Factors Affecting Response to Bacillus Calmette-Guérin Plus Interferon for Urothelial Carcinoma in Situ

Rosevear, Henry; Lightfoot, Andrew J.; Birusingh, Kevin K.; Maymí, José L.; Nepple, Kenneth G.; O’Donnell, Michael A.

doi:10.1016/j.juro.2011.04.073

Cited by 39 publications

(11 citation statements)

References 27 publications

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“…Our results are in line with those reported by Rosevear and colleagues, [ 15 ] where failure of induction BCG monotherapy within 6 months was associated with failure of combination BCG plus interferon therapy. Not only was BCG failure <6 months associated with failure of combination therapy but also 73.3% of patients undergoing cystectomy had failed BGC monotherapy within 6 months as well.…”

Section: Discussionsupporting

confidence: 93%

The Role of Interferon in the Management of BCG Refractory Nonmuscle Invasive Bladder Cancer

Correa

Theisen

Ferroni

et al. 2015

Advances in Urology

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Background. Thirty to forty percent of patients with high grade nonmuscle invasive bladder cancer (NMIBC) fail to respond to intravesical therapy with bacillus Calmette-Guerin (BCG). Interferon-α2B plus BCG has been shown to be effective in a subset of patients with NMIBC BCG refractory disease. Here we present a contemporary series on the effectiveness and safety of intravesical BCG plus interferon-α2B therapy in patients with BCG refractory NMIBC. Methods. From January of 2005 to April of 2014 we retrospectively found 44 patients who underwent induction with combination IFN/BCG for the management of BCG refractory NMIBC. A chart review was performed to assess initial pathological stage/grade, pathological stage/grade at the time of induction, time to IFN/BCG failure, pathological stage/grade at failure, postfailure therapy, and current disease state. Results. Of the 44 patients who met criteria for the analysis. High risk disease was found in 88.6% of patients at induction. The 12-month and 24-month recurrence-free survival were 38.6% and 18.2%, respectively. 25 (56.8%) ultimately had disease recurrence. Radical cystectomy was performed in 16 (36.4%) patients. Conclusion. Combination BCG plus interferon-α2B remains a reasonably safe alternative treatment for select patients with BCG refractory disease prior to proceeding to radical cystectomy.

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Section: Discussionsupporting

confidence: 93%

The Role of Interferon in the Management of BCG Refractory Nonmuscle Invasive Bladder Cancer

Correa

Theisen

Ferroni

et al. 2015

Advances in Urology

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“…At a median follow-up of 2 years, 45 % remained tumor free for those treated with BCG/interferon in the salvage setting, compared to a rate of 60 % in the BCG-naïve group; only 8 % of the patients experienced progression in each group [ 29 , 31 ]. In a subset analysis, having two or more BCG failures, higher stage disease and shorter time to recurrence were independently predictive of a poor response to BCG/ interferon [ 32 ]. These trials indicate that BCG/ interferon can be used effectively in the salvage setting, with potentially decreased toxicity associated with the lower BCG doses used.…”

Section: Resultsmentioning

confidence: 81%

“…The clinicopathologic variables associated with an increased risk of BCG failure include female gender [ 69 ], older age [ 92 ], multifocality [ 69 ], recurrent tumors [ 69 ], concurrent CIS (especially in the prostatic urethra) [ 67 ], lymphovascular invasion [ 93 ], detectable disease at 3-month surveillance cystoscopy [ 94 ], depth (and multifocality) of lamina propria invasion [ 95 ], timing of failure (i.e. early vs late) [ 96 ], and two or more prior courses of BCG therapy [ 32 ]. The goal in these high-risk patients is to identify prognostic factors for the patients who will benefi t from immediate radical cystectomy or limited intravesical therapy (single cycle of intravesical therapy).…”

Section: Identifying Patients At High Risk Of Bcg Failurementioning

confidence: 99%

Management of BCG Recurrent Bladder Cancer

Downs

Lee

Scherr

2014

Management of Bladder Cancer

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“…Other reports of the combination are in patients who have recurred after BCG. Some of these results suggest subsequent benefit, but others describe “BCG failure” as a poor prognostic factor for the combination, especially among those deemed truly “BCG unresponsive” [ 42 – 44 ].…”

Section: Consensus Recomendationsmentioning

confidence: 99%

Society for Immunotherapy of Cancer consensus statement on immunotherapy for the treatment of bladder carcinoma

Kamat¹,

Bellmunt²,

Galsky³

et al. 2017

j. immunotherapy cancer

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The standard of care for most patients with non-muscle-invasive bladder cancer (NMIBC) is immunotherapy with intravesical Bacillus Calmette-Guérin (BCG), which activates the immune system to recognize and destroy malignant cells and has demonstrated durable clinical benefit. Urologic best-practice guidelines and consensus reports have been developed and strengthened based on data on the timing, dose, and duration of therapy from randomized clinical trials, as well as by critical evaluation of criteria for progression. However, these reports have not penetrated the community, and many patients do not receive appropriate therapy. Additionally, several immune checkpoint inhibitors have recently been approved for treatment of metastatic disease. The approval of immune checkpoint blockade for patients with platinum-resistant or -ineligible metastatic bladder cancer has led to considerations of expanded use for both advanced and, potentially, localized disease. To address these issues and others surrounding the appropriate use of immunotherapy for the treatment of bladder cancer, the Society for Immunotherapy of Cancer (SITC) convened a Task Force of experts, including physicians, patient advocates, and nurses, to address issues related to patient selection, toxicity management, clinical endpoints, as well as the combination and sequencing of therapies. Following the standard approach established by the Society for other cancers, a systematic literature review and analysis of data, combined with consensus voting was used to generate guidelines. Here, we provide a consensus statement for the use of immunotherapy in patients with bladder cancer, with plans to update these recommendations as the field progresses.Electronic supplementary materialThe online version of this article (doi:10.1186/s40425-017-0271-0) contains supplementary material, which is available to authorized users.

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Factors Affecting Response to Bacillus Calmette-Guérin Plus Interferon for Urothelial Carcinoma in Situ

Abstract: Factors associated with a poor response to bacillus Calmette-Guérin plus interferon-α therapy in patients with carcinoma in situ are prior tumor stage, 2 or more prior bacillus Calmette-Guérin failures and a bacillus Calmette-Guérin failure pattern.

Cited by 39 publications

References 27 publications

The Role of Interferon in the Management of BCG Refractory Nonmuscle Invasive Bladder Cancer

The Role of Interferon in the Management of BCG Refractory Nonmuscle Invasive Bladder Cancer

Management of BCG Recurrent Bladder Cancer

Society for Immunotherapy of Cancer consensus statement on immunotherapy for the treatment of bladder carcinoma

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