Bladder Cancer   

If so, do you use it for all patients or only cisplatin doses >= 70 mg/m2? What dose of mannitol do you use?

If you do recommend adjuvant therapy, what regimen would you use?

NCCN states to consider adjuvant chemotherapy similar to muscle invasive bladder cancer in this scenario, but one would avert adjuvant chemotherapy in...

Would T or N group change your recommendation?

Does this raise concerns about the efficacy of adjuvant immune checkpoint inhibition? Are any preliminary results from AMBASSADOR (adjuvant pembrolizu...

Weekly (20 mg/m2 D1, D2) and q 3 wks (70 mg/m2 x 3c or 100 mg/m2 x 3c) regimens have all been listed as acceptable.  For reference, RTOG 97&...

The forest plot from CheckMate 274 did not show a benefit for such patients? How would you select between adjuvant chemotherapy and adjuvant nivoluma...

Do you think adjuvant nivolumab should be the new standard of care based on current CM274 DFS data? If OS turns out to be no different, will you still...

How does prior chemotherapy, site of disease, and pathological staging inform your decision? How about molecular markers (PD-L1, ctDNA)?

Is a 3 month delay too long in someone who had postoperative complications?

Does PDL1 status impact your decision?

NGS of TURBT specimen had high TMB (18 Muts/Mb).

Would you do consolidation radiation or active surveillance? Would presence of variant histology change your recommendation?

Would a PET avid pelvic lymph node without distant metastatic disease change your management?

If not carboplatin, would you recommend nivolumab instead?

If any clinical benefit (ie. CR, PR or SD) would you consider switch maintenance avelumab, surveillance until progression, or an alternate regimen?

Molecular profiling revealed no targetable alterations, however tumor mutational burden was >10 mut/Mb.

The recommended concurrent chemotherapy regimens (cisplatin/paclitaxel and cisplatin/FU) in NCCN are based on BID fractionation of radiation as in RTO...

How would non-regional adenopathy change management? What about poor surgical candidacy?

Would radical prostatectomy and PLND suffice or would a cystectomy be warranted (even in the absence of bladder involvement) as well? 

If no direct invasion into prostate from bladder or urethra, is there any role for systemic therapy?

Any role for surgical extirpation vs systemic treatment?

Patient has not had any prior systemic treatment and is cisplatin-eligible.

Can chemoradiation be curative without maximal debulking TURBT?

Given long term data from Keynote 052 for pembrolizumab presented at ASCO 2021. What factors impact your treatment decisions? For cis-ineligible PD-...

What would your treatment approach be- surgery or chemoRT? What is your preferred chemo regimen? Is there a % threshold other than 100% (e.g. 95%) th...

Assuming no actionable mutations?

Specifically, for cT2N0M0 small cell bladder cancer without response to neoadjuvant cisplatin and etoposide on imaging, would you proceed with cystect...

What neoadjuvant or adjuvant therapy would you give?

Would it change your decision if they had progressed on a first-line trial with cisplatin followed by pembrolizumab plus enfortumab vedotin maintenanc...

Is there a role for neoadjuvant cisplatin-based chemotherapy? Do patients with sarcomatoid histology respond to checkpoint inhibitors?

No actionable mutation on NGS testing. What approved therapy do you prefer? Are there specific investigational agents currently in clinical trial...

Any role of neoadjuvant chemotherapy?

i.e.  Cisplatin + Etoposide

Is there data to support proceeding directly to cystectomy?

If so, what regimen would you use? Would a carboplatin-based regimen be acceptable or only cisplatin?

Do you prefer surgery vs radiation? For surgical patients, do you offer neoadjuvant chemotherapy? If so what regimen? 

If so, for how long would you treat?

https://meetinglibrary.asco.org/record/186872/abstract How do you weigh the negative results from IMvigor 010 of adjuvant atezolizumab vs the results...

If offering neoadjuvant chemotherapy, which regimen would you use?

Would you forego neoadjuvant chemotherapy? Are you using growth factor support differently? Any changes to immunotherapy? Other considerations?

Any role to switch to MVAC?

Would you treat with chemoimmunotherapy based on IMvigor130 data presented at ESMO Congress 2019?

e.g. lymph node metastasis, presence of tumor involving the peritoneal surfaces and/or the abdominal wall. If so, which regimen would you offer?

Patient has small cell carcinoma of the bladder with extensive hepatic metastases. Would you extrapolate the approach from IMpower133?

NCCN guidelines suggest systemic therapy only or concurrent chemoradiotherapy. What is your approach?

There are now five PD-1/PDL-1 inhibitors approved for metastatic bladder CA, one (Atezolizumab) as first-line therapy in cisplatin-ineligible patients...

What systemic therapy do you use? Do you incorporate any multi-modality therapies?

Would you recommend radiation and/or systemic therapy? If you would irradiate, what would your fields/volumes look like? 

The current treatment for bladder adenoCA is surgery. However in non-surgical candidates, RT is an option. Would you consider adding chemo ? Also woul...

For a patient with a history of non-muscle invasive disease in the bladder, presenting with a prostatic urethra only recurrence, do you approach this ...

In the IMvigor 210 trial, increased PD-L1 expression in patients’ tumors was associated with response to atezolizumab, but some patients whose t...

Since the benefit of neoadjuvant chemotherapy is well-defined in muscle-invasive bladder cancer, is it reasonable to consider this in upper-tract tumo...

Assuming a patient who could tolerate either, which is preferred? Does this depend on the choice for concurrent chemotherapy (5FU+mitomycin vs ci...