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Dr. Andrea Apolo

👤 Person
291 total appearances

Appearances Over Time

Podcast Appearances

BackTable Urology
Ep. 193 Bladder Cancer Innovations: ESMO 2024 Highlights with Dr. Andrea Apolo

Now, that's not the way it was designed. Everybody got neoadjuvant in the treatment arm and everybody got adjuvant in the treatment arm. And in the control arm, nobody got adjuvant. But I think that it was a fair design without making it multi-arms. That would have been another way of doing it, but it's already a thousand patients.

BackTable Urology
Ep. 193 Bladder Cancer Innovations: ESMO 2024 Highlights with Dr. Andrea Apolo

Now, that's not the way it was designed. Everybody got neoadjuvant in the treatment arm and everybody got adjuvant in the treatment arm. And in the control arm, nobody got adjuvant. But I think that it was a fair design without making it multi-arms. That would have been another way of doing it, but it's already a thousand patients.

BackTable Urology
Ep. 193 Bladder Cancer Innovations: ESMO 2024 Highlights with Dr. Andrea Apolo

So this would have made it a lot larger where we don't give adjuvant in a different arm. And it's not an adaptive design. It's just a different arm where patients do get adjuvant and then another arm where patients don't get adjuvant. So I think a lot to learn from this trial and we yet don't have

BackTable Urology
Ep. 193 Bladder Cancer Innovations: ESMO 2024 Highlights with Dr. Andrea Apolo

So this would have made it a lot larger where we don't give adjuvant in a different arm. And it's not an adaptive design. It's just a different arm where patients do get adjuvant and then another arm where patients don't get adjuvant. So I think a lot to learn from this trial and we yet don't have

BackTable Urology
Ep. 193 Bladder Cancer Innovations: ESMO 2024 Highlights with Dr. Andrea Apolo

So this would have made it a lot larger where we don't give adjuvant in a different arm. And it's not an adaptive design. It's just a different arm where patients do get adjuvant and then another arm where patients don't get adjuvant. So I think a lot to learn from this trial and we yet don't have

BackTable Urology
Ep. 193 Bladder Cancer Innovations: ESMO 2024 Highlights with Dr. Andrea Apolo

The granularity of the data is if they did response, let's say they had a pathologic complete response, how did those patients do with adjuvant therapy versus if they didn't? How did they do with adjuvant therapy? How did they do in terms of event-free survival, which was the primary endpoint? So I think all these questions will be answered as the data is reported a little bit more and it matures.

BackTable Urology
Ep. 193 Bladder Cancer Innovations: ESMO 2024 Highlights with Dr. Andrea Apolo

The granularity of the data is if they did response, let's say they had a pathologic complete response, how did those patients do with adjuvant therapy versus if they didn't? How did they do with adjuvant therapy? How did they do in terms of event-free survival, which was the primary endpoint? So I think all these questions will be answered as the data is reported a little bit more and it matures.

BackTable Urology
Ep. 193 Bladder Cancer Innovations: ESMO 2024 Highlights with Dr. Andrea Apolo

The granularity of the data is if they did response, let's say they had a pathologic complete response, how did those patients do with adjuvant therapy versus if they didn't? How did they do with adjuvant therapy? How did they do in terms of event-free survival, which was the primary endpoint? So I think all these questions will be answered as the data is reported a little bit more and it matures.

