Adjuvant intravesical treatment for non-muscle invasive bladder cancer: The importance of the strain and maintenance

Guerrero-Ramos, F.; Lara-Isla, A.; Justo-Quintas, J.; Duarte-Ojeda, J.M.; Rosa-Kehrmann, Federico de la; Villacampa-Aubá, F.

doi:10.1016/j.acuroe.2017.08.008

Cited by 4 publications

(15 citation statements)

References 14 publications

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“…A recent meta-analysis comparing 10 BCG substrains was unable to find the best substrain, 16 and a previously published retrospective study performed by Guerrero-Ramos et al found similar recurrence-free survival rates between patients who had received BCG Connaught and those who had received BCG Tice. 17 Similar conclusions were reached by Unda-Urzaiz et al, who compared BCG Tokyo, Russian, Tice, Connaught and RIVM; 18 Krajewski et al, who compared BCG Tice, Moreau and RIVM; 14 and a recent study that compared the BCG Moreau and Tice substrains. 19 However, Rentsh et al demonstrated that BCG Connaught was significantly more effective in terms of recurrence-free survival than BCG Tice.…”

Section: Safety and Efficacysupporting

confidence: 54%

<p>Bacillus Calmette-Guérin (BCG) Therapy for Bladder Cancer: An Update</p>

Guallar-Garrido

Julián

2020

ITT

142

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Physicians treating patients affected by nonmuscle-invasive bladder cancer (NMIBC) have been in shock during the last six years since manufacturing restrictions on the production of the first-option medicine, Mycobacterium bovis Bacillus Calmette-Guérin (BCG), have resulted in worldwide shortages. This shortage of BCG has led to a rethinking of the established treatment guidelines for the rationing of the administration of BCG. Some possible schedule modifications consist of a decrease in the length of maintenance treatment, a reduction in the dose of BCG in intravesical instillations or the use of different BCG substrains. All these strategies have been considered valuable in times of BCG shortage. In addition, the lack of availability of BCG has also led to the general recognition of the need to find new treatment options for these patients so that they are not dependent on a single treatment. Few alternatives are committed to definitively replacing BCG intravesical instillations, but several options are being evaluated to improve its efficacy or to combine it with other chemotherapeutic or immunotherapeutic options that can also improve its effect. In this article, we review the current state of the treatment with BCG in terms of all of the aforementioned aspects.

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Section: Safety and Efficacysupporting

confidence: 54%

<p>Bacillus Calmette-Guérin (BCG) Therapy for Bladder Cancer: An Update</p>

Guallar-Garrido

Julián

2020

ITT

142

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“…In 43 of these studies (70%), BCG was used in all patients (100% treatment rate). 16,17,19,[21][22][23][24][25][26][27][28][29][30][31][32][33][34][35][36][37][38][40][41][42][43][44]46,49,51,54,56,57,[61][62][63]65,68,69,[72][73][74][75][76] BCG therapy was an inclusion criterion for some of these studies, which contributed to this high rate. In the remaining 18 studies (30%), the reported use of BCG instillations in HR-NMIBC patients ranged from 3% to 86%.- 18,20,39,45,47,48,50,…”

Section: Treatment Patternsmentioning

confidence: 99%

“…In the remaining 18 studies (30%), the reported use of BCG instillations in HR-NMIBC patients ranged from 3% to 86%.- 18,20,39,45,47,48,50,52,53,55,[58][59][60]64,66,67,70,71 Thirty-five studies reported on the use of BCG induction therapy specifically, 16,17,20-22,24-28,31,33-37,40,42,45,47,49,51,52, ClinicoEconomics and Outcomes Research 2022:14 https://doi.org/10.2147/CEOR.S341896 DovePress 37 54,56,57,59,61,63,65,68,74,75,77,78 of which 27 (77%) reported the use of BCG induction in all patients (100%). 16,17,21,22,[24][25][26][27][28]31,[33][34][35][36][37]40,42,49,…”

Section: Treatment Patternsmentioning

confidence: 99%

“…20,45,47,52,59,63,77,78 The use of maintenance BCG in HR-NMIBC was reported in 31 studies, with rates being more variable than those seen with induction therapy. 16,17,[26][27][28][29]31,33,34,36,37,40,42,45,46,[49][50][51][52]54,56,59,61,63,65,68,69,72,74,75,77 Only 7 studies (23%) reported BCG maintenance being used in all high-risk patients (100%). 26,28,29,40,49,56,61 Among the remaining 24 studies, use of maintenance BCG therapy ranged between 8-83%.…”

