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

Activity Details
  • Credit Amounts:
    • CME: 1.25
    • Other: 1.25
  • Cost: Free
  • Release: Jul 1, 2018
  • Expires: Jul 1, 2019
  • Estimated Time to Complete:
    1 Hour(s)  15 Minutes
  • System Requirements:
  • Average User Rating:
    (2 Ratings)


 This activity has 4 faculty members associated with it.
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Arjun V.  Balar Arjun V. Balar, MD
Director, Genitourinary Medical Oncology Program
NYU Langone Perlmutter Cancer Center
New York, New York

Robert Dreicer 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 Ashish Kamat, MD, MBBS, FACS
Professor of Urologic Oncology
Wayne B. Duddlesten Professor of Cancer Research
President, International Bladder Cancer Group (IBCG)
University of Texas, MD Anderson Cancer Center
Houston, Texas

Neal D.  Shore Neal D. Shore, MD, FACS
Medical Director and Certified Physician Investigator (CPI)
Carolina Urologic Research Center
Atlantic Urology Clinics
Myrtle Beach, South Carolina

Target Audience

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


At the conclusion of this activity, participants will 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.



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.

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.

ACGME Competencies

  • Patient care
  • Medical knowledge

IOM Competencies

  • Provide patient-centered care
  • Employ evidence-based practice

Creative Educational Concepts, Inc. certifies this activity for 1.25 hours of participation.

Faculty Disclosure

In accordance with the Food and Drug Administration, the speakers have disclosed that there is the potential for discussions concerning off-label uses of a commercial product/device during this educational activity.

Any person who may contribute to the content of this continuing education activity must disclose relevant relationships (and any known relationships of their spouse/partner) with commercial interests whose products or services are discussed in educational presentations. A commercial interest is defined as any entity producing, marketing, re-selling, or distributing health care goods or services consumed by, or used on, patients. Relevant relationships include receiving from a commercial interest research grants, consultant fees, travel, other benefits, or having a self-managed equity interest in a company.

Disclosure of a relationship is not intended to suggest or condone any bias in any presentation but is made to provide participants with information that might be of potential importance to their evaluation of a presentation.

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

Arjun V. Balar, MD—has disclosed that he is a consultant for AstraZeneca/MedImmune, Genentech, Merck, Pfizer, and Roche. He also receives grant/research support from Genentech, Merck, and Roche.
Robert Dreicer, MD, MS, MACP, FASCO—has disclosed that he is a consultant for Astellas, AstraZeneca, Bristol-Myers Squibb, EMD Serono, Orion, and Roche. He also receives grant/research support from Bayer, Genentech, and Lilly.
Ashish M. Kamat, MD, MBBS, FACS—has disclosed that he is a consultant for Abbott, AstraZeneca, Genentech, and Merck. He also receives grant/research support from FKD Therapies, Merck, and Photocure.
Neal D. Shore, MD, FACS—has disclosed that he is a consultant and receives grant/research support from AstraZeneca, EMD Serono, FKD Therapies, Genentech, Merck, and Pfizer.


Presented by Creative Educational Concepts, Inc. in collaboration with the Bladder Cancer Advocacy Network (BCAN).

This activity is supported by an independent educational grant from AstraZeneca.

Activity 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 regiments 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. 

Activity Instructions

Media: Internet Web Activity (Powerpoint slides and audio)


To receive a statement of credit, you must:

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


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.

Unlabeled Disclosure
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.