Flaig Discusses NCCN Guidelines in Bladder Cancer

Thomas Flaig, MD, discusses some of the updated and current NCCN guidelines for patients with bladder cancer.

Thomas Flaig, MD, vice chancellor of research for the University of Colorado Denver, member, University of Colorado Cancer Center, and the University of Colorado Anschutz Medical Campus, Chair of the National Comprehensive Cancer Network (NCCN) Guidelines Panel for Bladder Cancer, discusses some of the current NCCN guidelines in bladder cancer.

According to Flaig, there have been a number of changes in the NCCN guidelines. Included in the guidelines are now the use of avelumab as maintenance therapy, and use of immune checkpoint inhibitors (ICIs) for the first-line treatment of patients who are cisplatin-ineligible or patients with PD-1-positive or platinum-ineligible disease.

Over the past few years, there have been updates to systemic therapies. Some of these consist of new roles for ICIs in patients with BCG-unresponsive non-muscle invasive bladder cancer as well as the adjuvant treatment of muscle-invasive bladder cancer following cystectomy.


0:08 | For bladder cancer, we think about it broadly and the NCCN guidelines certainly have captured this. The treatment of bladder cancer has undergone a period of very rapid change over the last 5 or more years. If you'd look back 10 years ago, we had very little development in terms of new drugs and new therapies for bladder cancer. Then 5 or 6 years ago, we had the introduction of immune checkpoint inhibitors, and more recently, the integration of those across several different disease states in bladder cancer.

0:42 | More recently with the addition of antibody drug conjugates and targeted therapies with FGFR inhibitors and so forth, it's been a period of rapid growth in the therapeutic armamentarium for bladder cancer. The NCCN guidelines have worked to assess new data and decide how the guidelines should be changed along those lines. It is a very exciting time in bladder cancer for providers, patients, and advocates.