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Poster viewing 03

149P - A need for clear definitions and improved management for BCG-unresponsive tumors in Asia-Pacific

Date

03 Dec 2022

Session

Poster viewing 03

Presenters

Lui Shiong Lee

Citation

Annals of Oncology (2022) 33 (suppl_9): S1485-S1494. 10.1016/annonc/annonc1124

Authors

L.S. Lee1, R. Kanesvaran2, E. Kikuchi3, H. Kitamura4, J.H. Ku5, T. Lin6, H. Nishiyama7, A.C.F. Ng8, J. Ng9, D.M.C. Poon10, H.K. Seo11, R.R. Shamaileh12, C. Spiteri13, E.M. Tan14, B. Tran15, Y. Tsai16

Author affiliations

  • 1 Urology, Sengkang General Hospital, 544886 - Singapore/SG
  • 2 Division Of Medical Oncology, NCCS - National Cancer Centre Singapore, 169610 - Singapore/SG
  • 3 Department Of Urology, St. Marianna University School of Medicine Yokohama City Seibu Hospital, 241-0811 - Yokohama/JP
  • 4 Department Of Urology, Toyama University Hospital, 930-0194 - Toyama/JP
  • 5 Department Of Urology, Seoul National University (SNU) - Main Campus, 08826 - Seoul/KR
  • 6 Urology Department, Taipei Veterans General Hospital, 11217 - Taipei City/TW
  • 7 Urology Department, University of Tsukuba, 305-8577 - Tsukuba/JP
  • 8 Sh Ho Urology Centre, The Chinese University of Hong Kong, Shatin/HK
  • 9 Real-world Insights, IQVIA Asia Pacific, Singapore/SG
  • 10 Department Of Clinical Oncology, The Chinese University of Hong Kong, Hong Kong/HK
  • 11 Prostate Cancer Center, National Cancer Center - Graduate School of Cancer Science and Policy, 10408 - Goyang/KR
  • 12 Urology, Merck Sharp & Dohme (MSD) Philippines, 1226 - Metro Manila/PH
  • 13 Centre For Observational And Real-world Evidence, Merck Sharp & Dohme (Australia) Pty Ltd, 2113 - Macquarie Park/AU
  • 14 Real World Insights, IQVIA Asia Pacific, Singapore/SG
  • 15 Medical Oncology Dept., Peter MacCallum Cancer Centre, 3000 - Melbourne/AU
  • 16 Urology Department, NCKUH - National Cheng Kung University Hospital, 704 - Tainan City/TW

Resources

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Abstract 149P

Background

Clinical practice guidelines use different terminologies related to BCG-unresponsive non-muscle invasive bladder cancer (NMIBC) and recommend different treatment approaches. We examined the level of understanding of the terminologies and clinical management related to BCG-unresponsive NMIBC in Asia-Pacific.

Methods

This is a mixed methods study involving 2 parts: 1) a survey with 32 urologists and 8 medical oncologists (MOs) and 2) in-depth interviews with 23 urologists and 3 MOs. All clinicians had ≥8 years of experience managing NMIBC across Australia, Hong Kong, Japan, South Korea, Singapore, and Taiwan. Data from Part 1 were analysed descriptively. We used content and thematic analyses for Part 2.

Results

In part 1, 37% of clinicians defined BCG-unresponsive as BCG-refractory, BCG-relapse and BCG-resistant. Around 50% of clinicians selected radical cystectomy as preferred treatment for BCG-unresponsive patients with the remaining participants selecting bladder-sparing treatment. The most frequently used bladder-sparing treatment was BCG-retreatment (33%). In part 2, we found that 35%, 85% and 35% of the clinicians, respectively, used the terms BCG-unresponsive, BCG-refractory and BCG-relapse in clinical practice but with no consistent interpretation of these terms. When compared with the EAU definitions, less than 60% of clinicians appropriately classified tumor characteristics that are persistent or recurrent after adequate BCG. Clinicians reasoned that BCG re-treatment is still provided to BCG-unresponsive patients due to the lack of effective and low-cost bladder-sparing treatment.

Conclusions

The terminologies related to BCG-unresponsive NMIBC are ambiguous and do not work well in clinical practice. Clearer definition of and more effective bladder-sparing treatments for BCG-unresponsive NMIBC are needed.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

IQVIA Asia Solutions Pte Ltd.

