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Data + Perspectives: Clinical Investigators Discuss the Optimal Management of Urothelial Bladder Carcinoma
Released March 2020

Proceedings from a CME symposium held at the 2020 Genitourinary Cancers Symposium. Featuring perspectives from Drs Peter H O’Donnell, Daniel P Petrylak, Elizabeth R Plimack, Jonathan E Rosenberg and Guru Sonpavde. (Video Program)

CE Disclosures and Faculty Information

  • TARGET AUDIENCE
    This activity has been designed to meet the educational needs of medical and radiation oncologists, urologists and other allied healthcare professionals involved in the treatment of bladder cancer.

    OVERVIEW OF ACTIVITY
    The American Cancer Society estimates that 81,400 new cases of bladder cancer will be diagnosed in the United States in 2020 and 17,980 deaths will be attributable to this disease over that time. The disease is the fourth most common cancer in men in the United States and is 3 times as likely to be found in men than in women. Although bladder cancer is a heterogeneous collection of diseases, more than 90% of patients are diagnosed with its most common form, urothelial carcinoma. This activity will focus on the current and future management of urothelial carcinoma.

    LEARNING OBJECTIVES

    • Recall the recent FDA approval of anti-PD-1 antibody therapy for patients with high-risk non-muscle-invasive urothelial bladder cancer (UBC) that is unresponsive to BCG, and identify individuals who may be appropriate candidates for this approach in routine practice.
    • Compare and contrast the available clinical trial evidence with the use of first- and later-line immune checkpoint inhibitors for the treatment of metastatic UBC (mUBC) to determine the current utility of these agents in clinical practice.
    • Review available and emerging clinical trial data evaluating the use of anti-PD-1/PD-L1 antibodies in combination with chemotherapy for patients with previously untreated mUBC, and consider the potential role of this approach in routine practice.
    • Describe the frequency of fibroblast growth factor receptor (FGFR) abnormalities in patients with mUBC, and recognize the recent FDA approval of erdafitinib for individuals with susceptible FGFR3 or FGFR2 genetic alterations who have experienced disease progression during or after at least 1 line of prior platinum-containing chemotherapy.
    • Develop an understanding of the mechanism of action of and pivotal clinical trial findings leading to the recent FDA approval of enfortumab vedotin for patients with previously treated mUBC in order to appropriately integrate this novel compound into nonresearch treatment algorithms.
    • Appraise available research data and ongoing clinical trials evaluating anti-PD-1/PD-L1 antibodies in combination with targeted agents or other immunotherapeutic strategies for mUBC, and counsel appropriately selected patients about participation in active research protocols.
    • Recall new data with other investigational agents and strategies demonstrating promising activity in UBC, and discuss ongoing trial opportunities with eligible patients.

    PHYSICIAN COMPETENCIES TO BE ADDRESSED
    Medical Knowledge and Patient Care

    CONTACT INFORMATION
    If you have questions regarding credit, please contact cpdsupport@usf.edu, or call 813-224-7860.

    ACCREDITATION STATEMENT
    USF Health is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

    USF Health designates this enduring material for a maximum of 2.25 AMA PRA Category 1 Credits. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

    AMERICAN BOARD OF INTERNAL MEDICINE (ABIM) — MAINTENANCE OF CERTIFICATION (MOC)
    Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to 2.25 Medical Knowledge MOC points in the American Board of Internal Medicine’s (ABIM) Maintenance of Certification (MOC) program. Participants will earn MOC points equivalent to the amount of CME credits claimed for the activity. It is the CME activity provider’s responsibility to submit participant completion information to ACCME for the purpose of granting ABIM MOC credit.

    Please note, this program has been specifically designed for the following ABIM specialty: medical oncology.

    For ABIM MOC points, your information will be shared with the ABIM through USF Health's ACCME Program and Activity Reporting System (PARS). Please allow 6-8 weeks for MOC points to appear on your ABIM records.

    Personal information and data sharing: Research To Practice and USF Health aggregate deidentified user data for program-use analysis, program development, activity planning and site improvement. We may provide aggregate and deidentified data to third parties, including commercial supporters. We do not share or sell personally identifiable information to any unaffiliated third parties or commercial supporters. Please see our privacy policy at ResearchToPractice.com/Privacy-Policy for more information.

    HOW TO USE THIS CME ACTIVITY
    This CME activity consists of a video component. To receive CME credit and ABIM MOC points, the participant should review the CME information, watch the video, complete the Post-test with a score of 70% or better and fill out the Educational Assessment and Credit Form located at ResearchToPractice.com/GUCancers20/Bladder/CME.

    CONTENT VALIDATION AND DISCLOSURES
    USF Health adheres to ACCME Standards regarding commercial support of continuing medical education. It is the policy of USF Health and Research To Practice that the faculty and planning committee disclose real or apparent conflicts of interest relating to the topics of this educational activity, that relevant conflict(s) of interest are resolved and also that speakers will disclose any unlabeled/unapproved use of drug(s) or device(s) during their presentation.

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

    Peter H O’Donnell, MD
    Associate Professor, Department of Medicine
    Section of Hematology/Oncology
    Genitourinary Oncology Program
    The University of Chicago
    Chicago, Illinois

    Consulting Agreement: Merck; Honoraria: Astellas, Atheneum Partners, FirstWord Publication, Genentech, a member of the Roche Group, Health Advances, Janssen Biotech Inc, Merck, OncLive, Seattle Genetics, Schlesinger Associates, The Dedham Group; Ownership Interest: Allergan, PrescriptIQ; Paid Travel: Astellas, Genentech, a member of the Roche Group, Janssen Biotech Inc, Merck, Seattle Genetics; Independent Safety and Monitoring Board: Janssen Biotech Inc, Nektar.