Section: Treatment Patternsmentioning

confidence: 99%

“…26,28,29,40,49,56,61 Among the remaining 24 studies, use of maintenance BCG therapy ranged between 8-83%. 16,17,27,31,33,34,36,37,42,45,46,[50][51][52]54,59,63,65,68,69,72,74,75,77 Twelve studies reported the use of mitomycin C in high-risk patients. 23,28,30,46,48,64,66,70,72,[79][80][81] Treatment rates ranged from 2% to 53% in 9 studies, with few studies reporting its use in all patients (rate of 100% in 3 studies).…”

Section: Treatment Patternsmentioning

confidence: 99%

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Treatment Outcomes of High-Risk Non-Muscle Invasive Bladder Cancer (HR-NMIBC) in Real-World Evidence (RWE) Studies: Systematic Literature Review (SLR)

Musat¹,

Kwon²,

Masters³

et al. 2022

CEOR

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Background: To date, there has been limited synthesis of RWE studies in high-risk nonmuscle invasive bladder cancer (HR-NMIBC). The objective of this research was to conduct a systematic review of published real-world evidence to better understand the real-world burden and treatment patterns in HR-NMIBC. Methods: An SLR was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines with the scope defined by the Population, Intervention Comparators, Outcomes, and Study design (PICOS) criteria. EMBASE, MEDLINE, and Cochrane databases (Jan 2015-Jul 2020) were searched, and relevant congress abstracts (Jan 2018-Jul 2020) identified. The final analysis only included studies that enrolled ≥100 patients with HR-NMIBC from the US, Europe, Canada, and Australia. Results: The SLR identified 634 RWE publications in NMIBC, of which 160 studies reported data in HR-NMIBC. The average age of patients in the studies was 71 years, and 79% were males. The rates of BCG intravesical instillations ranged from 3% to 86% (29-95% for induction and 8-83% for maintenance treatment). Five-year outcomes were 17-89% recurrence-free survival (longest survival in patients completing BCG maintenance), 58-89% progression-free survival, 71-96% cancer-specific survival (lowest survival in BCG-unresponsive patients), and 28-90% overall survival (lowest survival in patients who did not receive BCG or instillation therapy). Conclusion: BCG treatment rates and survival outcomes in patients with HR-NMIBC vary in the real world, with better survival seen in patients completing maintenance BCG, responding to treatment, and not progressing to muscle-invasive disease. There is a need to better understand the factors associated with BCG use and discontinuation and for an effective treatment that improves outcomes in HR-NMIBC. Generalization of these results is limited by variations in data collection, reporting, and methodologies used across RWE studies.

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The comparison of different BCG strains in the intravesical treatment of non-muscle invasive urothelial carcinoma of urinary bladder-A real-world practice

Chen

Huang

Chang

et al. 2022

Journal of the Chinese Medical Association

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SII-ONCO-BCG (Moscow strain), and ImmunoBCG (Moreau RdJ strain). [4][5][6] Meta-analysis by the European Organization for Research and Treatment of Cancer (EORTC) (n = 2596) suggested no major differences in efficacy among various BCG strains used for intravesical instillation. 7,8 However, conflicting results from various studies have made this topic controversial. 9,10 ImmuCyst, the Connaught strain, had previously been widely accepted worldwide. Oncotice, the Tice strain, was introduced in 2013 in our institute owing to the worldwide shortage of the Connaught strain. There is conflicting evidence regarding the clinical efficacy of the Tice strain in comparison with the Connaught strain. According to a previous meta-analysis of 24 randomized clinical trials, maintenance treatment with BCG could reduce the risk of progression. 7 Hence, it would be interesting to compare the different BCG strains in real-world practice. We retrospectively compared the Connaught and Tice strains in terms of their efficacy and adverse events (AE) in patients who underwent at least one maintenance course after the induction course, that is, nine intravesical instillations. METHODSIn this single-center, retrospective study, patients with stage Ta, T1 NMIBC, or carcinoma in situ (CIS) from 2007 to 2018 after .

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Adjuvant intravesical treatment for non-muscle invasive bladder cancer: The importance of the strain and maintenance

Cited by 4 publications

References 14 publications

<p>Bacillus Calmette-Guérin (BCG) Therapy for Bladder Cancer: An Update</p>

<p>Bacillus Calmette-Guérin (BCG) Therapy for Bladder Cancer: An Update</p>

Treatment Outcomes of High-Risk Non-Muscle Invasive Bladder Cancer (HR-NMIBC) in Real-World Evidence (RWE) Studies: Systematic Literature Review (SLR)

The comparison of different BCG strains in the intravesical treatment of non-muscle invasive urothelial carcinoma of urinary bladder-A real-world practice

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