Analyzing Frontline Options for Patients With Bladder Cancer

Opinion
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Thomas Powles, MD, shares his advice for community oncologists treating patients with bladder cancer in the frontline setting. According to Powles, this is a setting where there is a lot of uncertainty that can make decision making difficult.

Thomas Powles, MD, Barts Cancer Institute, shares his advice for community oncologists treating patients with bladder cancer in the frontline setting. According to Powles, this is a setting where there is a lot of uncertainty that can make decision making difficult.

Powles advises clinicians treat patients who are biomarker-positive with immunotherapy, particularly those who will benefit from chemotherapy if the immunotherapy does not work. This also includes patients who have relatively low aggressive disease or rapidly progressive liver metastases.

For patients with slow progressive bladder cancer, clinical trials are looking for more attractive approaches than chemotherapy for these patients. While data are still not available from randomized trials, it is best to air on the safe side with chemotherapy treatment.

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