BackTable Tumor Board

When treating head and neck cancer, how can you tell the difference between true disease progression and pseudoprogression? In this episode of the BackTable Podcast, we discuss the practical implementation of the KEYNOTE-689 trial published in the New England Journal of Medicine, which demonstrated the benefit of adding neoadjuvant and adjuvant immunotherapy to standard head and neck cancer care. Our tumor board panel includes Dr. Mihir Patel, a head and neck surgeon from UNC Chapel Hill, Dr. Siddharth Sheth, a head and neck medical oncologist from UNC, Dr. Jennifer Johnson, a professor of medical oncology and otolaryngology at Sidney Kimmel Comprehensive Cancer Center, and Dr. Adam Luginbuhl, a head and neck surgical oncologist at Thomas Jefferson University.---SYNPOSISThe doctors address the trial's practical implications, patient selection, case management, dealing with tumor progression, and the integration of multidisciplinary care. They also emphasize the importance of communication, real-world application of trial protocols, and the potential benefits and challenges of such therapies.---TIMESTAMPS00:00 - Introduction03:18 - Discussing the New Indication for Immunotherapy11:42 - Challenges and Practical Implementation22:48 - Managing Tumor Progression: A Case Study28:07 - Exploring Treatment Options: Surgery vs. Chemotherapy36:46 - Operational Challenges and Future Directions43:58 - Concluding Thoughts and Future Directions---RESOURCESKeynote 689https://www.nejm.org/doi/full/10.1056/NEJMoa2415434

While the standard for adjuvant head and neck cancer treatment hasn't changed since 2004, a new trial using perioperative pembrolizumab is forcing clinicians to rethink their entire workflow, starting with diagnosis. In this episode of the BackTable Podcast, head and neck surgical oncologist Dr. Adam Luginbuhl is joined by colleagues Dr. Dylan Roden and Dr. Ravindra Uppaluri to discuss the implementation and implications of the Keynote-689 trial, which introduced neoadjuvant and adjuvant immunotherapy for locally advanced head and neck cancer.---SYNPOSISThe doctors discuss the trial details, FDA approval, and practical challenges of integrating this new paradigm into clinical practice. The conversation covers critical points such as the necessity of CPS score testing, timely drug administration, patient monitoring, and the importance of collaboration among multidisciplinary teams.---TIMESTAMPS00:00 - Introduction02:18 - Keynote-689 Trial Explained04:42 - Implementation Challenges and Strategies06:40 - Practical Considerations for CPS Testing13:59 - Case Studies and Real-World Applications30:48 - Future Directions and Final Thoughts---RESOURCESKeynote-689https://www.nejm.org/doi/full/10.1056/NEJMoa24154342004 Cisplatin Phase III Trialhttps://www.nejm.org/doi/full/10.1056/NEJMoa032646

One of the most common dilemmas in urologic oncology: what do you do when a patient has T1 disease in both the bladder and the ureter? In the final episode of the 2025 NMIBC Creator Weekend™ series, Dr. Vignesh Packiam, Dr. Mark Tyson and Dr. Sarah Psutka share how they approach complex bladder cancer cases with upper tract involvement. --- This podcast is supported by: ⁠Ferring Pharmaceuticals⁠ --- SYNPOSIS The doctors discuss complex bladder cancer cases, sequencing treatments for patients with dual ureteral and bladder T1 disease, the impact of cystectomy on quality of life, and the use of blue light cystoscopy and intravesical therapy. They also delve into the rise of bladder cancer in younger patients, considerations for low-grade intermediate-risk disease, and emerging therapeutic options. --- TIMESTAMPS 00:00 - Introduction05:52 - Upper Tract Positive Cytology Dilemma09:10 - Cystectomy Considerations15:55 - Developing Better Patient-Reported Outcomes20:26 - Challenges with New Therapeutics26:31 - Deescalating Treatment for Low-Grade Cancer33:29 - Closing Remarks

