A Prospective Comparative Study of Intravesical Bacillus Calmette-Guérin Therapy with the Tokyo or Connaught Strain for Nonmuscle Invasive Bladder Cancer

Sengiku, Atsushi; Ito, Masaaki; Miyazaki, Yu; Sawazaki, Harutake; Takahashi, Takeshi; Ogura, Keiji

doi:10.1016/j.juro.2013.01.084

Cited by 63 publications

(55 citation statements)

References 17 publications

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“…When analysis of fever cases was performed, some borderline associations were noted, with Moreau causing slightly more febrile states than other strains. Those differences were not observed in previous studies, which may be cause by differences in samples sizes [7][8][9].…”

Section: Toxicitycontrasting

confidence: 67%

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Are There Differences in Toxicity and Efficacy between Various Bacillus Calmette-Guerin Strains in Bladder Cancer Patients? Analysis of 844 Patients

et al. 2018

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Purpose: To evaluate if there are differences in toxicity and efficacy between different Bacillus Calmette-Guerin (BCG) stains used for intravesical immunotherapy in patients with non-muscle invasive bladder cancer. Methods: We retrospectively analysed a group of 844 patients who received TICE, RIVM and Moreau BCG strains. The allocation of the strain to each patient was random, stemming from differences in supply and distribution. The patients were analysed in terms of toxicity, recurrence-free (RFS), progression-free (PFS), cancer-specific (CSS) and overall survival (OS). Results: In the survival analysis, statistical significance was not reached in any tumour group for any clinical event. TICE caused more local and mild adverse effects and severe complications were mainly associated with RIVM strain. In a group in which the strain was changed during the course of the therapy, significantly more severe complications were observed and, in most of these cases, complications appeared right after the strain change. Conclusions: There were no differences in terms of RFS, PFS, CSS and OS after use of TICE, RIVM and Moreau strains. The complication profile differed statistically between used strains with TICE causing mostly mild complications. Also, strain change during the therapy course was associated with the increased risk of moderate to severe toxicity occurrence.

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Section: Toxicitycontrasting

confidence: 67%

“…In the Sengiku et al [9] paper, authors have compared 28-month analysis of RFS of 66 and 63 patients who received the Tokyo and Connaught stains respectively. There was no statistical difference in RFS rates and toxicity.…”

Section: Discussionmentioning

confidence: 99%

Are There Differences in Toxicity and Efficacy between Various Bacillus Calmette-Guerin Strains in Bladder Cancer Patients? Analysis of 844 Patients

et al. 2018

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“…Smaller studies without maintenance demonstrated some differences between strains. This clearly needs further evaluation in prospective trials [94,95] (LE: 2a).…”

Section: Bacillusmentioning

confidence: 99%

EAU Guidelines on Non–Muscle-invasive Urothelial Carcinoma of the Bladder: Update 2016

et al. 2017

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“…Two recent randomized controlled trials (RCTs) have compared different BCG strains. The Tice and Connaught strains have similar side effects (42% vs. 28%, P = 0.09) [25] and no difference in intolerability for the Tokyo and Connaught strains (8.1% vs. 9.8%, P = 0.70) was shown [26]. Andius et al reduced the instillation dwell time to less than 30 min [27].…”

Section: Discussionmentioning

confidence: 95%

BCG immunotherapy for non-muscle invasive bladder cancer: is efficacy related to toxicity?

Udovicich

Nankivell²,

Barberi

et al. 2017

Bladder

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OBJECTIVES:To examine the prevalence of local and systemic adverse effects (AEs) associated with Bacillus Calmette-Guerin (BCG) immunotherapy for non-muscle invasive bladder cancer (NMIBC) and to determine if there was any relationship between adverse effects and efficacy of treatment. PATIENTS AND METHODS:Patients receiving induction intravesical BCG immunotherapy for NMIBC from 1995 to 2013 were identified from a group urology practice. Patients completed an AE scoresheet and an AE was recorded if the patient experienced the symptom at any point in the week following instillation. Patients were dichotomised based on recurrence status (treatment efficacy was defined as non-recurrence) and association with AEs was investigated using univariate Cox regression analysis. RESULTS:One hundred and fifty eight patients were examined with a mean age of 70.2 years (range 41-88) and a male predominance (125, 79%). The most prevalent local AEs were frequency (107, 68%), dysuria (98, 62%) and nocturia (95, 60%). Malaise (54, 34%), myalgia (41, 26%) and fever (32, 20%) were the most common systemic AEs. Recurrence status was available for 82 patients, with 43 (52%) diagnosed with recurrence. There was no significant relationship between overall AEs and recurrence [hazard ratio (HR) 0.97, P = 0.57], or for local (HR 0.99, P = 0.90) and systemic (HR 0.88, P = 0.32) AEs. Only frequency was significantly associated with reduced recurrence (HR = 0.42, P = 0.04). CONCLUSIONS:AEs due to BCG immunotherapy are common in the induction period with nearly 70% of patients in our cohort experiencing individual symptoms. Local AEs are considerably more prevalent than systemic. Frequency was the only AE to be significantly associated with non-recurrence. Overall, AEs due to BCG instillation treatment were not related to efficacy for NMIBC.

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A Prospective Comparative Study of Intravesical Bacillus Calmette-Guérin Therapy with the Tokyo or Connaught Strain for Nonmuscle Invasive Bladder Cancer

Abstract: Results suggest no significant differences between the Tokyo and Connaught strains in the complete response, recurrence-free survival or adverse event rate.

Cited by 63 publications

References 17 publications

Are There Differences in Toxicity and Efficacy between Various Bacillus Calmette-Guerin Strains in Bladder Cancer Patients? Analysis of 844 Patients

Are There Differences in Toxicity and Efficacy between Various Bacillus Calmette-Guerin Strains in Bladder Cancer Patients? Analysis of 844 Patients

EAU Guidelines on Non–Muscle-invasive Urothelial Carcinoma of the Bladder: Update 2016

BCG immunotherapy for non-muscle invasive bladder cancer: is efficacy related to toxicity?

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