BCa18: Shifting landscape prompts new approaches

10 March 2018

With new genetic research, drug development and fresh insights in immunology, rapid changes are unfolding in the diagnosis and management of urothelial tumours, a tall challenge that prompts onco-urological specialists to adjust their approach for new and optimal management strategies.

To address this challenge and offer an educational event that critically looks into various and novel ways of diagnosis and treatment, the EAU Update on Bladder Cancer presents a unique two-day update meeting on 8 and 9 June in Munich, Germany.

“We are witnessing many novel developments in diagnosis and treatment that impacts on current guidelines and practices. How do we optimize our management within the context of current standards while keeping in mind the possibilities offered by new medical therapies? How does systemic treatment impact on more radical options such as surgery? Balancing these pathways and making a timely, insightful decision is a challenge,” says Prof. Hein van Poppel, member of the Steering Committee together with Profs. Francesco Montorsi and Manfred Wirth.

“There are new opportunities in both locally advanced and metastatic disease. Identifying these potential drug therapies and taking them into careful consideration for the right patient (after careful selection) and at the right time can help improve quality of life or even impact survival prospects,” said Montorsi. He said the European Association of Urology (EAU) and the European Society for Medical Oncology (ESMO) has collaborated to pool their expertise and resources for an expert-led update.

Recent trials have made inroads in bladder cancer outcomes realized through immuno-oncology approaches. “There is, therefore, the urgent need to further deploy multidisciplinary care not only in muscle-invasive bladder cancer but also in non-muscle invasive bladder cancer,” noted Van Poppel.
A compact and fully interactive meeting, BCa19 goes straight into the core topics and treatment dilemmas of metastatic and high-risk bladder disease. It will explore and identify key issues with Day 1 divided into two parts. The first session “High risk non-muscle invasive bladder cancer: From guidelines to future approaches” will go through EAU and ESMO Guidelines on non-muscle invasive bladder cancer (NMIBC), and pinpoint the gaps between guideline recommendations and actual clinical practice. Surgical and systemic approaches in muscle invasive and advanced bladder cancer, meanwhile, will be the focus of the second session.

A fully interactive case discussion segment will link the two sessions with participants breaking out into three groups for a more detailed, one-on-one discussions with the expert faculty. Aside from questions posed by participants, direct voting regarding treatment decisions will enable both faculty and participants to ferret out insights on best practices, multidisciplinary considerations and drug sequencing, which helps refine clinical practice. To-the-point commentary and evidence-based medicine will characterize the active exchange between the expert panel and participants.

Forward-looking management strategies
Day 2 will look into forward-looking treatment options and clinical opportunities with the first session taking up “What is new in bladder cancer classification and treatment?” and the second examining postoperative management of surgical patients. As in Day 1, and following three update lectures, the breakout groups will go into detailed discussions. Each faculty group will consists of two experts examining topics such as indications and patient selection in palliative cystectomy, management of metastatic bladder cancer, and dealing with histological variants in bladder cancer.

Post-operative management issues will examine enhanced recovery after radical cystectomy (ERAS) and immunonutrition in bladder cancer patients. In the case discussions, issues up for discussion are optimising peri- and post-operative management and managing complications in radical cystectomy, and selection and optimal treatment in bladder sparing for muscle invasive bladder cancer (MIBC).

Organisers are aware of the need for cancer specialists from various disciplines to update and refine their practices in the wake of new or anticipated outcomes.

“Ongoing trials are coming up with fresh insights and how to employ or integrate new knowledge and translate them into bedside practice for effective patient management are the main goals of this update meeting,” said Van Poppel, as he added that it is a unique opportunity for two frontline medical organizations to harness the expertise of their members.