Siamak Daneshmand, MD

BCG-unresponsive NMIBC requires vigilant surveillance during new treatments to avoid missing signs of progression and avoid delaying cystectomy, which remains the best chance for cure if intravesical therapies are failing.

BCG-unresponsive non-muscle invasive bladder cancer has multiple emerging treatment options in trials showing good response rates, though optimal sequencing remains to be determined.

TAR-200 is being studied for carcinoma in situ with or without papillary disease since it addresses diffuse CIS that cannot be surgically removed, though future trials will expand to papillary disease as adjuvant therapy like BCG, with the goal of extending the disease-free period before potentially reintroducing therapy as needed.

The TAR-200 treatment has demonstrated a favorable safety profile in clinical trial, with primarily low-grade irritated voiding symptoms that are manageable and expected with intravesical therapy, without concerning systemic side effects, making it a promising new option to delay or reduce radical cystectomy in patients with BCG-unresponsive NMIBC.

The TAR-200 treatment for BCG-unresponsive NMIBC works through a catheter-placed intravesical device that elutes gemcitabine over 3 weeks, providing a high complete response rate of 77% in early testing, likely due to the sustained release mechanism.

BCG-unresponsive NMIBC treatment aims to eradicate disease or prolong disease-free intervals, with radical cystectomy as gold standard; newer options like pembrolizumab and gemcitabine/docetaxel provide improved alternatives, though logistic challenges remain.

BCG-unresponsive non-muscle invasive bladder cancer risks invasive progression; providers should suspect disease based on any abnormalities in cystoscopy and cytology, not just voiding symptoms.

Siamak Daneshmand, MD, discusses TAR-200 and what led investigators to evaluate the agent in the phase 2b SunRISE-1 study.

Sia Daneshmand, MD on the non-muscle invasive bladder cancer treatment paradigm.

Siamak Daneshmand, MD, associate professor of Urology, Director of Clinical Research, Keck School of Medicine of USC, discusses blue light cystoscopy compared with white light cystoscopy for patients with bladder cancer.