Improving patient outcomes & advancing the field. #BladderCancer #RoboticSurgery French Urologist at @Hopital_Bicetre @APHP
Le Kremlin-Bicêtre, France
Joined January 2014
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Cédric Lebâcle retweeted
💥 MIBC is no longer surgery-first—oncology is rewriting the rulebook.
🩺 Surgery & Chemo (traditional backbone)
Radical cystectomy ± peri-op cisplatin chemo remains standard, but morbidity & patient fitness limit its universal application.
🧬 Immunotherapy integration
Neo/adjuvant ICB now proven:
• CheckMate-274 → Nivolumab improved DFS & OS
• AMBASSADOR → Pembrolizumab improved DFS
• NIAGARA → Durvalumab peri-op improved DFS & OS
🧪 ctDNA as MRD tool
• Detectable ctDNA predicts relapse post-cystectomy
• IMvigor010, TOMBOLA, MODERN exploring ctDNA-guided escalation/de-escalation 🚦
→ Personalised systemic therapy decisions on horizon.
🎯 ADCs + ICB combos
• EV+pembro (EV-302) revolutionised metastatic setting
• Now moving peri-op in VOLGA, KEYNOTE-905, KEYNOTE-B15
→ Potential to boost cure rates in cisplatin-eligible & ineligible pts.
🛡️ Bladder-sparing strategies
• TURBT + systemic therapy → durable CR in select pts (HCRN GU16-257, RETAIN)
• Emerging risk-adapted, biomarker-driven pathways
• Goal: preserve organ without compromising cure.
➡️ The next decade = convergence of powerful therapeutics + precise biomarkers + risk-adapted strategies.
Not just longer survival-cure + quality of life together.
📖 JCO 2025 Review: ascopubs.org/doi/full/10.120…
@ASCO @oncoalert @uro_today @theNCI
#BladderCancer #Oncology #UroOnc #Immunotherapy #CancerResearch
TAR-200 achieves the highest CR rates reported to date in BCG-unresponsive NMIBC, with durable responses and manageable safety. While single-arm and still early in follow-up, these results may redefine the bladder-sparing landscape if confirmed in phase III SunRISe trials.
Cédric Lebâcle retweeted
Phase II SunRISe-1: TAR-200 (slow drug-releasing system for gemcitabine) achieved CR in 82% of pts with BCG-unresponsive high-risk NMIBC @JCO_ASCO
🩺@siadaneshmand
❕#FDA priority review granted
ascopost.com/news/august-202…
L’exposition cumulative à l’anesthésie générale accélère le déclin cognitif : ≈2 ans pour les fonctions exécutives, ≈10 ans pour la vitesse de traitement, ≈26 ans pour l’attention (Stroop) après 2 h d’AG. Effet modeste mais réel, loin derrière l’âge et les comorbidités.
Impressive to finally see OS benefit in MIBC with a ctDNA-guided strategy. Benefit in MRD+ while sparing MRD– patients is a paradigm shift. Still, questions remain on assay dependency, lead-time bias, and durability. Congratulations on moving the field forward.
Vegetarian diets show no clear reduction in major urologic cancers (prostate, kidney, bladder).
➡️ Highlights the need for site-specific analyses — not all cancers respond equally to dietary patterns.
Beyond clotting: platelets emerge as stealth couriers of tumor DNA.
Exciting for #LiquidBiopsy — but the challenge will be to turn this hidden reservoir into a reliable clinical tool.
Yet: retrospective, selection bias, limited IO/ADC, frequent cN/pN mismatch.
=> Surgery may help, but only in selected pts, within MDT & multimodal strategy.
Cédric Lebâcle retweeted
Heal with steel in cN+ UTUC. 🩹🩹
🇹🇼 Nationwide cohort (n=288): RNU ↓ UTUC-specific mortality 69%→36%, 5-yr CSS 0%→39% vs. no surgery.
Surgery still matters N+disease
#UroOnc #UTUC nature.com/articles/s41598-0…
Cédric Lebâcle retweeted
💫🌟📢 The impact of radical cystectomy (RC) on sexual health & QoL🌟💫
Presenter: @PignotG | Moderator: @CLebacle
#BLADDR24 @OncoAlert @mirrorsmed
🔍 Key Points:
🟠RC impacts sexual function significantly. Yet, 41.2% of urologists avoid discussing sexual outcomes with patients.
🟠Gender gap: Women are underserved in sexual health post-RC, highlighting the need for PROMS to guide improvements.
🟠Functional recovery: Sexual-sparing strategies lead to better sexual function & urinary continence, boosting QoL.
🟠Multimodal management (incl. sex therapy, physical treatments) enhances post-op outcomes for both genders.
🛠️ Call to Action: Incorporate sexual outcomes as a surgical endpoint & empower patients with comprehensive pre-op counseling!
