Roger Li: Yeah, so this year we had one and a half topics, if you will. So, the larger topic is centered around the topic of biomarkers, which has become so important in how we treat bladder cancer, whether it be in the nonmuscle invasive space, in the perioperative space, and also in the metastatic space. So, we gathered a lot of experts within the field, and also industry partners too, to share with us what is coming down the pike, what is exciting for them. The other topic that we had consensus on was to look at bladder-related toxicity, specifically when we're dealing with intravesical therapy, we know that there is a lot of bladder-related toxicity that may not be as well-reported or as well-developed as some of the other toxicity categories within the CTCAE.
And as urologists, I think we have the best voice to frame how we categorize these toxicities, what constitutes dose-limiting toxicity, what constitutes a severe AE within the bladder. And so, we not only looked at intravesical therapy, but also extended it to radiation therapy, as well as systemic therapy, so included in that process our radiation oncology colleagues, as well as our medical oncology colleagues. So, it turned out to be a really great discussion amongst all of us within those two topics.
Ashish Kamat: Thanks, Roger. One of the things that we pride ourselves in the IBCG is that we make it truly multidisciplinary and also global. And from that aspect, Shilpa, if you could share with the audience a little bit your thoughts and your perspective on what makes these discussions special, being that we have multiple disciplines and patient advocates and others involved.
Shilpa Gupta: Yeah. Ashish, first of all, congratulations on such a successful meeting third year in a row, and I think what makes this meeting unique is the multidisciplinary aspect of having all the specialties represented, but more importantly, the global aspect. We have people from the US, Canada, then we had people from Asia, Morocco, and Europe... So, I think it was really... And India. And I think that makes it even more important that every question that we ask is not just limited to how you would practice things in the US, but globally. And I think the perspectives are also very global, and that's why sometimes the discussion on voting gets very controversial because the access and disparities is a problem in the rest of the world. So, I think to me, that is really the biggest strength of this meeting.
Ashish Kamat: And then, of course, you've been an advocate of the patient voice, so having the patients there, having the regulatory bodies there, I think really opens our eyes sometimes to the nuances of what we're discussing. Any thoughts about that, Shilpa?
Shilpa Gupta: Yeah, absolutely. I think the patients are the center of what we do and why we do, and I think having a panel only with the patient advocates and hearing their perspectives, as simple as what kind of terminology we use sometimes, how we describe access, and I think it's very eye-opening, and having that collaboration with the World Bladder Cancer Coalition and the Bladder Cancer Advocacy Network really is the icing on the cake. Because as you have that newly-formed patient-centric mission with the World Bladder Coalition, I think it will really be very important to partner with our advocates, which we are already doing through IBCG.
Ashish Kamat: Great. So, Pat, Roger talked about the topics and why we chose them, and of course, Shilpa shared her thoughts on the composition of the folks that we invite, could you share with our audience a little bit about the process that we follow through the IBCG? What the whole general process is that allows us to come out with not just the recommendation statements, but truly something that's globally applicable.
Patrick Hensley: Yeah. I think one of the great joys of this meeting is a lot of the hard work is done pre-meeting, so that we can really enjoy spending time with colleagues and refining the work once we're in person. So, for months leading up to the retreat, we developed these working groups within subtopics based on individual provider specialty and research interests, and we develop these drafted consensus statements. And they go through a very iterative process, these groups meet very frequently, these are international colleagues that are working at crazy hours to collaborate on refining these statements before the meeting. There is a period of pre-meeting voting, where all of the IBCG faculty actually get to vote whether or not they agree with a pre-meeting statement. And then, during the meeting, there's a period of scientific discussion, each one of the statements gets re-presented, refined based on feedback, and then the meeting concludes on Saturday with what we call the consensus voting process, whereby final statements that achieve greater than or equal to 75% agreement actually achieve consensus, and form the framework for the manuscript.
Ashish Kamat: Yeah, I think one of the things that, as all three of you mentioned, that makes it truly unique is that, and I want to quote one of our patient advocates, I won't quote his name, but that, "We are literally a pain in the behind when it comes to the other regulatory bodies." Because we can truly actually make our recommendations on what we think is important for the patient perspective, not that the others don't care, but different organizations have to worry about their constituents, the legalese, everything that goes hand in hand, we're not really here to make recommendations to favor any particular payer, or to favor any particular body, it truly is what we, and when I say we, I mean the collective we, the entire membership feels is best for the patient.
So, I really think that is something that drives our mission, drives our vision, and then the partnership, right? The partnership with everybody there, and also with UroToday, for example. Thanks to UroToday for partnering with the IBCG for things in general, but also for allowing us to feature this on the channel and spread the word. And if anybody is doing bladder cancer work and is interested, I would recommend that they reach out to us through our website, we have an application process, and the application process is obviously reviewed by the board, the board meets periodically, and then we welcome anybody that's doing bladder cancer work to join the organization so that we can help you help your patients in whichever part of the world that you live in. So, Shilpa, Roger, Pat, thank you for taking the time, and thanks to UroToday.
Roger Li: Thank you.
Shilpa Gupta: Thank you.
Patrick Hensley: Thanks so much.