    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, 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, AstraZeneca Pharmaceuticals LP, Bayer HealthCare Pharmaceuticals, Bristol-Myers Squibb Company, Clovis Oncology, Endocyte Inc, Genentech, Innocrin Pharmaceuticals Inc, Lilly, Merck, Novartis, Pfizer Inc, Progenics Pharmaceuticals Inc, Roche Laboratories Inc, Sanofi Genzyme, Seattle Genetics; Ownership Interest: Bellicum Pharmaceuticals Inc, Tyme Inc.

    Elizabeth R Plimack, MD, MS
    Chief, Division of Genitourinary Medical Oncology
    Director, Genitourinary Clinical Research
    Professor, Department of Hematology/Oncology
    Fox Chase Cancer Center
    Temple Health
    Philadelphia, Pennsylvania

    Advisory Committee: Bristol-Myers Squibb Company, Flatiron Health, Genentech, Merck, Seattle Genetics; Contracted Research: Astellas, Bristol-Myers Squibb Company, Genentech, Merck; Data and Safety Monitoring Board/Committee: AstraZeneca Pharmaceuticals LP, Pfizer Inc.

    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

    Consulting Fees, Contracted Research: Astellas, AstraZeneca Pharmaceuticals LP, Bayer HealthCare Pharmaceuticals, Genentech, Mirati Therapeutics, Roche Laboratories Inc, Seattle Genetics; Consulting Agreements: Adicet Bio, Astellas, AstraZeneca Pharmaceuticals LP, Bayer HealthCare Pharmaceuticals, BioClin/Rainier Therapeutics, Biotherapeutics, Boehringer Ingelheim Pharmaceuticals Inc, Bristol-Myers Squibb Company, Fortress Biotech, Genentech, GlaxoSmithKline, Janssen Biotech Inc, Merck, Mirati Therapeutics, Pharmacyclics LLC, an AbbVie Company, QED Therapeutics, Roche Laboratories Inc, Seattle Genetics, Sensei Biotherapeutics, Western Oncolytics; Contracted Research: Astellas, AstraZeneca Pharmaceuticals LP, Bayer HealthCare Pharmaceuticals, Genentech, Novartis, QED Therapeutics, Roche Laboratories Inc, Seattle Genetics; Honorarium: Chugai Pharmaceutical Co Ltd; Data and Safety Monitoring Board/Committee: BioClin/Rainier Therapeutics.

    Guru Sonpavde, MD
    Director, Bladder Cancer
    Dana-Farber Cancer Institute
    Boston, Massachusetts

    Advisory Committee: Amgen Inc, Astellas, AstraZeneca Pharmaceuticals LP, Bristol-Myers Squibb Company, Bicycle Therapeutics, Eisai Inc, EMD Serono Inc, Exelixis Inc, Genentech, Janssen Biotech Inc, Merck, National Comprehensive Cancer Network, Novartis, Pfizer Inc, Sanofi Genzyme, Seattle Genetics; Research Support to Institution: AstraZeneca Pharmaceuticals LP, Bayer HealthCare Pharmaceuticals, Boehringer Ingelheim Pharmaceuticals Inc, Celgene Corporation, Merck, Onyx Pharmaceuticals, an Amgen subsidiary, Pfizer Inc, Sanofi Genzyme; Travel Costs: AstraZeneca Pharmaceuticals LP, Bristol-Myers Squibb Company; Speaking Fees: Physicians Education Resource (PER), OncLive, Research To Practice, Clinical Care Options; Writing Fees: UpToDate; Steering Committee of Trials: Astellas, Bavarian Nordic, Bristol-Myers Squibb Company, Debiopharm Group, QED Therapeutics, Seattle Genetics (all unpaid), and AstraZeneca Pharmaceuticals LP and Debiopharm Group (both paid); Consulting Agreements: AstraZeneca Pharmaceuticals LP, Merck; Data and Safety Monitoring Board/Committee: Boehringer Ingelheim Pharmaceuticals Inc.

    COURSE DIRECTOR/PANEL 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, AstraZeneca Pharmaceuticals LP, Bayer HealthCare Pharmaceuticals, Biodesix Inc, bioTheranostics Inc, Blueprint Medicines, Boehringer Ingelheim Pharmaceuticals Inc, Boston Biomedical Inc, Bristol-Myers Squibb Company, Celgene Corporation, Clovis Oncology, Daiichi Sankyo Inc, Dendreon Pharmaceuticals Inc, Eisai Inc, EMD Serono Inc, Exelixis Inc, Foundation Medicine, Genentech, a member of the Roche Group, Genmab, Genomic Health Inc, Gilead Sciences Inc, GlaxoSmithKline, 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, A GSK Company, Teva Oncology, Tokai Pharmaceuticals Inc and Tolero Pharmaceuticals.

    USF HEALTH CPD STAFF, RESEARCH TO PRACTICE CME PLANNING COMMITTEE MEMBERS, STAFF AND REVIEWERS — 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, Genentech, a member of the Roche Group, 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: March 2020
    Expiration date: March 2021

    After completing the Post-test, learners may download and review the answers here in order to identify further areas of study.

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