Tolerability of bacille Calmette-Guérin maintenance therapy for superficial bladder cancer

Saint, F.; Irani, Jacques; Patard, Jean Jacques; Salomon, Laurent; Hoznek, A.; Zammattio, Sylvie; Debois, Henri; Abbou, Claude C.; Chopin, Dominique

doi:10.1016/s0090-4295(00)01117-1

Cited by 84 publications

(44 citation statements)

References 21 publications

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“…Also, it is reported that bacillus Calmette-Guérin vaccine application can exhibit significantly beneficial effect in controlling the malignancy, in particular the bladder cancers (41,42). Because many microbes are indicated to produce and secrete nonpeptide Ags for human ␥␦ T cells such as alkyl pyrophosphates and alkyl amines (43)(44)(45)(46)(47)(48)(49)(50)(51)(52)(53)(54)(55), it is tempting to speculate that these microbial nonpeptide Ags may contribute to the restriction of growth of incidental tumor cells via stimulation of ␥␦ T cells to proliferate and produce IFN-␥ as well as sensitization of the tumor cells for the ␥␦ T cell-mediated cytotoxicity.…”

Section: Discussionmentioning

confidence: 99%

Targeting of Tumor Cells for Human γδ T Cells by Nonpeptide Antigens

Kato

Tanaka

Miyagawa

et al. 2001

The Journal of Immunology

140

131

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Human Vγ2/Vδ2+ γδ T cells respond to low molecular-mass nonpeptide Ags in a γδ TCR-dependent manner. Although requirements of Ag presentation have remained controversial, we have indicated that specific responses of the primary γδ T cells to pamidronate were dependent on monocytic adherent cells for Ag presentation. Here, we show that human tumor cells can efficiently present aminobisphosphonate and pyrophosphomonoester compounds to γδ T cells, inducing specific proliferation and IFN-γ production. γδ TCR dependency of the response to Ag-pulsed tumor cells was confirmed by using a Jurkat line transfected with a Vγ2/Vδ2 γδ TCR. Furthermore, γδ T cells exhibited markedly enhanced cytotoxicity against the Ag-pulsed tumor cells as compared with untreated tumor cells. Survey of a number of human tumor cell lines of different origins revealed that the majority of them became susceptible for γδ T cell-mediated cytotoxicity following the Ag pulsing except for breast cancer lines so far examined, while normal PHA blast cells remained resistant. The results not only imply a unique mode of nonpeptide Ag recognition by human γδ T cells but also may provide a novel strategic clue for immunotherapy of human malignancy.

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Section: Discussionmentioning

confidence: 99%

Targeting of Tumor Cells for Human γδ T Cells by Nonpeptide Antigens

Kato

Tanaka

Miyagawa

et al. 2001

The Journal of Immunology

140

131

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“…Other studies have also investigated the relationship between BCG-associated AEs and efficacy in preventing recurrence. Individual symptoms such as fever, dysuria and frequency have been demonstrated to show association with reduced risk of recurrence [10,12]. Most of these studies evaluated AEs in both the induction and maintenance period and thus these patients were exposed to BCG for longer periods of time.…”

Section: Discussionmentioning

confidence: 99%

“…Other studies have recorded AEs in a similar method to our study while others recorded only a limited range of AEs or defined an AE only if it results cessation of treatment. A BCG adverse event score was created by Saint et al [12] which included an extensive four class classification grid on local and systemic adverse. This shares many similarities to our symptom form.…”

Section: Discussionmentioning

confidence: 99%

“…These can range from haematuria, frequency, fever and malaise to rare cases of disseminated infection such as severe sepsis [5,9]. It has been suggested that the same BCG instillation immune response which stimulates anti-tumor activity is the cause of these AEs however this is currently inconclusive [10][11][12][13]. Studies have mostly analyzed maintenance treatment or only a limited number of AEs.…”

Section: Introductionmentioning

confidence: 99%

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BCG immunotherapy for non-muscle invasive bladder cancer: is efficacy related to toxicity?

