PD26-03 SEQUENTIAL INTRAVESICAL GEMCITABINE AND DOCETAXEL FOR BCG-NAïVE HIGH-RISK NON-MUSCLE INVASIVE BLADDER CANCER

Abstract

the estimated area and the area annotated by the doctor exceeded 50%; otherwise, the results were considered inaccurate. The evaluation was performed using a five-fold cross-validation test.RESULTS: For the test dataset, containing 1,650 cystoscopy images (WLI 217 and NBI 64 images of bladders with tumors and WLI 1,104 and NBI 265 images of normal bladders), and at the threshold where the F1 score in the training dataset was the maximum, the proposed AI model exhibited average sensitivity, specificity, and F1 scores of 83.7%, 82.3%, and 0.637, respectively. We adapted the AI model to all frames of a clinical cystoscopy video of a case and detected the lesion sites.CONCLUSIONS: By applying the analysis of still images to video, real-time detection of bladder tumor lesions for both WLI and NBI is possible, with AI showing the probability map of the lesion sites using the proposed method. This may improve diagnostic accuracy by creating awareness among urologists of all skill levels and by encouraging more robust observations.

Phase 1/2 Trial Results of a Large Surface Area Microparticle Docetaxel for the Treatment of High-Risk Nonmuscle-Invasive Bladder Cancer

“…1,2 However, approximately half of high-risk NMIBC patients treated with BCG will have recurrence within 2 years, and many of these patients will become BCG unresponsive. 3,4 Despite moderate efficacy with intravesical chemotherapy for BCG-exposed NMIBC, there remains a need to enhance therapeutic options to improve the efficacy of these treatments.…”

Sequential Intravesical Valrubicin and Docetaxel for the Salvage Treatment of Non–Muscle-Invasive Bladder Cancer

“…24 Gem/Doce has demonstrated efficacy as a salvage therapy, and prospective investigation as up-front therapy appears promising given recent pilot data. 8 With this report, Val/Doce may provide another option for those with recurrence.…”

“…5-7 For those with high-grade (HG) NMIBC naïve to BCG, Gem/Doce has shown promising initial results of 84% HG RFS at 2 years, paralleling modern BCG cohorts. 8,9 Unfortunately, following recurrence, effective salvage therapies are lacking. While cystectomy is the gold standard in this setting, this operation has a significant (59%-64%) complication rate with 13%-15% requiring surgical intervention.…”

Editorial Comment

“…Use of adjuvant gemcitabine or mitomycin C reduces recurrence in low-risk NMIBC and can be used in an induction/maintenance format for treatment of intermediate-risk NMIBC. 1 The combination of gemcitabine and docetaxel is often used as second-line therapy after bacillus Calmette-Guérin failure 2 (and sometimes as a frontline approach 3 ) for high-risk NMIBC. Optimizing and improving locally administered chemotherapy to treat NMIBC may have tremendous benefits for patients.…”