Dr. Grivas on Bladder Preservation in Localized Bladder Cancer

Petros Grivas, MD, PhD, director, University of Washington Medicine’s Genitourinary Cancers Program, associate professor, oncology, University of Washington, Seattle Cancer Care Alliance, discusses data on bladder preservation in patients with localized bladder cancer.

There is a significant effort being devoted to improving upon the data with bladder preservation, explains Grivas. Historically, physicians have used concurrent chemotherapy and radiation and chemoradiation as a backbone for patients with localized disease. An ongoing intergroup trial with SWOG, NRG Oncology, ECOG-ACRIN, and ALLIANCE is looking at chemoradiation alone or chemoradiation plus atezolizumab (Tecentriq) to see whether the combination could improve upon bladder intact disease-free survival and other endpoints. If the trial accrues well, it will add to the current body of knowledge on bladder preservation, explains Grivas.

Biomarkers are crucial here, he adds. In those trials—especially the neoadjuvant trials—investigators are collecting tissue as well as blood and urine samples. By collecting those biospecimens, investigators may be able to identify potential biomarkers. To help biomarker discovery and validation, investigators have to align more endpoints, and therein, attempts of which biomarkers to look for, says Grivas. As an oncology community, physicians need to work smarter, so that the appropriate treatment can be selected for the right patient.