Dr. Steinberg on the Standard of Care in Non-Muscle Invasive Bladder Cancer

Gary D. Steinberg, MD
Published: Wednesday, Jan 23, 2019



Gary D. Steinberg, MD, director, Urologic Oncology, The University of Chicago Medicine, discusses the standard of care in patients with non-muscle invasive bladder cancer (NMIBC).

Bacillus Calmette-Guérin (BCG) is the current frontline standard for patients who are diagnosed with NMIBC, especially those with high-risk or high-grade disease, says Steinberg. Based on accumulated data sets, less than half of patients who should be receiving intravesical BCG actually are. Approximately 30% to 40% of patients with high-risk disease who receive BCG will progress to recurrent high-grade bladder cancer or develop progressive muscle-invasive bladder cancer.

Although the intravesical immunotherapy has been around since the 1980s, it remains an underutilized approach, says Steinberg. This may be a result of a lack of adherence to current guidelines, he adds. In 2015, the American Urology Association released new guidelines for patients with NMIBC which clearly outline how to diagnose, treat, and survey the disease—revisions of which Steinberg hopes are more commonly utilized moving forward.
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Gary D. Steinberg, MD, director, Urologic Oncology, The University of Chicago Medicine, discusses the standard of care in patients with non-muscle invasive bladder cancer (NMIBC).

Bacillus Calmette-Guérin (BCG) is the current frontline standard for patients who are diagnosed with NMIBC, especially those with high-risk or high-grade disease, says Steinberg. Based on accumulated data sets, less than half of patients who should be receiving intravesical BCG actually are. Approximately 30% to 40% of patients with high-risk disease who receive BCG will progress to recurrent high-grade bladder cancer or develop progressive muscle-invasive bladder cancer.

Although the intravesical immunotherapy has been around since the 1980s, it remains an underutilized approach, says Steinberg. This may be a result of a lack of adherence to current guidelines, he adds. In 2015, the American Urology Association released new guidelines for patients with NMIBC which clearly outline how to diagnose, treat, and survey the disease—revisions of which Steinberg hopes are more commonly utilized moving forward.



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