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Breakfast with the Investigators: Current and Future Management of Urothelial Bladder Carcinoma
Released July 2019

Proceedings from a CME symposium held at the 2019 ASCO Annual Meeting. Featuring perspectives from Dr Daniel P Petrylak, Prof Thomas Powles and Dr Jonathan E Rosenberg. (Video Program)

CE Disclosures and Faculty Information

    This activity is intended for hematologists, medical oncologists and other healthcare providers involved in the treatment of bladder cancer.

    It is estimated that 80,470 new cases of bladder cancer will be diagnosed in 2019 and 17,670 deaths will be attributable to this disease. Optimal treatment of its most common form, urothelial bladder cancer (UBC), is dependent upon the stage and grade of the tumor and preexisting patient comorbidities. For those patients who present with or develop metastatic lesions beyond the bladder, cure is not attainable and thus the goal of therapy is to prolong the quantity and quality of life. Historically, therapeutic options in this setting were largely limited to chemotherapy, but more recently a number of novel agents and strategies have yielded favorable outcomes, leading to a spate of FDA approvals and promise that more may be forthcoming. In addition, significant enthusiasm exists for the investigation of these approaches in nonmetastatic disease. These developments, coupled with the plethora of controversies and uncertainties plaguing the current management of this challenging disease, provide a solid impetus for ongoing efforts that seek to enhance the knowledge of practicing clinicians.

    These video proceedings from a CME symposium held during the 2019 ASCO Annual Meeting feature discussions with leading researchers with an expertise in UBC regarding actual cases from their practices and the published data that drive clinical decision-making for patients in those and diverse other situations. By providing information on the latest research developments and their potential application to routine practice, this activity is designed to assist with the formulation of up-to-date clinical management strategies.


    • Appraise recent data on diagnostic and therapeutic advances in UBC, and integrate this information, as appropriate, into current clinical care.
    • Compare and contrast the available clinical trial evidence with the use of immune checkpoint inhibitors for the treatment of UBC to determine the current utility of these agents in clinical practice.
    • Appreciate recent revisions to the FDA approvals of atezolizumab and pembrolizumab limiting the use of these agents for patients with locally advanced or metastatic UBC who have not received prior therapy, are not eligible for cisplatin-containing treatment or who have low expression of PD-L1.
    • Describe ongoing research to assist in the identification of biomarkers, tumor characteristics or other clinical features that are predictive of response to immune checkpoint inhibitors in patients with UBC.
    • Recognize immune-related adverse events and other common side effects associated with approved immune checkpoint inhibitors, and use this information to develop supportive management plans for patients with UBC undergoing treatment with these agents.
    • Consider available and emerging data with anti-PD-1/PD-L1 antibodies alone in earlier disease settings or in combination with other systemic approaches, and refer eligible patients for appropriate trial participation.
    • Recognize the mechanisms of action and available trial data with approved and investigational novel targeted agents with activity in patients with relapsed/refractory UBC to determine the current or future utility of these agents in practice.
    • Recall new data with other investigational agents and strategies demonstrating promising activity in UBC, and discuss ongoing trial opportunities with eligible patients.

    Research To Practice is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.

    CME credit is no longer available for this issue

    CME credit is no longer available for this issue

    This CME activity consists of a video component.
    CME credit is no longer available for this issue

    Research To Practice (RTP) is committed to providing its participants with high-quality, unbiased and state-of-the-art education. We assess conflicts of interest with faculty, planners and managers of CME activities. Conflicts of interest are identified and resolved through a conflict of interest resolution process. In addition, all activity content is reviewed by both a member of the RTP scientific staff and an external, independent physician reviewer for fair balance, scientific objectivity of studies referenced and patient care recommendations.

    FACULTY — The following faculty (and their spouses/partners) reported relevant conflicts of interest, which have been resolved through a conflict of interest resolution process:

    Daniel P Petrylak, MD
    Professor of Internal Medicine (Medical Oncology) and Urology
    Yale University
    New Haven, Connecticut

    Consulting Agreements: Advanced Accelerator Applications, Amgen Inc, Astellas Pharma Global Development Inc, AstraZeneca Pharmaceuticals LP, Bayer HealthCare Pharmaceuticals, Boehringer Ingelheim Pharmaceuticals Inc, Bristol-Myers Squibb Company, Clovis Oncology, Exelixis Inc, Incyte Corporation, Janssen Biotech Inc, Lilly, Pfizer Inc, Pharmacyclics LLC, an AbbVie Company, Roche Laboratories Inc, Seattle Genetics, UroGen Pharma; Contracted Research: Advanced Accelerator Applications, Astellas Pharma Global Development Inc, AstraZeneca Pharmaceuticals LP, Bayer HealthCare Pharmaceuticals, Bristol-Myers Squibb Company, Clovis Oncology, Endocyte Inc, Genentech, Innocrin Pharmaceuticals Inc, Lilly, MedImmune Inc, Merck, Novartis, Pfizer Inc, Progenics Pharmaceuticals Inc, Roche Laboratories Inc, Sanofi Genzyme, Seattle Genetics; Ownership Interest: Bellicum Pharmaceuticals Inc, Tyme Inc.

