Barriers Considered When Treating Patients With Bladder Cancer

Petros Grivas, MD, PhD, clinical director of the genitourinary cancers program at University of Washington Medicine and professor at Fred Hutchinson Cancer Center in Seattle, Washington, discusses challenges in cancer care in the bladder cancer setting.

The first barrier Grivas notes is limited infusion room capacity and the need for rapid chair turnover. Other external barriers for patients include transportation and lodging. Grivas highlights that healthcare disparities remain a global concern.

Regulatory approvals, NCCN guidelines, and insurance coverage decisions impact treatment accessibility for patients with bladder cancer. Advances in next-generation sequencing, molecular profiling, and HER2 testing—especially with trastuzumab deruxtecan’s (Enhertu) approval in 2024—offer promising opportunities. The field is making progress, improving patient outcomes, and ongoing clinical trials aim to further enhance future treatments. Efforts continue to optimize efficiency, equity, and care quality in oncology, according to Grivas.

TRANSCRIPTION:

0:09 | Sometimes barriers may include a certain capacity and bandwidth that we have in the infusion rooms, infusion suites these days in the cancer centers, the need for a rapid turnover of the infusion chairs—but that's an issue across the board, I would say. We always want to strive to give the best possible care for the patients, and that's what we're striving for. I always think about efficiencies and the ways to be more efficient in clinic. Also, patients sometimes may have challenges in terms of transportation, in terms of lodging, their own time, so we need to make sure we meet that need. Obviously, the issue of healthcare disparities is a major issue globally, and it's something that always is relevant in those discussions.

0:59 | Regulatory approvals and NCCN and other guidelines are relevant to support even the decision by payers, insurance companies, whether to cover some particular medications, particular therapies. And, of course, there are opportunities for broader use of tumor next-generation sequencing, molecular profiling, as well as HER2 immunohistochemistry staining based on the gastric cancer calling algorithm in the setting of the recent approval of trastuzumab deruxtecan across tumor types. So overall, we're very excited about the progress being made in the field and the better outcomes for our patients, and we keep accruing in clinical trials in order to try to make the future even better for our patients and further improve the outcomes through ongoing research.