Compared Efficacy of Adjuvant Intravesical BCG-TICE vs. BCG-RIVM for High-Risk Non-Muscle Invasive Bladder Cancer (NMIBC)

Background: Intravesical immunotherapy with bacillus Calmette-Guerin (BCG) is the standard therapy for high-risk non-muscle invasive bladder cancer (NMIBC). The superiority of any BCG strain over another could not be demonstrated yet. Methods: Patients with NMIBCs underwent adjuvant induction ± main...

Descripción completa

Detalles Bibliográficos
Autores: Del Giudice, Francesco|||0000-0003-3865-5988, Flammia, Rocco Simone|||0000-0002-3129-0544, Chung, Benjamin I.|||0000-0001-9660-2732, Moschini, Marco|||0000-0002-3084-2458, Pradere, Benjamin|||0000-0002-7768-8558, Mari, Andrea|||0000-0001-9070-5706, Soria, Francesco|||0000-0001-8443-8453, Albisinni, Simone|||0000-0001-5529-3064, Krajewski, Wojciech, Szydełko, Tomasz, Laukhtina, Ekaterina|||0000-0002-8953-0272, D'Andrea, David|||0000-0003-1625-1077, Gallioli, Andrea|||0000-0002-3316-5691, Mertens, Laura S.|||0000-0003-3317-6427, Maggi, Martina|||0000-0003-4672-850X, Sciarra, Alessandro|||0000-0002-7899-8056, Salciccia, Stefano|||0000-0003-4873-3257, Ferro, Matteo|||0000-0002-9250-7858, Scornajenghi, Carlo Maria|||0000-0001-7600-7434, Asero, Vincenzo|||0000-0001-5293-9253, Cattarino, Susanna, Angelis, Mario De, Cacciamani, Giovanni E.|||0000-0002-8892-5539, Autorino, Riccardo|||0000-0001-7045-7725, Pandolfo, Savio Domenico|||0000-0001-9621-3059, Falagario, Ugo Giovanni, D'Altilia, Nicola, Mancini, Vito|||0000-0003-3050-8748, Chirico, Marco, Cinelli, Francesco, Bettocchi, Carlo, Cormio, Luigi, Carrieri, Giuseppe, De Berardinis, Ettore, Busetto, Gian Maria|||0000-0002-7291-0316
Tipo de recurso: artículo
Fecha de publicación:2022
País:España
Institución:Universitat Autònoma de Barcelona
Repositorio:Dipòsit Digital de Documents de la UAB
Idioma:inglés
OAI Identifier:oai:ddd.uab.cat:277686
Acceso en línea:https://ddd.uab.cat/record/277686
https://dx.doi.org/urn:doi:10.3390/cancers14040887
Access Level:acceso abierto
Palabra clave:Bladder cancer
Re-TUR
BCG strain
BCG-TICE
BCG-RIVM
Recurrence-free survival
Progression-free survival
Cancer-specific survival
Descripción
Sumario:Background: Intravesical immunotherapy with bacillus Calmette-Guerin (BCG) is the standard therapy for high-risk non-muscle invasive bladder cancer (NMIBC). The superiority of any BCG strain over another could not be demonstrated yet. Methods: Patients with NMIBCs underwent adjuvant induction ± maintenance schedule of intravesical immunotherapy with either BCG TICE or RIVM at two high-volume tertiary institutions. Only BCG-naïve patients and those treated with the same strain over the course of follow-up were included. One-to-one (1:1) propensity score matching (PSM) between the two cohorts was utilized to adjust for baseline demographic and tumor characteristics imbalances. Kaplan-Meier estimates and multivariable Cox regression models according to high-risk NMIBC prognostic factors were implemented to address survival differences between the strains. Sub-group analysis modeling of the influence of routine secondary resection (re-TUR) in the setting of the sole maintenance adjuvant schedule for the two strains was further performed. Results: 852 Ta-T1 NMIBCs (n = 719, 84.4% on TICE; n = 133, 15.6% on RIVM) with a median of 53 (24-77) months of follow-up were reviewed. After PSM, no differences at 5- years RFS, PFS, and CSS at both Kaplan-Meier and Cox regression analyses were detected for the whole cohort. In the sub-group setting of full adherence to European/American Urology Guidelines (EAU/NCCN), BCG TICE demonstrated longer 5-years RFS compared to RIVM (68% vs. 43%, p = 0.008; HR: 0.45 95% CI 0.25-0.81). Conclusion: When routinely performing re-TUR followed by a maintenance BCG schedule, TICE was superior to RIVM for RFS outcomes. However, no significant differences were detected for PFS and CSS, respectively.

Similares en LA Referencia