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

Navigating NMIBC treatment changes

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

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After listening to this podcast, are you more confident in aligning your NMIBC treatment decisions with current recommendations and real-world practice?

Episode 5. Ashish Kamat and Roger Li dissect the clinical complexities of Bacillus Calmette–Guérin (BCG)-unresponsive NMIBC, including how strict trial criteria translate to real-world patient selection, the clinical impact of carcinoma in situ versus papillary disease, and the rise of gemcitabine–docetaxel as a preferred first-line option in academic centers. The discussion reveals why efficacy, toxicity, and cost drive therapy choices, how sustained-release platforms may reshape chemotherapy delivery, and the challenges of guiding increasingly informed patients through data-driven decisions. “We want to choose the most efficacious agent for all of our patients,” concludes Li, underscoring the balance between evidence, experience, and patient-centered care. View transcript.

Chapters
00:37 Managing BCG-unresponsive NMIBC
02:42 Defining BCG-unresponsive disease
07:10 Doublet chemotherapy: Practical insights
11:54 Treatment for patients with CIS
16:49 Sustained-release platforms in NMIBC
18:29 Patient support in therapy choices

 

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Meet the guest speaker

Roger Li, circle profile imageRoger Li, MD

Roger Li is a urologic oncologist at Moffitt Cancer Center, Tampa, Florida, USA, specializing in bladder, upper tract urothelial, and prostate cancer. He leads research on molecular profiling and immunotherapy in urothelial malignancies, with a focus on BCG-unresponsive disease. He has authored over 150 peer-reviewed publications and contributes to multiple international urology journals.

Disclosures: Research funding from American Cancer Society, Bladder Cancer Advocacy Network (BCAN), and US Department of Defense.

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