Dr. Wright on Unmet Needs in Muscle-Invasive Bladder Cancer

Jonathan L. Wright, MD, MS, FACS
Published: Monday, Mar 11, 2019



Jonathan L. Wright, MD, MS, FACS, medical director of the University of Washington Medical Center Urology Clinic, associate professor of Urology at University of Washington, and affiliate investigator at the Fred Hutchinson Cancer Research Center, discusses unmet needs in muscle-invasive bladder cancer.

From a clinical perspective, the biggest unmet need in muscle-invasive bladder cancer is determining which patients will respond to neoadjuvant chemotherapy, says Wright. Physicians know that the approach results in improved survival; however, not all patients are going to respond to the therapy. Ongoing research is evaluating features of the tumor itself as well as gene expression for potential predictors of response, adds Wright.

Further, investigators are looking at the individual patient to determine if they harbor certain mutations that might make them more or less sensitive to cisplatin. That way, physicians can identify not only the patients with the highest chance for response, but those in whom chemotherapy should be avoided, says Wright.

Physicians also need to adopt more of a multidisciplinary approach in the management of patients with bladder cancer, he adds. That approach involves collaboration between urologists, medical oncologists, and radiation oncologists. He adds that more work needs to be focused on survivorship. Because bladder cancer is the most expensive cancer from diagnosis to death, guiding patients and their families on coping with the disease is a critical aspect of care that needs to be better addressed, concludes Wright.
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Jonathan L. Wright, MD, MS, FACS, medical director of the University of Washington Medical Center Urology Clinic, associate professor of Urology at University of Washington, and affiliate investigator at the Fred Hutchinson Cancer Research Center, discusses unmet needs in muscle-invasive bladder cancer.

From a clinical perspective, the biggest unmet need in muscle-invasive bladder cancer is determining which patients will respond to neoadjuvant chemotherapy, says Wright. Physicians know that the approach results in improved survival; however, not all patients are going to respond to the therapy. Ongoing research is evaluating features of the tumor itself as well as gene expression for potential predictors of response, adds Wright.

Further, investigators are looking at the individual patient to determine if they harbor certain mutations that might make them more or less sensitive to cisplatin. That way, physicians can identify not only the patients with the highest chance for response, but those in whom chemotherapy should be avoided, says Wright.

Physicians also need to adopt more of a multidisciplinary approach in the management of patients with bladder cancer, he adds. That approach involves collaboration between urologists, medical oncologists, and radiation oncologists. He adds that more work needs to be focused on survivorship. Because bladder cancer is the most expensive cancer from diagnosis to death, guiding patients and their families on coping with the disease is a critical aspect of care that needs to be better addressed, concludes Wright.



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