The Oncologist’s Role in Counseling Patients With MIBC Through Complex Treatment Decisions

Karine Tawagi, MD University of Illinois Cancer Center

Key Points

• Balancing the risks and benefits: a look at neoadjuvant therapy in muscle-invasive bladder cancer.

• Discussing the potential adverse events and safety profile of durvalumab.

• The importance of provider-patient discussions in treatment decision-making.

Novel treatment strategies are extending survival for patients with muscle-invasive bladder cancer—a historically aggressive disease. The NIAGARA trial produced a clinically meaningful improvement in event-free survival and overall survival with the addition of perioperative durvalumab to neoadjuvant gemcitabine and cisplatin compared to chemotherapy alone.

As this regimen moves into the community oncology setting, it becomes essential for providers to have open discussions with their patients about the potential risks and benefits, including adverse events (AEs) reported in the trial. 

Karine Tawagi, MD, of the University of Illinois Cancer Center, Chicago, Illinois, offered clinical insights into how the NIAGARA trial supports shared decision-making in real-world practice. Moreover, Dr. Tawagi discussed the low incidence of immune-related AEs with durvalumab, while also emphasizing the importance of counseling patients on rare but serious AEs.