Funding

MSD International GmBH (Singapore Branch).

Disclosure

L.S. Lee: Financial Interests, Personal, Funding: Merck Sharp & Dohme LLC; Financial Interests, Personal, Advisory Board: MSD, AstraZeneca, Bayer, Astellas, Janssen; Financial Interests, Personal, Research Grant: Janssen; Financial Interests, Personal, Invited Speaker: AstraZeneca, MSD, Bayer, Janssen. R. Kanesvaran: Financial Interests, Institutional, Invited Speaker: Astellas, Johnson and Johnson, Ipsen, Amgen, BMS, MSD, Novartis, AstraZeneca, Sanofi; Financial Interests, Institutional, Advisory Board: Johnson and Johnson, Pfizer, Ipsen, Amgen, BMS, MSD, Bayer, AstraZeneca, Ferring; Financial Interests, Institutional, Research Grant: Sanofi, Eisai, Johnson and Johnson; Non-Financial Interests, Personal, Leadership Role, Past President: Singapore Society of Oncology; Non-Financial Interests, Personal, Leadership Role, President: SIOG; Non-Financial Interests, Personal, Leadership Role, Vice Chairman: Singapore Cancer Society; Non-Financial Interests, Personal, Leadership Role, Medical Advisory Board Member: International Kidney Cancer Coalition. E. Kikuchi: Financial Interests, Personal and Institutional, Research Grant: Nippon Kayaku; Financial Interests, Personal and Institutional, Invited Speaker: Chugai, Nippon Kayaku, Janssen; Financial Interests, Personal, Advisory Board: MSD. H. Kitamura: Financial Interests, Personal, Research Grant: AstraZeneca, Bristol Myers Squibb, MSD; Financial Interests, Personal, Invited Speaker: Astellas, AstraZeneca, MSD, Sanofi, Takeda, Bristol Myers Squibb, Merck Biopharma, Janssen; Financial Interests, Personal, Advisory Board: MSD, Janssen. J.H. Ku: Financial Interests, Personal, Advisory Board: MSD. T. Lin: Financial Interests, Personal and Institutional, Other, Honoraria for presentations: Astellas, Ferring pharmaceuticals, Janssen, Bayer, AstraZeneca; Non-Financial Interests, Personal and Institutional, Member, Urological oncology committee: Taiwan Urological Association; Non-Financial Interests, Personal and Institutional, Product Samples, Docetaxel/cabazitaxel compounds: Sanofi; Financial Interests, Personal, Advisory Board: MSD. H. Nishiyama: Financial Interests, Personal, Research Grant: Astellas, Ono Pharmaceutical, Takeda Pharmaceutical; Financial Interests, Personal, Invited Speaker: MSD, Chugai Pharmaceutical, Astellas. A.C.F. Ng: Financial Interests, Personal, Advisory Board: MSD, Newlife Medical Limited, Nonagen, Jiangsu Hengrui Medicine; Financial Interests, Personal, Advisory Role: Cornerstone Medical, Agilis; Financial Interests, Personal, Invited Speaker: Boston Scientfic, Olympus, Ipsen, Janssen, Bayer. J. Ng: Financial Interests, Personal, Full or part-time Employment: IQVIA; Financial Interests, Institutional, Sponsor/Funding, Corporate-sponsored research: MSD. D.M.C. Poon, H.K. Seo, Y. Tsai: Financial Interests, Personal, Advisory Board: MSD. R.R. Shamaileh, C. Spiteri: Financial Interests, Personal, Full or part-time Employment: MSD. E.M. Tan: Financial Interests, Personal, Full or part-time Employment: IQVIA; Financial Interests, Institutional, Sponsor/Funding, Corporate-sponsored research: MSD. B. Tran: Financial Interests, Personal, Research Grant: MSD; Financial Interests, Personal, Research Grant, Individual honoraria: Bristol Myers Squibb ; Financial Interests, Personal, Research Grant, Individual consulting/ advisory role: Ipsen; Financial Interests, Personal and Institutional, Research Grant, Individual honoraria: Astellas Pharma, Janssen-Cilag, Amgen, Pfizer, Bayer; Financial Interests, Institutional, Research Grant: Genentech, AstraZeneca; Financial Interests, Personal, Other, Individual honoraria: Sanofi, Tolmar; Financial Interests, Personal, Advisory Role: Novartis, Roche Molecular Diagnostics.

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