Patrick Soon-Shiong, Chairman of Chan Soon-Shiong Family Foundation, Executive Chairman at ImmunityBio, and Executive Chairman of the Los Angeles Times, shared Ashish M. Kamat’s, President at IBCG, Associate Editor at European Urology Oncology, post on X, adding:
“Thanks, Ashish. Your book entitled, “Bladder Cancer: A Practical Guide” says it all. Together we face patients on a day-to-day level in which we have to make decisions in the best interest of the patient with nothing else considered. I was so grateful for you to have shared with me your views on whether CIS and papillary from a clinical perspective was the same disease and also how you treat patients who have failed all BCG and have papillary disease and face losing their bladder to a life-changing operation of cystectomy.
I was blown away at this year’s AUA2026 when a researcher presented a slide showing that the morbidity and mortality of a cystectomy exceeds even that of a Whipple in which the pancreas, gallbladder portion of the stomach and spleen are all removed. That blew my mind especially since there is an option to save the bladder. I am posting the segment of our long conversation relating to your views of whether CIS and high grade papillary are treated clinically as the same disease. I was glad to hear the next day at the FDA workshop that your fellow expert colleagues completely agreed with this sentiment that you expressed in our conversation.”
Quoting Ashish M. Kamat’s post:
“Appreciate the thoughtful discussion, Patrick. Enjoyed discussing how we move the field forward together, especially with the patient at the center of every conversation. Important dialogue on durability of response, meaningful endpoints, and ensuring broader access to effective therapies for patients worldwide.”
Patrick Soon-Shiong also added:
“Next onto my conversation with Dr. Ashish Kamat and one of the country’s leading bladder cancer experts to hear his clinical decision making process as to how he treats patients with BCG unresponsive high-grade papillary disease when no CIS disease is found. (I said the word ‘found’ since sometimes once high-grade papillary disease is identified, physicians don’t bother to look for CIS since their decision making process for treatment is the same if high-grade papillary alone exists. Worse, only 6% of urologists have the blue-light cystoscopy scope that helps them find CIS disease).
Dr. Kamat who participated in the initial guidelines discussion with regard to BCG unresponsive in 2016, gave me an insightful answer as to how he treats patients clinically with high-grade papillary alone. Please listen to his insightful answer, the editor of the seminal textbook entitled, “Bladder Cancer: A Practical Guide“. He treats patients with high-grade papillary disease alone no differently than in patients with high-grade papillary and CIS disease. This was not surprising for me to hear since he and many others believe that CIS and papillary are the same disease!
The next day I attended the FDA workshop in which his fellow colleagues concurred that CIS and papillary was the same disease and also said that they approached patients with BCG unresponsive high-grade papillary disease in the same way as he shared with me in this interview, taken the day before the FDA workshop. His fellow colleagues and experts at the workshop said that they “struggled” and were compelled to make decisions with no option but to prescribe “off-label” therapies for patients who they see (with papillary disease alone) by writing a prescription for already FDA approved therapies for papillary and CIS disease.
So the consensus at this panel completely matched the panel of experts from comprehensive cancer centers across the nation who made up the NCCN and provided category 2A status for Anktiva + BCG for the treatment of BCG unresponsive papillary disease alone.
Cancer is a war against time
Disclaimer: Anktiva + BCG for the treatment of BCG unresponsive papillary disease is not approved and is awaiting review by the FDA as a supplemental BLA. For more details of ANKTIVA + BCG, please refer to our package insert and important safety information.
ANKTIVA is approved by the FDA in combination with BCG for the treatment of adult patients with BCG-unresponsive NMIBC with carcinoma in-situ (CIS), with or without papillary tumors.
Important Safety Information
U.S. Important Safety Information
Indication And Usage: ANKTIVA® is an interleukin-15 (IL-15) receptor agonist indicated with Bacillus Calmette-Guérin (BCG) for the treatment of adult patients with BCG-unresponsive non-muscle invasive bladder cancer (NMIBC) with carcinoma in situ (CIS) with or without papillary tumors.
Warnings And Precautions: Risk of Metastatic Bladder Cancer with Delayed Cystectomy. Delaying cystectomy can lead to the development of muscle-invasive or metastatic bladder cancer, which can be lethal. If patients with CIS do not have a complete response to treatment after a second induction course of ANKTIVA® with BCG, reconsider cystectomy.
Dosage And Administration: For Intravesical Use Only. Do not administer by subcutaneous or intravenous routes. Please see the complete Indication and Important Safety Information and Prescribing Information for ANKTIVA® at Anktiva.com.”
Other articles featuring Patrick Soon-Shiong and Ashish M. Kamat on OncoDaily.