Do Prognostic Parameters of Remission versus Relapse after Bacillus Calmette–Guérin (BCG) Immunotherapy Exist? Analysis of a Quarter Century of Literature

Saint, F.; Salomon, Laurent; Quintela, Rodrigo; Cicco, Antony; Hoznek, Andràs; Abbou, Claude C.; Chopin, Dominique

doi:10.1016/s0302-2838(03)00048-4

Cited by 73 publications

(37 citation statements)

References 61 publications

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“…However, 30% to 50% of cancers either fail to respond to or relapse from the therapy within the first 5 years of treatment. Although there have been many reports about factors predicting the response to intravesical BCG therapy for bladder cancer, no independent prognostic factor for the bladder cancer response to BCG has yet been identified (4).…”

Section: Intravesical Instillation Of Bacillus Calmette-guerin (Bcg) Ismentioning

confidence: 99%

Effect of Human Leukocyte Antigen Class I Expression of Tumor Cells on Outcome of Intravesical Instillation of Bacillus Calmette-Guerin Immunotherapy for Bladder Cancer

Kitamura

Torigoe

Honma

et al. 2006

Clinical Cancer Research

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Purpose: Various immune systems play important roles in the clinical efficacy of intravesical Bacillus Calmette-Guerin (BCG) instillation for bladder cancer. However, human leukocyte antigen (HLA) class I molecules on tumor cells and various immune system cells infiltrating to/around the tumor have not been evaluated, although many prognostic factors, including clinical, pathologic, and molecular ones, have been investigated. The aim of this study was to determine immunologic prognostic factors of BCG immunotherapy for bladder cancer. Experimental Design: Immunohistochemical staining for HLA class I, CD4, CD8, CD20, CD68, TIA-1, S-100, and FOXP3 was carried out on specimens from 30 patients who underwent BCG immunotherapy from whom both pretreatment and posttreatment specimens were obtained.We did univariate and multivariate analyses of factors affecting recurrence-free survival. The positive, weakly positive, and negative groups of cells that infiltrated to/around the tumor were compared with recurrence-free survival using the Kaplan-Meier method and log-rank test. Results: HLA class I was a significant prognostic factor both in univariate and multivariate analyses. The 5-year recurrence-free survivals of the patients with HLA class I^positive tumors and those with HLA class I^negative tumors were 55.7% and 19.1%, respectively (P = 0.019). There was a significant association between infiltration of CD8, CD20, and CD68-positive cells after BCG therapy and therapeutic effects. Conclusions: Our data show that expression of HLA class I molecules on tumor cells contributes significantly to the therapeutic effect of BCG immunotherapy for bladder cancer. It is suggested that CTLs may be one of main effectors in this therapy.

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Section: Intravesical Instillation Of Bacillus Calmette-guerin (Bcg) Ismentioning

confidence: 99%

Effect of Human Leukocyte Antigen Class I Expression of Tumor Cells on Outcome of Intravesical Instillation of Bacillus Calmette-Guerin Immunotherapy for Bladder Cancer

Kitamura

Torigoe

Honma

et al. 2006

Clinical Cancer Research

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“…Uspješnost BCG terapije očekujemo u 50 to 70 % pacijenata oboljelih od CIS-a 19 . Pacijenti sa slabo diferenciranim T1 papilarnim tumorima, multiplim tumorima ili konkomitantnim CIS-om su visoko ugroženi pojavom recidiva ili progresijom bolesti, te se u njih također indicira BCG profilaksa kao inicijalna terapija (slike 4-6) 21,22 . Uspješnost liječenja je istovjetna kao u pacijenata s CIS-om.…”

Section: Klinički Aspekti Bcg Imunoterapije: Indikacije Kontraindikaunclassified

Immunotherapy of transitional cell carcinoma of urinary bladder

Krpina

2017

Med. flum.

