TUMORS OF BLADDER.pptx
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This document discusses tumors of the urinary bladder. It begins with an introduction to the urothelial lining of the bladder and then discusses the etiology of bladder tumors, including cigarette smoking, industrial exposure to chemicals, infections like schistosomiasis, and immunosuppressive drugs. It covers the classification of bladder tumors, which are mostly urothelial carcinomas, and describes the pathogenesis, grading, morphology, staging, and clinical features. It then discusses the role of the pathologist and various treatment options depending on the stage, including transurethral resection, Bacillus Calmette-Guérin therapy for non-muscle invasive tumors, and radical cystectomy or radiation therapy for muscle invasive
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There is increasing confidence that cell therapies will soon play a role in the treatment of autoimmune disorders, but the extent of this impact remains to be seen. Early readouts on autologous CAR-Ts in lupus are encouraging, but manufacturing and cost limitations are likely to restrict access to highly refractory patients. Allogeneic CAR-Ts have the potential to broaden access to earlier lines of treatment due to their inherent cost benefits, however they will need to demonstrate comparable or improved efficacy to established modalities.
In addition to infrastructure and capacity constraints, CAR-Ts face a very different risk-benefit dynamic in autoimmune compared to oncology, highlighting the need for tolerable therapies with low adverse event risk. CAR-NK and Treg-based therapies are also being developed in certain autoimmune disorders and may demonstrate favorable safety profiles. Several novel non-cell therapies such as bispecific antibodies, nanobodies, and RNAi drugs, may also offer future alternative competitive solutions with variable value propositions.
Widespread adoption of cell therapies will not only require strong efficacy and safety data, but also adapted pricing and access strategies. At oncology-based price points, CAR-Ts are unlikely to achieve broad market access in autoimmune disorders, with eligible patient populations that are potentially orders of magnitude greater than the number of currently addressable cancer patients. Developers have made strides towards reducing cell therapy COGS while improving manufacturing efficiency, but payors will inevitably restrict access until more sustainable pricing is achieved.
Despite these headwinds, industry leaders and investors remain confident that cell therapies are poised to address significant unmet need in patients suffering from autoimmune disorders. However, the extent of this impact on the treatment landscape remains to be seen, as the industry rapidly approaches an inflection point.
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TUMORS OF BLADDER.pptx
- 1. TUMORS OF URINARY BLADDER DR KHOWSALYA SUBRAJAA K MD PATHOLOGY(JIPMER)
- 2. OUTLINE • INTRODUCTION • ETIOLOGY • CLASSIFICATION • PATHOGENESIS • GRADING • MORPHOLOGY • STAGING • CLINICAL FEATURES & MANAGEMENT • OTHER TUMORS • QUESTIONS
- 3. INTRODUCTION
- 10. ETIOLOGY
- 12. Industrial exposure to Aryl amines Cancer appears 15 to 40 years after the first exposure
- 14. Long term use
- 15. Immunosuppresive agent – Long term use
- 16. Irradiation of other pelvic malignancy
- 17. ETIOLOGY • Cigarette Smoking • Industrial exposure to Aryl amines • Schistosoma haematobium • Long-term use of analgesics • Heavy long-term exposure to cyclophosphamide • Irradiation
- 18. CLASSIFICATION
- 19. TUMORS OF URINARY BLADDER •Urothelial (Transitional) tumors (90%) Non Invasive - Papilloma - Flat Non invasive carcinoma Invasive - Invasive Papillary carcinoma - Flat Invasive Carcinoma OTHERS Adenocarcinoma Squamous cell carcinoma Mixed carcinoma Small – cell carcinoma Sarcomas
- 20. CLASSIFICATION BASED ON MORPHOLOGICAL PATTERNS
- 21. pathogenesis
- 22. PATHOGENESIS
- 23. GRADING
- 24. Grading of Noninvasive Urothelial (Transitional Cell) Tumors
- 25. MORPHOLOGY
- 26. FLAT LESION
- 27. FLAT LESION
- 28. FLAT LESION
- 29. PAPILLARY LESION
- 31. STAGING
- 35. CLINICAL FEATURES • Painless hematuria is the most common symptom of bladder cancer • Frequency • Urgency • Dysuria • Occasionally, obstruction of the ureteral orifice may lead to pyelonephritis or hydronephrosis
- 37. MANAGEMENT TUMORS OF URINARY BLADDER •Non muscle Invasive Low Grade Diagnostic transurethral resection High Grade Intravesical instillation of bacillus Calmette- Guérin (BCG) Muscle Invasive Radical cystectomy or radiation therapy with neoadjuvant and/or adjuvant chemotherapy
- 39. Intravesical instillation of bacillus Calmette-Guérin (BCG)
- 40. RADICAL CYSTECTOMY - MALE
- 41. RADICAL CYSTECTOMY - FEMALE
- 42. OTHER TUMORS
- 43. OTHER BLADDER TUMORS OTHER EPITHELIAL TUMORS - SQUAMOUS CELL CARCINOMA - ADENOCARCINOMA - SMALL CELL CARCINOMA MESENCHYMAL TUMORS - BENIGN : LEIOMYOMA - SARCOMA: EMBRYONAL RHABDOMYOSAR COMA (MC bladder sarcoma of childhood) SECONDARY TUMORS Direct extension of cancers arising in adjacent organs, mainly the cervix, uterus, prostate, and rectum
- 44. THANK YOU