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Light microscopy of the internal lining of the urinary bladder; haematoxylin and eosin stain
Managing High-Risk NMIBC

How emerging therapies could change practice

Last updated: 23rd Oct 2025
Published: 23rd Oct 2025

After listening to this podcast, are you more confident in evaluating emerging treatment options and understanding their potential impact on the care of people with NMIBC?

Episode 6. Joshua Meeks and Ashish Kamat discuss the evolving treatment landscape for NMIBC, including the enduring role of Bacillus Calmette–Guérin (BCG), the implications of the CREST trial, and the potential of TAR-200 and gemcitabine–docetaxel. They explore how diagnostics, patient profiles, and cost considerations are reshaping clinical decisions, and Meeks shares his approach to therapy sequencing and bladder preservation: “You have to start with the known winner… I always begin with BCG.” The conversation delves into what happens when patients can’t or won’t follow the standard path, and how close we are to truly personalized care, especially in the intermediate-risk setting. View transcript.

Chapters
00:58 SoC guidance for BCG-naive patients
03:32 CREST trial: Clinical insights
06:08 Personalizing combination therapy
08:27 Can BCG be replaced in the future?
10:40 Guiding patient treatment choices
14:51 Cost barriers to novel therapies
17:09 Novel therapies in IR-NMIBC
19:47 How emerging diagnostics shape treatment 

 

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Meet the guest speaker

Joshua Meeks, circular photoJoshua Meeks, MD, PhD

Joshua Meeks is an Associate Professor of Urology, Biochemistry, and Molecular Genetics at Northwestern University Feinberg School of Medicine and Section Chief of Robotic Surgery at the Jesse Brown VA Medical Center in Chicago, Illinois, USA. He is a urologic surgeon with expertise in the diagnosis, treatment, and management of bladder cancer.

Disclosures: Consultant for AstraZeneca, Bristol Myers Squibb, Calibr, CG Oncology, Ferring, ImmunityBio, Imvax, Janssen, Merck, Pfizer, Photocure, Prokarium, Protara, Seagen/Astellas, and UroGen.

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