Management of High Risk NMIBC—What’s New in Intravesical Therapy | Treatment of Bladder Cancer

Jodi K. Maranchie, MD, FACS, Associate Professor of Urology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, presents an update on the management of high-risk non-muscle-invasive bladder cancer and reviews new developments in intravesical therapy. She begins with a case illustrating recurrence after BCG and the sequence of decisions involved in bladder-sparing treatment. High-risk NMIBC is defined, and the presentation reviews response rates to BCG, risk of recurrence, and the risk of progression if definitive treatment is delayed. Dr. Maranchie discusses sequential gemcitabine and docetaxel as a commonly used bladder-sparing option and reviews its use after BCG failure and in BCG-naive settings. She also reviews recently approved and emerging therapies, including nadofaragene firadenovec, nogapendekin alfa inbakicept given with BCG, TAR-200, and cretostimogene grenadenorepvec, as well as additional investigational agents. Dr. Maranchie shares patient-reported outcomes from the CISTO study, including physical function and quality-of-life measures, comparing patients who chose bladder-sparing therapy with those who chose cystectomy. This presentation reviews current treatment options and counseling considerations for patients with high-risk NMIBC. Don't forget to join the GRU Community: https://grandroundsinurology.com/regi... Follow us on Twitter/X: https://x.com/GRUrology And like and subscribe to us here on YouTube! #BladderCancer #NMIBC #Urology #IntravesicalTherapy #BCG