LONG-TERM RESULTS AND RISK FACTORS OF TUMOR RECURRENCE IN PATIENTS WITH SUPERFICIAL BLADDER CANCER WHO WERE TREATED BY INTRAVESICAL BACILLUS CALMETTE-GUERIN (BCG) INSTILLATION

The high incidence of tumor recurrence following transurethral resection (TUR) represents a major problem encountered in the management of bladder cancer. This study examined the efficacy of intravesical chemotherapy in superficial bladder cancer. We retrospectively analyzed 90 Japanese cases with low-grade superficial transitional cell carcinoma (stage T1, grades 1 and 2) who were rendered tumor-free by TURBT (TUR of bladder tumor) and who thereafter were treated with or without intravesical chemotherapy. Among them, instillation was terminated in 2 patients due to adverse effects (severe but reversible chemical cystitis). Remaining 88 patients were divided into 2 groups according to therapy: the TURBT-only group(n=46), defined as patients treated with TURBT alone, and the Instillation group(n=42), defined as patients treated with weekly intravesical instillation therapies using epirubicin plus Ara-C. Recurrence-free rate was significantly higher in the Instillation group than in the TURBT-only group (p=0.02, HR = 0.457). The 5-year recurrence-free rate was 58.5% for the Instillation group and 38.6% for the TURBT-only group. Our instillation schedule represents the most intensive regimen among previously reported therapies and resulted in a 54.3% decrease in incidence of tumor recurrence. We believe that the results of this study could provide useful information on management of bladder cancer.

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Long-Term Results and Complications of Intracavitary Bacillus Calmette-Guerin Therapy for Bladder Cancer

The Journal of Urology ◽

10.1016/s0022-5347(17)49690-x ◽

1984 ◽

Vol 132 (3) ◽

pp. 457-459 ◽

Cited By ~ 115

Author(s):

Alvaro Morales

Keyword(s):

Bladder Cancer ◽

Long Term Results ◽

Bacillus Calmette Guerin

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Additional Extension of the Mathematical Model for BCG Immunotherapy of Bladder Cancer and Its Validation by Auxiliary Tool

International Journal of Nonlinear Sciences and Numerical Simulation ◽

10.1515/ijnsns-2018-0181 ◽

2019 ◽

Vol 20 (6) ◽

pp. 675-689 ◽

Cited By ~ 2

Author(s):

Ekaterina Guzev ◽

Sarel Halachmi ◽

Svetlana Bunimovich-Mendrazitsky

Keyword(s):

Bladder Cancer ◽

Superficial Bladder Cancer ◽

Treatment Protocol ◽

Bacillus Calmette Guerin ◽

Cancer Cell Growth ◽

Model Improvement ◽

Unnecessary Death ◽

Clinical Potential ◽

The Mathematical Model ◽

Bcg Instillation

AbstractImmunotherapy with bacillus Calmette–Guérin (BCG) is a classic treatment for superficial bladder cancer. Although BCG instillation is a well-established protocol, some patients do not respond to this treatment. To model improvement of this protocol, Bunimovich-Mendrazitsky (B-M) et al. provided a platform for in silico testing of modified protocols of BCG instillation and combination with IL-2. The purpose of this work is to improve and further develop this BCG model describing the tumor–immune interactions occurring in the bladder in response to BCG and IL-2 therapies, based on novel clinical data.To validate this BCG model, we used the results of BCG treatment of 10 patients with bladder cancer 3-5 years ago. Individual data for each patient was entered to simulate the model. As a result, a treatment protocol was obtained which coincided with the protocol assigned by the doctor. In addition, cancer cell growth graphs were obtained from the model simulations, which coincided with the clinical conclusions of the patient’s treatment outcome. Moreover, the program provides a more optimal treatment protocol for each patient.We show that calculated protocols from the model can prevent excess side effects of immunotherapy and even of unnecessary death for some patients, informing the clinical potential of our model.

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