@UrsulaVogl
@PGrivasMDPhD
@achoud72
@ZilliThomas
@fabioturco92
@yekeduz_emre
@bavilima
@niklas_kluemper
@nachoduranm
@schmidingerRCC
@DrDabestani
@PignotG
@lisapic
@DrYukselUrun
@b_szabados
#BladderCancer #UroOncology #QoL #PatientCare 🧑⚕️👩⚕️
Cédric Lebâcle retweeted
💡 Highlights from #BLADDR24: Translating Data into Practice 🚨
Moderators: @CLebacle & Fred Witjes
🔥 Practical insights into intravesical instillation for bladder cancer:
@OncoAlert @mirrorsmed
Efficacy Tips: Limit voiding before therapy 🚫💧 & drink fluids after 💦.
Toxicity Risks: Hygiene matters! Men should void sitting 👨⚕️🚻.
Post-op timing matters for MMC—best on surgery day ⏰🔬.
2023 Guidelines: Continuous saline irrigation 🌊 recommended for chemo-ineligible.
New tools like TAR-200 & GemRIS showing promise 🌟.
@UrsulaVogl
@PGrivasMDPhD
@achoud72
@ZilliThomas
@fabioturco92
@yekeduz_emre
@bavilima
@niklas_kluemper
@nachoduranm
@schmidingerRCC
@DrDabestani
@PignotG
@lisapic
@DrYukselUrun
@b_szabados
#OncoTwitter #UroOncology #BladderCancer
Cédric Lebâcle retweeted
Fantastic talks on practical surgical questions on DAY 2 of #BLADDR24
- Practical aspects of intravesical instillation by Fred Witjes
- The optimal TURBT by Ben-Max de Ruiter
- The impact of RC on sexual function/experience by @PignotG
Moderation: @CLebacle
@OncoAlert
Cédric Lebâcle retweeted
So fun to debate my friend & colleague @b_szabados on role of ctDNA in #bladdercancer citing data from TOMBOLA IMvigor011, etc. Great moderation by @DanieleRaggi83
@tompowles1 @Uromigos @AndreaNecchi @MattGalsky @JoshMeeks @achoud72 @KilianGust @OncoAlert @mirrorsmed #BLADDR24
💫🌟Debate: The Role of ctDNA in Adjuvant MIBC Management
Moderator: Daniele Raggie
SUPER PRESENTATION !!👏👏@PGrivasMDPhD, @b_szabados
#BLADDR24 @OncoAlert @mirrorsmed
🔸️ctDNA+ post-RC detected in 52% of patients; 75% had recurrence <4 months. 🚨
🔸️Only 3% of ctDNA-negative patients developed metastases, promising for risk stratification. 🧬
🔸️IMvigor 010: ctDNA clearance correlated with improved DFS & OS! (HR 0.59) 📊
🔸️TOMBOLA trial highlights: ctDNA's predictive role needs validation—impact on NIAGARA awaited. 🔄
🟠🌟Future: Serial ctDNA testing to refine prognosis but requires addressing logistical hurdles. 📅
@UrsulaVogl
@PGrivasMDPhD
@achoud72
@ZilliThomas
@fabioturco92
@yekeduz_emre
@bavilima
@niklas_kluemper
@nachoduranm
@schmidingerRCC
@DrDabestani
@PignotG
@lisapic
@DrYukselUrun
@b_szabados
#BLADDR24 #UroOncology #BladderCancer #ctDNA #PrecisionMedicine @OncoAlert @mirrorsmed
Cédric Lebâcle retweeted
Day One of #BLADDR24
Presenter: Dr Cédric Lebâcle
Debate: Are we ready to de-intensify treatment and surveillance in low-grade NMIBC?
PRO and CON
PRO:
The debate on whether we are ready to de-intensify treatment and surveillance in low-grade non-muscle invasive bladder cancer (NMIBC) sees the "pro" side arguing that an adapted de-intensification strategy offers several benefits. These include minimizing the risks and side effects of interventions, reducing patient anxiety, and easing the treatment burden, all while ensuring safe and effective care. From a global perspective, this approach can help decrease unnecessary procedures in low-risk NMIBC patients without compromising cancer control, maintaining oncological outcomes while improving overall patient quality of life.
@UrsulaVogl
@PGrivasMDPhD
@achoud72
@ZilliThomas
@fabioturco92
@nataliagandur
@yekeduz_emre
@bavilima
@niklas_kluemper
@DrYukselUrun
@mirrorsmed
@bkonety
@evacomperat
@Achard_Verane
@daandm
@mdesantis234
@KilianGust
@bkonety
@CLebacle
@LAUrology_NL
@Renate_Pichler
@DanieleRaggi83
@CelenaBergdahl
@bm_deruiter
Still time to Register:
buff.ly/3Z4aEt3
Cédric Lebâcle retweeted
Big AI discovered a new structural class of antibiotics!
The last one took 38 years with multiple compounds effective vs methicillin-resistant Staph aureus, without toxicity.
Article: nature.com/articles/s41586-0…
Si on souhaite mettre en évidence 10% de complications en moins, il faudrait 392 patients par groupe. Partant ?
Cédric Lebâcle retweeted
A big day for bladder ca patients @US_FDA. Massive team effort. Platinum based chemo superseded at last. EV/pembro will transform the lives of many pts with this difficult disease. Still lots to do but it’s a pretty good day and worth pausing for a moment. bit.ly/3GLntQn
