A New Paradigm in Urothelial Cancer: The Convergence of Immuno-Oncology & Urology

Released On
July 1, 2018

Expires On
July 1, 2019

Media Type

Completion Time
75 minutes

Urology, Oncology

Urothelial Cancer

Scroll to the Bottom of this Information to Begin this Course

This activity is provided by Creative Educational Concepts, Inc.


Supported by an independent educational grant from AstraZeneca.

Credit Available

  • Physicians — maximum of 1.25 AMA PRA Category 1 Credit(s)

All other health care professionals completing this course will be issued a statement of participation.

Target Audience

This activity is designed to meet the educational needs of urologists, oncologists, and other healthcare professionals who diagnose and manage urothelial cancer.

Program Overview

Immuno-oncology for bladder cancer has been around for more than four decades in the form of BCG intravesical therapy for NMIBC. For more advanced disease, systemic platinum-based chemotherapy has been the standard first-line treatment. While objective response rates are as high as 60%, and complete responses (CRs) occur in ~20% of patients, duration of response is brief. With a median overall survival of ~15 months and a 5-year survival rate of ≤15%, relapsed urothelial bladder cancer (UBC) represents a substantial unmet medical need.

Not surprisingly, UBC is particularly susceptible to immune checkpoint inhibitors (ICIs), with these agents demonstrating acceptable safety profiles that are often more tolerable than platinum-based chemotherapy. Beyond approved indications for ICIs, these agents are being studied in bladder-sparing regimens in multimodal combinations of interest to the urologist.

Selecting the appropriate agent for a given patient is important to obtain optimal efficacy. Ongoing debates related to ICI treatment include: how to use biomarkers to guide therapy selection, how best to sequence ICIs with other therapies, the appropriate duration of checkpoint inhibitor treatment, and how to stop/restart immunotherapy if interrupted by immune-related adverse events (irAEs). This activity will highlight current best practices and emerging strategies, with a multidisciplinary panel where specialists in urology, medical oncology, and urologic oncology will debate hot topics of interest to the urologist actively managing UBC.

Learning Objectives

Upon completion of this activity, participants should be able to:

  1. Describe the underlying concepts of cancer immunotherapy, including intravesical immunotherapy and systemic immune checkpoint blockade, and rationale for its use in urothelial cancer.
  2. Examine current and emerging clinical data for the use of immune checkpoint inhibitors in urothelial cancer.
  3. Evaluate the strategies required to incorporate systemic immunotherapy into urologic practice.
  4. Explore future directions of immunotherapy in urothelial cancer, including its potential role in the perioperative clinical setting.
  5. Identify practical strategies to prevent, anticipate, and manage immune-related adverse events (irAEs) in patients with urothelial cancer in your practice.


Arjun V. Balar, MD

Director, Genitourinary Medical Oncology Program
Laura and Isaac Perlmutter Cancer Center NYU Langone Health
New York, New York

Robert Dreicer, MD, MS, MACP, FASCO

Associate Director for Clinical Research
Deputy Director, University of Virginia Cancer Center
Section Head, Medical Oncology
Co-Director, Paul Mellon Urologic Cancer Institute
Professor of Medicine and Urology
University of Virginia School of Medicine
Charlottesville, Virginia

Ashish Kamat, MD, MBBS, FACS

Professor of Urology and Cancer Research
Department of Urology
MD Anderson Cancer Center
Houston, Texas

Neal D. Shore, MD, FACS

Director and Certified Physician Investigator (CPI)
Carolina Urologic Research Center
Atlantic Urology Clinics
Myrtle Beach, South Carolina

Joint Accreditation Statement

In support of improving patient care, Creative Educational Concepts is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.

Credit Designation Statement

CEC designates this enduring material for a maximum of 1.25 AMA PRA Category 1 Credit(s)™. Physicians should only claim credit commensurate with the extent of their participation in the activity.

Disclosures of Conflicts of Interest


Joan B. Fowler, PharmD, BCPP, has no relevant financial relationships to disclose in relation to the content of this activity.


Arjun V. Balar, MD

  • Consultant: AstraZeneca/MedImmune, Genentech, Merck, Pfizer, and Roche
  • Grant/research support : Genentech, Merck, and Roche.

Robert Dreicer, MD, MS, MACP, FASCO

  • Consultant : Astellas, AstraZeneca, Bristol-Myers Squibb, EMD Serono, Orion, and Roche
  • Grant/research support : Bayer, Genentech, and Lilly

Ashish M. Kamat, MD, MBBS, FACS

  • Consultant: Abbott, AstraZeneca, Genentech, and Merck
  • Grant/research support : FKD Therapies, Merck, and Photocure.

Neal D. Shore, MD, FACS

  • Consultant: AstraZeneca, EMD Serono, FKD Therapies, Genentech, Merck, and Pfizer.
  • Grant/research support : AstraZeneca, EMD Serono, FKD Therapies, Genentech, Merck, and Pfizer.

Disclosure of Unlabeled Use

This activity may include discussions of products or devices that are not currently approved for use by the Food and Drug Administration (FDA), or are currently investigational.

Method of Participation

There are no fees to participate in the activity.

  1. Read the target audience, learning objectives, and author disclosures
  2. Review the full content of the activity and reflect upon its teaching
  3. Complete the questions and evaluation at the end of the activity
  4. Have a passing score of 75% on the post-test (you will have two [2] opportunities to complete the post-test)


Course Viewing Requirements

Supported Browsers:
Internet Explorer 8.0+ for Windows 2003, Vista, XP, Windows 7, Windows 8.1 and above
Google Chrome 28.0+ for Windows, Mac OS, or Linux
Mozilla Firefox 23.0+ for Windows, Mac OS, or Linux
Safari 6.0+ for Mac OSX 10.7 and above

Supported Phones & Tablets:
Android 4.0.3 and above
iPhone/iPad with iOS 6.1 or above.


It is the policy of CEC to ensure independence, balance, objectivity, scientific rigor, and integrity in their continuing education activities.

Those involved in the development of this continuing education activity have made all reasonable efforts to ensure that information contained herein is accurate in accordance with the latest available scientific knowledge at the time of accreditation of this continuing education activity. Information regarding drugs (e.g., their administration, dosages, contraindications, adverse reactions, interactions, special warnings, and precautions) and drug delivery systems is subject to change, however, and the reader is advised to check the manufacturer's package insert for information concerning recommended dosage and potential problems or cautions prior to dispensing or administering the drug or using the drug delivery systems.

Fair balance is achieved through ongoing and thorough review of all presentation materials produced by faculty, and all educational and advertising materials produced by supporting organizations, prior to educational offerings. Approval of credit for this continuing education activity does not imply endorsement by CEC for any product or manufacturer identified.

Additional Content

Click here for the downloadable reference list: A New Paradigm in Urothelial Cancer: The Convergence of Immuno-Oncology & Urology