    Thomas Powles, MBBS, MRCP, MD
    Professor of Genitourinary Oncology
    Barts Cancer Institute
    Director of Barts Cancer Centre
    Queen Mary University of London
    London, United Kingdom

    Consulting Agreements: Exelixis Inc, Incyte Corporation, Ipsen Biopharmaceuticals Inc, Seattle Genetics.

    Jonathan E Rosenberg, MD
    Chief, Genitourinary Medical Oncology Service
    Division of Solid Tumor Oncology
    Enno W Ercklentz Chair
    Memorial Sloan Kettering Cancer Center
    New York, New York

    Advisory Committee: Bristol-Myers Squibb Company, Merck; Consulting Agreements: Adicet Bio, Astellas Pharma Global Development Inc, AstraZeneca Pharmaceuticals LP, Bayer HealthCare Pharmaceuticals, Bristol-Myers Squibb Company, EMD Serono Inc, Fortress Biotech, Genentech, GlaxoSmithKline, Gritstone Oncology, Inovio Pharmaceuticals Inc, Lilly, Merck, Mirati Therapeutics, Pharmacyclics LLC, an AbbVie Company, Rainier Therapeutics, Roche Laboratories Inc, Seattle Genetics, Sensei Biotherapeutics, Western Oncolytics; Contracted Research: Novartis; Data and Safety Monitoring Board/Committee: Rainier Therapeutics.

    MODERATOR — Dr Love is president and CEO of Research To Practice. Research To Practice receives funds in the form of educational grants to develop CME activities from the following commercial interests: AbbVie Inc, Acerta Pharma — A member of the AstraZeneca Group, Adaptive Biotechnologies, Agendia Inc, Agios Pharmaceuticals Inc, Amgen Inc, Ariad Pharmaceuticals Inc, Array BioPharma Inc, Astellas Pharma Global Development Inc, AstraZeneca Pharmaceuticals LP, Bayer HealthCare Pharmaceuticals, Biodesix Inc, bioTheranostics Inc, Boehringer Ingelheim Pharmaceuticals Inc, Boston Biomedical Inc, Bristol-Myers Squibb Company, Celgene Corporation, Clovis Oncology, Daiichi Sankyo Inc, Dendreon Pharmaceuticals Inc, Eisai Inc, Exelixis Inc, Foundation Medicine, Genentech, Genmab, Genomic Health Inc, Gilead Sciences Inc, Guardant Health, Halozyme Inc, ImmunoGen Inc, Incyte Corporation, Infinity Pharmaceuticals Inc, Ipsen Biopharmaceuticals Inc, Janssen Biotech Inc, administered by Janssen Scientific Affairs LLC, Jazz Pharmaceuticals Inc, Kite Pharma Inc, Lexicon Pharmaceuticals Inc, Lilly, Loxo Oncology Inc, a wholly owned subsidiary of Eli Lilly & Company, Merck, Merrimack Pharmaceuticals Inc, Myriad Genetic Laboratories Inc, Natera Inc, Novartis, Oncopeptides, Pfizer Inc, Pharmacyclics LLC, an AbbVie Company, Prometheus Laboratories Inc, Puma Biotechnology Inc, Regeneron Pharmaceuticals Inc, Sandoz Inc, a Novartis Division, Sanofi Genzyme, Seattle Genetics, Sirtex Medical Ltd, Spectrum Pharmaceuticals Inc, Taiho Oncology Inc, Takeda Oncology, Tesaro, Teva Oncology, Tokai Pharmaceuticals Inc and Tolero Pharmaceuticals.

    RESEARCH TO PRACTICE CME PLANNING COMMITTEE MEMBERS, STAFF AND REVIEWERS — Planners, scientific staff and independent reviewers for Research To Practice have no relevant conflicts of interest to disclose.

    This educational activity contains discussion of published and/or investigational uses of agents that are not indicated by the Food and Drug Administration. Research To Practice does not recommend the use of any agent outside of the labeled indications. Please refer to the official prescribing information for each product for discussion of approved indications, contraindications and warnings. The opinions expressed are those of the presenters and are not to be construed as those of the publisher or grantors.

    This activity is supported by educational grants from Astellas and Seattle Genetics, AstraZeneca Pharmaceuticals LP, Genentech and Merck.

    Hardware/Software Requirements:
    A high-speed Internet connection
    A monitor set to 1280 x 1024 pixels or more
    Internet Explorer 11 or later, Firefox 56 or later, Chrome 61 or later, Safari 11 or later, Opera 48 or later
    Adobe Flash Player 27 plug-in or later
    Adobe Acrobat Reader
    (Optional) Sound card and speakers for audio

    Release date: July 2019
    Expiration date: July 2020

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