Matthew Galsky, MD, is a professor of medicine, director of genitourinary medical oncology, and co-director of the Center of Excellence for Bladder Cancer at The Tisch Cancer Institute, and associate director for translational research at The Tisch Cancer Institute.
An expert discusses how the availability of subcutaneous (SC) immune checkpoint inhibitors (ICI) for bladder cancer impacts treatment selection by offering improved convenience and accessibility, particularly in advanced/metastatic and perioperative settings. SC formulations may reduce costs, time, and patient burden while enhancing treatment compliance and follow-up.
An expert discusses how medical professionals counsel eligible patients about adjuvant immune checkpoint inhibitor (ICI) therapy by discussing its potential to reduce cancer recurrence, emphasizing the benefits in high-risk cases. They carefully assess patient eligibility, explaining potential immune-related adverse events and balancing these risks with the treatment’s potential lifesaving benefits.
An expert discusses how medical professionals monitor and manage adverse events (AEs) with adjuvant nivolumab through regular assessments, including laboratory tests and clinical evaluations. While approaches may overlap with metastatic settings, adjuvant treatment often emphasizes early detection of immune-related AEs, as patients are generally healthier.
An expert discusses how medical professionals are increasingly utilizing circulating tumor DNA (ctDNA) and tissue PD-L1 to guide recommendations for adjuvant immune checkpoint inhibitor (ICI) therapy. ctDNA helps monitor minimal residual disease and early treatment response while tissue PD-L1 status aids in predicting ICI efficacy, optimizing patient treatment plans.
An expert discusses how enthusiasm for adjuvant anti–PD-1 therapy varies based on key factors. Receipt of neoadjuvant chemotherapy (NAC), nodal involvement, positive margins, variant histology, and PD-L1 expression influence recommendations. Observation may be preferred in frail, elderly, or autoimmune-prone patients. muscle-invasive urothelial carcinoma (MIBC) status is critical in decision-making.
An expert discusses how recent data on adjuvant anti–PD-1 trials highlight the significance of disease-free survival (DFS) and overall survival (OS), guiding clinical decisions. In muscle-invasive urothelial carcinoma (MIBC), event-free survival (EFS) and OS benefits without delaying curative cystectomy are crucial. Adjuvant nivolumab is typically initiated within 12 weeks post cystectomy, considering pathology, recovery, and performance status.
An expert discusses how the updated results from CheckMate 274 (Galsky 2025) include updated disease-free survival (DFS) and interim overall survival (OS), along with other key end points such as nonurothelial tract recurrence-free survival (NUTRFS), distant metastasis-free survival (DMFS), and second progression-free survival (PFS2). An exploratory analysis assessed outcomes in the muscle-invasive urothelial carcinoma (MIBC) subgroup, prior neoadjuvant chemotherapy (NAC) use, and PD-L1 expression. This analysis was conducted to further evaluate efficacy across subgroups and refine the understanding of treatment impact.
An expert discusses how CheckMate 274 is a phase 3, randomized, double-blind trial evaluating adjuvant nivolumab vs placebo in patients with high-risk muscle-invasive urothelial carcinoma (MIUC) after surgery. It enrolled 709 patients, assessing disease-free survival and overall survival as primary end points.
An expert discusses how adjuvant therapy options for high-risk muscle-invasive bladder cancer (MIBC); ypT2-ypT4a or N+) include cisplatin-based chemotherapy, which improves survival by targeting micrometastatic disease. Immune checkpoint inhibitors, such as atezolizumab and nivolumab, offer alternatives for cisplatin-ineligible patients.
An expert discusses how patients with muscle-invasive urothelial carcinoma (MIUC) undergoing radical cystectomy face a significant recurrence risk. High-risk factors include advanced stage, lymph node involvement, and positive surgical margins. Neoadjuvant cisplatin-based chemotherapy can improve survival but does not eliminate recurrence risk. Other predictors include lymphovascular invasion, variant histology, and systemic inflammation markers.
Matthew Galsky, MD, discusses why some physicians were surprised at the positive outcomes of nivolumab trials in bladder cancer compared with trials of similar agents.
Matthew Galsky, MD, discusses the disease-free survival of nivolumab vs placebo in patients with high-risk muscle-invasive bladder cancer.
Dr Matthew Galsky contemplates how he would use immunotherapy in patients with MIBC, if it were available for use in both the neoadjuvant and adjuvant setting.
Matthew Galsky, MD, highlights some remaining unmet needs for patients with MIBC, and currently ongoing clinical trials in the neoadjuvant MIBC treatment setting that excite him.
Dr Matthew Galsky explains the adjuvant therapy regimen he would have recommended for the patient with MIBC from the presented case, and whether patient preference factors into his decisions in clinical practice.
Matthew Galsky, MD, explains safety and efficacy data from the CheckMate 274 trial, which led to the FDA approval of adjuvant nivolumab for patients with MIBC, and highlights important data updates from recent conferences.
Dr Matthew Galsky reviews the available adjuvant therapy options for patients with stage II or III MIBC who previously underwent bladder removal surgery.
Matthew Galsky, MD, presents the case of a 55-year-old man with stage T2N0M0 muscle-invasive bladder cancer (MIBC) for review, and explains how cisplatin eligibility is defined in patients.
Matthew Galsky, MD, discusses the most recent data in patients with bladder cancer.
Matthew Galsky, MD, discusses how the phase II HCRN GU14-182 study helps to define the role of switch maintenance therapy in patients with urothelial cancer. The study looked at maintenance with pembrolizumab versus placebo following frontline chemotherapy in patients with metastatic urothelial cancer.
Matthew Galsky, MD, professor of Medicine at the Mount Sinai School of Medicine, discusses results of a study examining nivolumab monotherapy in metastatic bladder cancer.
Matthew Galsky, MD, professor of Medicine, Mount Sinai School of Medicine, discusses the significant findings in, and the rationale behind conducting the CheckMate-275 trial during an interview at the 2016 ESMO Congress.
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