BackTable Urology
Ep. 287 Urothelial Carcinoma: Understanding CTDNA and Precision Medicine with Dr. Amanda Nizam and Dr. Brad McGregor
And the question about consolidative radiation in those patients who do have exceptional responses is also going to come up as well.
BackTable Urology
Ep. 287 Urothelial Carcinoma: Understanding CTDNA and Precision Medicine with Dr. Amanda Nizam and Dr. Brad McGregor
So as Brad said, we are very early in that, but that question will come up.
BackTable Urology
Ep. 287 Urothelial Carcinoma: Understanding CTDNA and Precision Medicine with Dr. Amanda Nizam and Dr. Brad McGregor
And I think it's very important that we discuss it with our patients.
BackTable Urology
Ep. 287 Urothelial Carcinoma: Understanding CTDNA and Precision Medicine with Dr. Amanda Nizam and Dr. Brad McGregor
So if we go back to what you were asking me before, how do I discuss with my stage 2 bladder cancer patients or muscle-invasive bladder cancer patients?
BackTable Urology
Ep. 287 Urothelial Carcinoma: Understanding CTDNA and Precision Medicine with Dr. Amanda Nizam and Dr. Brad McGregor
I ask about their preferences and what's important to them and their quality of life.
BackTable Urology
Ep. 287 Urothelial Carcinoma: Understanding CTDNA and Precision Medicine with Dr. Amanda Nizam and Dr. Brad McGregor
What is your most important thing?
BackTable Urology
Ep. 287 Urothelial Carcinoma: Understanding CTDNA and Precision Medicine with Dr. Amanda Nizam and Dr. Brad McGregor
Do you want your bladder out?
BackTable Urology
Ep. 287 Urothelial Carcinoma: Understanding CTDNA and Precision Medicine with Dr. Amanda Nizam and Dr. Brad McGregor
Do you want to save your bladder?
BackTable Urology
Ep. 287 Urothelial Carcinoma: Understanding CTDNA and Precision Medicine with Dr. Amanda Nizam and Dr. Brad McGregor
And that kind of guides the discussion in terms of what options we can work with.
BackTable Urology
Ep. 287 Urothelial Carcinoma: Understanding CTDNA and Precision Medicine with Dr. Amanda Nizam and Dr. Brad McGregor
And of course, if someone has T3, T4, N1, I'm going to tell them about radiation, but I'm going to tell them I strongly, you are not a good candidate for this.
BackTable Urology
Ep. 287 Urothelial Carcinoma: Understanding CTDNA and Precision Medicine with Dr. Amanda Nizam and Dr. Brad McGregor
The risk of recurrence would be much too high.
BackTable Urology
Ep. 287 Urothelial Carcinoma: Understanding CTDNA and Precision Medicine with Dr. Amanda Nizam and Dr. Brad McGregor
But patients who are good candidates, very select patients, as Brad said, no CIS, small tumor, unifocal, urothelial histology, I do ask.
BackTable Urology
Ep. 287 Urothelial Carcinoma: Understanding CTDNA and Precision Medicine with Dr. Amanda Nizam and Dr. Brad McGregor
And that kind of helps us guide the discussion.
BackTable Urology
Ep. 287 Urothelial Carcinoma: Understanding CTDNA and Precision Medicine with Dr. Amanda Nizam and Dr. Brad McGregor
But the most important thing is that patients are informed of all of their options.
BackTable Urology
Ep. 287 Urothelial Carcinoma: Understanding CTDNA and Precision Medicine with Dr. Amanda Nizam and Dr. Brad McGregor
And our radiation oncologists and our urologists, at least at Cleveland Clinic, are fantastic.
BackTable Urology
Ep. 287 Urothelial Carcinoma: Understanding CTDNA and Precision Medicine with Dr. Amanda Nizam and Dr. Brad McGregor
And they are...
BackTable Urology
Ep. 287 Urothelial Carcinoma: Understanding CTDNA and Precision Medicine with Dr. Amanda Nizam and Dr. Brad McGregor
all send.
BackTable Urology
Ep. 287 Urothelial Carcinoma: Understanding CTDNA and Precision Medicine with Dr. Amanda Nizam and Dr. Brad McGregor
You know, we actually have a bladder-sparing clinical trial going on that was started by Omar Mian, the RAD-SG trial, that is looking at sexytuzumab, guvatican, and muscle-invasive bladder cancer.
BackTable Urology
Ep. 287 Urothelial Carcinoma: Understanding CTDNA and Precision Medicine with Dr. Amanda Nizam and Dr. Brad McGregor
So that's a small trial, about 20 patients, and we're almost done accruing for that.
BackTable Urology
Ep. 287 Urothelial Carcinoma: Understanding CTDNA and Precision Medicine with Dr. Amanda Nizam and Dr. Brad McGregor
So we will learn about the role of ADCs and chemoradiation in the coming years, and it'll definitely...