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EAU18 – Biomarkers becoming a pillar in diagnosis of bladder cancer

Prof. Arnulf Stenzl (DE), Scientific Congress Office Chairman looked back on a well-attended Specialty Session on bladder cancer on Friday, the first day of EAU18. The session consisted of a series of case-based debates between some of the biggest names in uro-oncology.

The wide variety of debates had a common theme: biomarkers are maturing as a third pillar in diagnosis. Stenzl: “We don’t want to rely just on the pathologist, so we’ve used clinical assessment as well. And now the use of biomarkers is evolving into a feasible third pillar.”

“All these discussions took place in areas where the EAU Guidelines are not conclusive. Urologists need to find more data, and we are getting closer. You could almost say that it’s done. Several speakers and audience members are already using molecular markers, despite not being in the guidelines.”

Despite not being part of the EAU Guidelines recommendations yet, Prof. Stenzl anticipates a “major shift” in the coming years. “This is a pressing issue, there’s a lot of uncertainty at the moment. We know that these things will be changing, there’s not been a change for decades in bladder cancer Guidelines. Studies with thousands of patients are being published. There is an unmet need, and there is good data. I expect a change to the EAU Bladder Cancer Guidelines soon.”

Debate “winners

Experts like Profs. David McConkey (USA), Joan Palou (ES), Maurizio Brausi (IT) and Jim Catto (GB) presented cases and led discussions on topics like cystoscopy, treatment options following molecular classification and what to do when BCG fails.

“It’s hard to say that there were winners in these ‘debates’,” Prof. Stenzl conceded. “This topic is much too sophisticated and grey to have clear “winners”. Nevertheless, this session was one of the most important and well-attended of the day. These kinds of case-based debate sessions could be something we will be seeing more of at the Annual Congress.”