Intravesical bacillus Calmette-Guérin versus mitomycin C for Ta and T1 bladder cancer

Schmidt, Stefanie; Kunath, Frank; Coles, Bernadette; Draeger, Desiree Louise; Krabbe, Laura‐Maria; Dersch, Rick; Jensen, Katrin; Dahm, Philipp; Meerpohl, Joerg J

doi:10.1002/14651858.cd011935

Cited by 12 publications

(16 citation statements)

References 35 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Nevertheless, adverse events that caused by chemotherapy are rare. MMC generated fewer local toxicities (30% vs. 44%) and systemic toxicities than BCG (12% vs. 19%) 31 . IFN instillation was well tolerated, and no complications were reported in numerous studies 28,29,36,37 .…”

Section: Discussionmentioning

confidence: 92%

“…BCG and MMC are similar, with no significant difference between the two therapies in PMA with regard to both recurrence and progression. A recent Cochrane review compared the efficacy of BCG and MMC in Ta and T1 bladder cancer based on HR 31 . Although the pooled effect sizes based on time to recurrence, progression, and death favor BCG, their differences were non‐significant 31 .…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Efficacy of intravesical therapies on the prevention of recurrence and progression of non‐muscle‐invasive bladder cancer: A systematic review and network meta‐analysis

Xia

et al. 2020

Cancer Medicine

View full text Add to dashboard Cite

Intravesical instillation therapy is the mainstay of prophylaxis of tumor recurrence and progression in non‐muscle‐invasive bladder cancer. However, there is no study evaluating the superiority of monotherapy. The aim of this study is to compare the efficacy of preventing recurrence and progression of intravesical monotherapies via network meta‐analysis (NMA) of randomized controlled trials. Database searches were conducted on Embase, Ovid Medline, Web of Science, ScienceDirect, Cochrane Library, and ClinicalTrials.com from the time of establishment to February 6, 2020. The monotherapies included Bacille Calmette‐Guérin (BCG), mitomycin C (MMC), interferon (IFN), adriamycin, epirubicin, gemcitabine (GEM), and thiotepa (THP). A Bayesian consistency network model was generated under a random‐effects model. The superiority of therapy was identified based on the surface under the cumulative ranking curve (SUCRA). Fifty‐seven studies with 12462 patients are included. NMA shows that GEM (SUCRA = 0.92), BCG (SUCRA = 0.82), and IFN (SUCRA = 0.78) are the top three effective drugs to reduce recurrence. GEM (SUCRA = 0.87) is the most effective therapy to prevent progress, followed by BCG, MMC, THP, and IFN with similar efficacy. Subgroup analysis of pairwise meta‐analysis and NMA was performed on publication year, trial initiation year, study origin, center involvement, sample size, drug schedule, tumor characteristics, and trial quality to address confounding factors, which suggests the robustness of the results with stable effect sizes. Network meta‐regression also indicates consistent rank by analyzing year, sample size, and quality. Compared with BCG, GEM is also a promising therapy with favorable efficacy to reduce tumor recurrence and progression. IFN and MMC could be alternative therapies for BCG with slightly inferior efficacy in recurrence prevention and similar efficacy in progression prevention. However, the results of this study should be treated with caution since most of the included studies are of moderate to high risk of bias.

show abstract

Section: Discussionmentioning

confidence: 92%

Section: Discussionmentioning

confidence: 99%

Efficacy of intravesical therapies on the prevention of recurrence and progression of non‐muscle‐invasive bladder cancer: A systematic review and network meta‐analysis

Xia

et al. 2020

Cancer Medicine

View full text Add to dashboard Cite

show abstract

“…Moreover, progression and long-term survival rates were available for 1,880 patients but not statistically different across groups. A Cochrane review reached similar conclusions regarding likely reduced recurrence rates but greater serious adverse events with BCG versus MMC, with no significant difference in progression risk, although this meta-analysis highlighted that the certainty of the evidence was low 253 .…”

Section: Recommendation) O Patients With High-intermediate-risk Nmibc (≥3 Factors) May Be Treated As High-risk Patients With Induction Anmentioning

confidence: 76%

“…Although BCG is associated with more adverse effects than intravesical chemotherapy, serious toxicity occurs in only 5% of patients 270,285 . The most common local side effect of BCG instillation is the development of cystitis-like symptoms (urgency, dysuria and increased urinary frequency) that can be present in up to 71% of patients 253 . In such instances, a urine culture should be performed to rule out urinary tract infection 286 .…”

Section: Bcg Toxicitymentioning

confidence: 99%

Canadian Urological Association guideline on the management of non-muscle invasive bladder cancer

Bhindi

Kool

Kulkarni

et al. 2021

CUAJ

View full text Add to dashboard Cite

“…BCG is the internationally recommended conservative treatment for T1 BC patients [4] and is the only bladder instillation treatment shown to reduce progression rates of T1 tumors, but with modest effect, reducing progression rate from 13 to 9%, a risk reduction of 27% [10]. Although controversies regarding impact of progression [17,18] and survival [4] BCG has remained essential in T1BC treatment for decades [19]. Our total rate of T1 patients having BCG either as early or as delayed treatment is 41%.…”

Section: Discussionmentioning

confidence: 99%

T1 bladder cancer in Norway: treatment and survival

Blindheim

Fosså

Babigumira

et al. 2020

Scandinavian Journal of Urology

View full text Add to dashboard Cite

Aim: Evaluation of treatment and survival of pT1 stage (T1) bladder cancer (BC) patients diagnosed with transitional cell carcinoma of the urinary bladder in Norway. Material and Methods: According to the Cancer Registry of Norway, 1,108 patients were diagnosed with T1 BC between 2008-2012. Information on surgical and medical procedures was provided by the Norwegian Patients Registry. Regression and survival models were applied to characterize patients receiving bacillus Calmette-Guerin (BCG) and radical cystectomy (RC) as early and delayed treatment and to estimate overall and cause specific survival rates (OS; CSS). Adjustments for sex, age, WHO grade and concomitant cis were made. Results: In total, 449 (41%) patients received BCG treatment, 162 (15%) as early treatment. RC represented the early treatment in 96 (9%) patients and the delayed treatment in 84 (8%). Overall, 850 (77%) patients received neither BCG nor RC as early treatment, of whom 287 (26%) were treated with BCG and 66 (6%) with RC during follow-up. Patients <75 years and patients with high grade tumors or concomitant cis were more likely to receive BCG and RC as early treatment. 5-year survival rates for all T1 BC patients were 84% (CSS) and 65% (OS). Delayed RC was associated with the lowest 5-year CSS (70%). After adjustment, gender did not impact treatment choice and CSS. Conclusions: The use of BCG as early treatment indicates low adherence to existing guidelines. Delayed RC was associated with low survival rates. An increased focus on the management of T1 patients is needed in Norway.

show abstract

Intravesical bacillus Calmette-Guérin versus mitomycin C for Ta and T1 bladder cancer

Cited by 12 publications

References 35 publications

Efficacy of intravesical therapies on the prevention of recurrence and progression of non‐muscle‐invasive bladder cancer: A systematic review and network meta‐analysis

Efficacy of intravesical therapies on the prevention of recurrence and progression of non‐muscle‐invasive bladder cancer: A systematic review and network meta‐analysis

Canadian Urological Association guideline on the management of non-muscle invasive bladder cancer

T1 bladder cancer in Norway: treatment and survival

Contact Info

Product

Resources

About