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Sažetak. Karcinom prijelaznog epitela mokraćnog mjehura najčešći je karcinom mokraćnog sustava. Klinički razlikujemo dva oblika ove bolesti: mišićno-neinvazivni i mišićno-invazivni oblik. Temeljna klinička odrednica mišićno-neinvazivnih tumora su recidivne novotvorinske promjene; 60 -90 % mišićno-neinvazivnih tumora recidivirat će ako se liječe samo transuretralnom resekcijom (TUR). Upravo stoga se nakon TUR-a u pacijenata u kojih postoji visoki rizik od ponovne pojave ili progresije bolesti provodi intravezikalna imunoterapija BCGom (bacillus Calmette-Guerin). BCG predstavlja živi atenuirani soj Mycobacterium bovis. U primjeni BCG-a intravezikalne terapije razlikujemo indukcijsku terapiju i terapiju održavanja. Intravezikalna aplikacija BCG-a uzrokuje masivan ulazak upalnih stanica u stijenku mokraćnog mjehura te produkciju citokina detektibilnih u sluznici mjehura i u urinu, što dovodi do imunog odgovora protiv tumora. Činjenica je kako BCG uzrokuje dugotrajan i dugodjelujući imuni odgovor. Do eradikacije tumorskih stanica dolazi zbog celularnih fokusa u stijenci mjehura, a kao direktan antitumorski efektorski mehanizam navodi se direktna antitumorska aktivnost IFN (interferon) i citotoksičnost NK (engl. natural killer) stanica. Ključne riječi: BCG; imunoterapija; karcinom mokraćnog mjehuraAbstract. Bladder cancer is the most common cancer in urinary system. There are two clinical aspects of this disease: muscle non-invasive and muscle invasive disease. Basic characteristic of non-muscle invasive disease is tumor recurrence; 60-90 % of tumors will recurr if treated by transurethral resection (TUR) only. That is the reason why patients in whom exists the risk of recurrence or progression undergo intravesical bacillus Calmette-Guerin (BCG) immunotherapy. BCG represents live attenuated Mycobacterium bovis. There are two phases in BCG therapy: induction and maintenance therapy. Intravesical BCG application causes massive agregation of immune cells in bladder wall and producton of cytokins which causes cytotoxic tumor response. Direct effector mechanism is achieved by IFN (interferon) and NK (natural killer) cell cytotoxicity.

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“…29 Although host, tumour and immunologic parameters can be useful, no single prognostic factor is capable of predicting a positive response. An excellent review by F. Saint 30 adequately summarizes the knowledge on prognostic parameters of remission versus relapse following BCG therapy.…”

Section: Prediction Of Bcg Failurementioning

confidence: 99%

The management of BCG failure in non-muscle-invasive bladder cancer: an update

Zlotta

Fleshner

Jewett

2013

CUAJ

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Up to 40% of patients with non-muscle-invasive bladder cancer (NMIBC) will fail intravesical bacillus Calmette-Guérin (BCG) therapy. There is unfortunately no current gold standard for salvage intravesical therapy after appropriate BCG treatment. Indeed, outcomes are at best suboptimal. The vast majority of low-grade NMIBC are prone to recur but very rarely progress. Failure after intravesical BCG in these patients is usually superficial and lowgrade. At the other end of the spectrum, failure to respond to BCG in high-risk T1 bladder cancer and/or carcinoma in situ (CIS or TIS) is more problematic, since those tumours often have the potential to progress to muscle invasion. In these cases, radical cystectomy remains the mainstay after BCG failure. With appropriate selection, certain patients who "fail" BCG (but with favourable risk factors) can be managed with intravesical regimens, including repeated BCG, BCG plus cytokines, intravesical chemotherapy, thermochemotherapy or new immunotherapeutic modalities. In this review, reasons explaining BCG failure, how to define BCG failure, optimal risk stratification and prediction of response and management of BCG failures are discussed.

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Do Prognostic Parameters of Remission versus Relapse after Bacillus Calmette–Guérin (BCG) Immunotherapy Exist? Analysis of a Quarter Century of Literature

Cited by 73 publications

References 61 publications

Effect of Human Leukocyte Antigen Class I Expression of Tumor Cells on Outcome of Intravesical Instillation of Bacillus Calmette-Guerin Immunotherapy for Bladder Cancer

Effect of Human Leukocyte Antigen Class I Expression of Tumor Cells on Outcome of Intravesical Instillation of Bacillus Calmette-Guerin Immunotherapy for Bladder Cancer

Immunotherapy of transitional cell carcinoma of urinary bladder

The management of BCG failure in non-muscle-invasive bladder cancer: an update

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