Udovicich

Nankivell²,

Barberi

et al. 2017

Bladder

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OBJECTIVES:To examine the prevalence of local and systemic adverse effects (AEs) associated with Bacillus Calmette-Guerin (BCG) immunotherapy for non-muscle invasive bladder cancer (NMIBC) and to determine if there was any relationship between adverse effects and efficacy of treatment. PATIENTS AND METHODS:Patients receiving induction intravesical BCG immunotherapy for NMIBC from 1995 to 2013 were identified from a group urology practice. Patients completed an AE scoresheet and an AE was recorded if the patient experienced the symptom at any point in the week following instillation. Patients were dichotomised based on recurrence status (treatment efficacy was defined as non-recurrence) and association with AEs was investigated using univariate Cox regression analysis. RESULTS:One hundred and fifty eight patients were examined with a mean age of 70.2 years (range 41-88) and a male predominance (125, 79%). The most prevalent local AEs were frequency (107, 68%), dysuria (98, 62%) and nocturia (95, 60%). Malaise (54, 34%), myalgia (41, 26%) and fever (32, 20%) were the most common systemic AEs. Recurrence status was available for 82 patients, with 43 (52%) diagnosed with recurrence. There was no significant relationship between overall AEs and recurrence [hazard ratio (HR) 0.97, P = 0.57], or for local (HR 0.99, P = 0.90) and systemic (HR 0.88, P = 0.32) AEs. Only frequency was significantly associated with reduced recurrence (HR = 0.42, P = 0.04). CONCLUSIONS:AEs due to BCG immunotherapy are common in the induction period with nearly 70% of patients in our cohort experiencing individual symptoms. Local AEs are considerably more prevalent than systemic. Frequency was the only AE to be significantly associated with non-recurrence. Overall, AEs due to BCG instillation treatment were not related to efficacy for NMIBC.

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“…Grade 2 chemical cystitis was defined as severe and/or > 48 hours cystitis according to the World Health Organization grading scale (14). Patients with systemic side effects related to BCG, active genitourinary tract infections, actinic bladder, follow-up < 1 year, or incomplete data were excluded.…”

Section: Methodsmentioning

confidence: 99%

Intravesical administration of combined hyaluronic acid and chondroitin sulfate can improve symptoms in patients with refractory bacillus Calmette-Guerin-induced chemical cystitis: Preliminary experience with one-year follow-up

Imperatore

Creta²,

Meo³

et al. 2018

Arch Ital Urol Androl

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Objective: We investigated the efficacy of intravesical instillations of combined hyaluronic acid (HA) and chondroitin sulphate (CS) in patients with bacillus Calmette-Guérin (BCG)-induced chemical cystitis unresponsive to first-line therapies. Patients and methods: We retrospectively reviewed the clinical records of patients with grade 2 BCG-induced chemical cystitis unresponsive to first line therapeutic options performed according to the International Bladder Cancer Group guidelines who underwent intravesical instillations of HA/CS. Bladder pain, urinary urgency, voiding volume and number of voids/24 hours recorded prior to treatment, at the end of the treatment, at six months and at one-year follow-up were recorded and analyzed. Results: The records of 20 patients were identified. All patients underwent eight weekly instillations of HA/CS. Mean baseline visual analogue scale (VAS) scores ± Standard Deviation (SD) for urinary urgency and bladder pain were 7.8 ± 0.5 and 7.2 ± 1.0, respectively. Mean number of voids/24 hours ± SD was 15.4 ± 2.3 and mean urine volume per void ± SD was 85.8 ± 21.0 mL. At the end of the treatment, mean VAS scores ± SD for urgency and pain significantly decreased to 4.7 ± 1.1 and 4.2 ± 0.9, respectively (p < 0.05 in both cases). Mean number of voids/24 hours ± SD decreased to 9.6 ± 1.4 (p < 0.05) and mean urine volume per void ± SD significantly increased to 194.1 ± 59.5 mL (p < 0.05). At six months and one-year followup, all outcome measures remained stable. Conclusions: Bladder instillations of HA/CS provide significant and durable improvement of bladder pain, urinary urgency, urinary volume per void and urinary frequency in patients with refractory BCG-induced chemical cystitis.

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Tolerability of bacille Calmette-Guérin maintenance therapy for superficial bladder cancer

Cited by 84 publications

References 21 publications

Targeting of Tumor Cells for Human γδ T Cells by Nonpeptide Antigens

Targeting of Tumor Cells for Human γδ T Cells by Nonpeptide Antigens

BCG immunotherapy for non-muscle invasive bladder cancer: is efficacy related to toxicity?

Intravesical administration of combined hyaluronic acid and chondroitin sulfate can improve symptoms in patients with refractory bacillus Calmette-Guerin-induced chemical cystitis: Preliminary experience with one-year follow-up

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