:
https://www.ncbi.nlm.nih.gov/books/NBK569796/table/Ch3-t0001/
TRACE Trial:
https://pubs.rsna.org/doi/full/10.1148/radiol.211806
PREMIERE Trial:
https://www.gastrojournal.org/article/S0016-5085(16)34971-X/fulltext
EMERALD-1 Trial:
https://ascopubs.org/doi/10.1200/JCO.2024.42.3_suppl.LBA432
LEAP O12 Study:
https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(24)02575-3/abstract