BackTable Urology
Ep. 193 Bladder Cancer Innovations: ESMO 2024 Highlights with Dr. Andrea Apolo

We've been using it as a surrogate for what's going on in the rest of the body. If you're downstaging, if you're responding in the bladder, which is something that we can observe and stage, although you can argue not as well as we think we can, at least that kind of gives us an idea of what's going on. And

BackTable Urology
Ep. 193 Bladder Cancer Innovations: ESMO 2024 Highlights with Dr. Andrea Apolo

We've been using it as a surrogate for what's going on in the rest of the body. If you're downstaging, if you're responding in the bladder, which is something that we can observe and stage, although you can argue not as well as we think we can, at least that kind of gives us an idea of what's going on. And

BackTable Urology
Ep. 193 Bladder Cancer Innovations: ESMO 2024 Highlights with Dr. Andrea Apolo

We've been using it as a surrogate for what's going on in the rest of the body. If you're downstaging, if you're responding in the bladder, which is something that we can observe and stage, although you can argue not as well as we think we can, at least that kind of gives us an idea of what's going on. And

BackTable Urology
Ep. 193 Bladder Cancer Innovations: ESMO 2024 Highlights with Dr. Andrea Apolo

And that's I think this study will actually help us to understand the role of pathologic complete response. And there's so many definitions of what actually is a complete response, a complete pathologic response. Do you count the carcinoma in situ? Do you count the low grade TAs? How rigid are you? Or is it just any non-muscle invasive diseases counted as a pathologic response?

BackTable Urology
Ep. 193 Bladder Cancer Innovations: ESMO 2024 Highlights with Dr. Andrea Apolo

And that's I think this study will actually help us to understand the role of pathologic complete response. And there's so many definitions of what actually is a complete response, a complete pathologic response. Do you count the carcinoma in situ? Do you count the low grade TAs? How rigid are you? Or is it just any non-muscle invasive diseases counted as a pathologic response?

BackTable Urology
Ep. 193 Bladder Cancer Innovations: ESMO 2024 Highlights with Dr. Andrea Apolo

And that's I think this study will actually help us to understand the role of pathologic complete response. And there's so many definitions of what actually is a complete response, a complete pathologic response. Do you count the carcinoma in situ? Do you count the low grade TAs? How rigid are you? Or is it just any non-muscle invasive diseases counted as a pathologic response?

BackTable Urology
Ep. 193 Bladder Cancer Innovations: ESMO 2024 Highlights with Dr. Andrea Apolo

I think that there's the definitions have been really variable. So it's been a hard endpoint to use. But I think we'll learn a lot from this trial.

BackTable Urology
Ep. 193 Bladder Cancer Innovations: ESMO 2024 Highlights with Dr. Andrea Apolo

I think that there's the definitions have been really variable. So it's been a hard endpoint to use. But I think we'll learn a lot from this trial.

BackTable Urology
Ep. 193 Bladder Cancer Innovations: ESMO 2024 Highlights with Dr. Andrea Apolo

I think that there's the definitions have been really variable. So it's been a hard endpoint to use. But I think we'll learn a lot from this trial.

BackTable Urology
Ep. 193 Bladder Cancer Innovations: ESMO 2024 Highlights with Dr. Andrea Apolo

I think that'll be really important because that will be our ultimate goal. So those patients that failed because they didn't get a cystectomy, if it was by choice, then it's not really a failure. I think those patients should be followed. And I don't know if they got adjuvant therapy. I think it was mixed. Some of them did get adjuvant therapy, even though they did not undergo a cystectomy.

BackTable Urology
Ep. 193 Bladder Cancer Innovations: ESMO 2024 Highlights with Dr. Andrea Apolo

I think that'll be really important because that will be our ultimate goal. So those patients that failed because they didn't get a cystectomy, if it was by choice, then it's not really a failure. I think those patients should be followed. And I don't know if they got adjuvant therapy. I think it was mixed. Some of them did get adjuvant therapy, even though they did not undergo a cystectomy.

BackTable Urology
Ep. 193 Bladder Cancer Innovations: ESMO 2024 Highlights with Dr. Andrea Apolo

I think that'll be really important because that will be our ultimate goal. So those patients that failed because they didn't get a cystectomy, if it was by choice, then it's not really a failure. I think those patients should be followed. And I don't know if they got adjuvant therapy. I think it was mixed. Some of them did get adjuvant therapy, even though they did not undergo a cystectomy.