When standard therapy fails, it does not have to be the end of the road for high-risk bladder cancer patients. Modern treatments, biomarkers, and clinical studies have opened up new avenues for treating recurrent non-muscle invasive bladder cancer (NMIBC). The penultimate episode of the 2025 NMIBC Creator Weekend™ series features urologic oncologists Dr. Vignesh Packiam, Dr. Mark Tyson, and Dr. Sarah Psutka discussing how they navigate complex bladder cancer scenarios. --- This podcast is supported by an educational grant from Ferring Pharmaceuticals. --- SYNPOSIS The doctors share treatment strategies, staging processes, and post-therapy patient management techniques. They address recurrent disease, approaches to different stages of cancer, the role of biomarkers in determining treatment paths, and considerations for both high-risk and intermediate-risk patients. Additionally, the episode touches on new treatments, clinical trials, and patient quality of life post-treatment. --- TIMESTAMPS 00:00 - Introduction02:08 - Case Study: Initial Patient Assessment04:59 - Surgical Considerations and Techniques10:22 - Managing Bladder Cancer Recurrence11:15 - Treatment Options and Clinical Trials15:12 - Advanced Treatment Strategies28:14 - Closing Remarks and Credits

With the right protocols (and the right team!), urology clinics can proactively manage the side effects of intravesical therapy. This in-studio episode from the 2025 NMIBC Creator Weekend™ series features unique perspectives from Vanderbilt nurse practitioner Meredith Donahue and surgical neuro-oncology nurse Brynn Moore, a surgical neuro-oncology nurse, both with focuses in urologic oncology. Hosted by Dr. Ruchika Talwar, we cover the practical and logistical considerations in intravesical therapy administration. --- This podcast is supported by: ⁠Ferring Pharmaceuticals⁠ --- SYNPOSIS Donahue and Moore share their experiences with intravesical therapy, discussing practical issues such as patient management, scheduling, and handling side effects. They emphasize the importance of creating a supportive environment in clinics, proactive treatment plans, and ensuring effective communication among the multidisciplinary team. They also share resources and tips for nurses and nurse practitioners new to urologic oncology. --- TIMESTAMPS 00:00 - Introduction07:09 - Multidisciplinary Team Dynamics11:34 - Resources for Patients18:55 - Transvaginal Estrogen Cream26:56 - Optimizing Intravesical Therapy Clinics35:57 - The Importance of Multidisciplinary Collaboration36:27 - Conclusion

As new genetic and AI-powered tools emerge for bladder cancer screening, are we getting closer to reducing the need for invasive cystoscopies? In part five of the 2025 BackTable NMIBC Creator Weekend™ series, host Dr. Vignesh Packiam engages in an insightful discussion with Dr. Sarah Psutka from the University of Washington and Dr. Katie Murray from NYU about the complexities and potential benefits of using biomarkers in non-muscle invasive bladder cancer (NMIBC). --- This podcast is supported by: ⁠Ferring Pharmaceuticals⁠ --- SYNPOSIS The conversation covers the current challenges of interpreting positive biomarkers without clinical correlates, the gold standard of biopsies, and the potential of various biomarkers such as urine cytology, FISH, and newer genomic tests like the Decipher Bladder Genomic Classifier. They also touch upon the role of AI in pathology, the cost implications of biomarkers, and how these tools might influence future clinical practices and patient decisions. The episode emphasizes the need for precision medicine, careful patient counseling, and the impact of false positives and negatives on both patients and healthcare providers. --- TIMESTAMPS 00:00 - Introduction05:25 - Challenges with Current Biomarkers08:10 - New Biomarkers and Genomic Classifiers21:10 - AI and Pathology in Bladder Cancer35:13 - Screening and Future Directions41:20 - Challenges and Future Directions in Bladder Cancer Surveillance57:51 - Conclusion

With the introduction of checkpoint inhibitors into non-muscle invasive bladder cancer (NMIBC) management, who’s on point for planning, administering, and optimizing combination therapies? Is it still the urologist, or does medical oncology play a more significant role now than it did before? In this episode of the BackTable 2025 NMIBC Creator Weekend™ series, host Dr. Bogdana Schmidt sits down with Dr. Tyler Stewart, medical oncologist from the University of California San Diego, to discuss the contemporary role of medical and surgical oncology in treating non-muscle invasive bladder cancer. --- This podcast is supported by: ⁠Ferring Pharmaceuticals⁠ --- SYNPOSIS The conversation covers the efficacy and safety of checkpoint inhibitors like pembrolizumab, the importance of a multidisciplinary approach, and the challenges of balancing systemic and localized treatments. They also touch upon the potential future role of biomarkers in reducing invasive procedures and improving patient outcomes. --- TIMESTAMPS 00:00 - Introduction02:04 - The Role of Medical Oncologists in Bladder Cancer12:58 - Combination Therapies and Patient Outcomes21:18 - The CREST Study26:59 - Managing Adverse Events34:44 - Collaboration Between Urologists and Oncologists41:06 - Conclusion and Final Thoughts

