Impact of maintenance therapy using a half dose of the bacillus Calmette–Guérin Tokyo strain on recurrence of intermediate and high-risk nonmuscle invasive bladder cancer: a retrospective single-center study

Abstract

Background Data are scarce regarding intravesical maintenance therapy (MT) with the low-dose bacillus Calmette–Guérin (BCG) Tokyo strain. We investigated the efficacy and safety of MT with a half dose of the Tokyo strain for patients following transurethral resection of nonmuscle invasive bladder cancer (NMIBC). Methods This study retrospectively reviewed clinical data on 78 patients diagnosed with intermediate or high-risk NMIBC followed by either MT (n = 38) or IT alone (n = 40) between January 2012 and March 2018. Statistical analysis was performed to compare recurrence-free survival (RFS) and adverse effects between the two groups. BCG was instilled once weekly for 6 weeks as IT, then once weekly in 2-week for a total of 20 instillations over 3 years. Results Kaplan–Meier analyses showed that patients undergoing MT had significantly better RFS than did those undergoing IT alone (hazard ratio (HR):0.32, 95% confidence interval (CI):0.12–0.89, P = 0.02). The 3-year RFS was 65.0% in the IT group and 89.5% in the MT group. Multivariate analysis showed that MT was associated with a reduced risk of recurrence (HR: 0.32, 95% CI:0.11–0.93, P = 0.03). One MT patient (2.6%) exhibited progression. Conclusions The BCG Tokyo strain showed acceptable efficacy and safety in patients undergoing MT; thus, it is a potential treatment for preventing bladder cancer recurrence.

Effects of intravesical BCG maintenance therapy duration on recurrence rate in high-risk non-muscle invasive bladder cancer (NMIBC): Systematic review and network meta-analysis according to EAU COVID-19 recommendations

“…The characteristics and recurrence rates described in the 19 included studies are shown in Table 1 [13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30][31]. These eligible studies were published between 1987 and 2021.…”

Efficacy of Intravesical Instillation Therapy with Low-Dose Tokyo-172 Bacillus Calmette-Guérin to Prevent Recurrence of Non-Muscle-Invasive Bladder Cancer and Treat Carcinoma in situ: A Multi-Institutional Retrospective Study

“…Because in the KURG study, the number of maintenance instillations was reduced from three to two, patients tolerated BCG treatment well, and the completion rates were high during the 3 years of treatment, with cancer control rates comparable to other reports [20, 23]. Koguchi et al [24] reported that maintenance therapy with the low-dose BCG Tokyo-172 strain (40 mg) showed acceptable efficacy and safety on the same schedule as the KURG study. In our study, we excluded patients who received BCG maintenance therapy and examined only those who received BCG induction therapy because the BCG maintenance therapy schedule was different for each institution.…”

Efficacy of Different Bacillus of Calmette-Guérin (BCG) Strains on Recurrence Rates among Intermediate/High-Risk Non-Muscle Invasive Bladder Cancers (NMIBCs): Single-Arm Study Systematic Review, Cumulative and Network Meta-Analysis

“…Sixty-two studies [ 2 , 3 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 , 65 , 66 , 67 , 68 , 69 , 70 , 71 , 72 , 73 , 74 , 75 , 76...…”

“…The vast majority of the studies (n = 34, [ 24 , 25 , 26 , 27 , 28 , 29 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 48 , 50 , 51 , 53 , 55 , 56 , 60 , 62 , 63 , 65 , 68 , 69 , 71 , 75 , 76 , 77 , 79 , 80 , 81 ]) were single-arm with no direct comparison across other strains. On the contrary, the remaining n = 27 [ 2 , 3 , 23 , 30 , 31 , 32 , 33 , 43 , 44 , 45 , 47 , 49 , 52 , 54 , 57 , 58 , 59 , 61 , 64 , 66 , …”