New FDA-approved therapies for BCG-refractory non-muscle invasive bladder cancer (NMIBC)–where do they fit in the treatment algorithm, and how do you administer them? This installment of the 2025 NMIBC Creator Weekend™ series features host Dr. Bogdana Schmidt, assistant professor of Urologic Oncology at the University of Utah, and leading urologic oncologists Dr. Mark Tyson from Mayo Clinic Arizona and Dr. Suzanne Merrill from Colorado Urology. --- This podcast is supported by: ⁠Ferring Pharmaceuticals⁠ --- SYNPOSIS The discussion delves into the newest treatment strategies and FDA-approved therapies for non-muscle invasive bladder cancer with an emphasis on BCG-refractory patients. They highlight their approaches to sequencing therapies, the real-world applicability of these treatments, and the impact of patient factors in clinical decision-making. The panel also explores emerging trials and innovative treatment mechanisms, emphasizing the importance of personalized care in oncology. --- TIMESTAMPS 00:00 - Introduction05:09 - Challenges and Strategies in Treatment10:55 - Bladder Sparing Therapies21:41 - Practical Tips for Therapy Administration30:39 - Challenges and Considerations in Reinduction37:05 - Clinical Trials and Future Directions44:11 - Counseling Patients on Treatment Options57:36 - Concluding Thoughts and Future Outlook

When a patient is diagnosed with non-muscle invasive bladder cancer (NMIBC), how do you tailor the conversation and treatment plan to their individual needs (and fears)? In part two of the 2025 NMIBC Creator Weekend™ series, host Dr. Vignesh Packiam is joined by Dr. Sima Porten from UCSF and Dr. Patrick Hensley from the University of Kentucky to discuss patient-centered diagnostic and therapeutic approaches for non-muscle invasive bladder cancer. --- This podcast is supported by: ⁠Ferring Pharmaceuticals⁠ --- SYNPOSIS The conversation covers initial patient consultations, discussing diagnoses, personalized treatment options such as BCG, gemcitabine, clinical trials, and managing side effects. The experts emphasize the importance of clear communication, understanding patient preferences, and tailoring approaches to enhance the patient's quality of life. They also explore insights from recent studies like the CISTO trial and highlight novel research directions. --- TIMESTAMPS 00:00 - Introduction04:28 - Counseling Patients on Diagnostic Findings12:03 - Symptom Management and Patient Care19:30 - Post-Procedure Care and Counseling28:50 - Recovery After TURBT: Medications and Patient Care44:16 - The Impact of Radical Cystectomy on Quality of Life49:15 - Final Thoughts and Future Directions in Bladder Cancer Care

How are leading urologic oncologists using advanced biomarkers and artificial intelligence to refine the diagnosis and management of non-muscle invasive bladder cancer (NMIBC)? In the opening episode of our 2025 NMIBC Creator Weekend™ series, host Dr. Bogdana Schmidt engages in an insightful, in-studio discussion with Dr. Anne Schuckman and Dr. Piyush Agarwal about contemporary strategies and challenges in the diagnosis of non-muscle invasive bladder cancer. --- This podcast is supported by: ⁠Ferring Pharmaceuticals⁠ --- SYNPOSIS The doctors emphasize the importance of having an experienced cytopathologist and discuss the use of different biomarkers and imaging modalities in bladder cancer diagnosis. The conversation delves into risk stratification, patient management strategies, and the evolving role of technology and artificial intelligence in enhancing diagnostic accuracy. The experts also share their perspectives on future advancements and their potential impact on clinical practice. --- TIMESTAMPS 00:00 - Introduction04:05 - Surveillance and Follow-Up Strategies10:10 - Biomarkers in Bladder Cancer18:02 - Blue Light Cystoscopy and Patient Comfort30:56 - Risk Assessment and Counseling42:56 - Future of Bladder Cancer Diagnostics47:00 - Concluding Thoughts