Pd09-01 the tolerability and efficacy of bcg administration after recurrence in bladder-preserving therapy for muscle-invasive bladder cancer

You have accessJournal of UrologyCME1 Apr 2023PD09-01 THE TOLERABILITY AND EFFICACY OF BCG ADMINISTRATION AFTER RECURRENCE IN BLADDER-PRESERVING THERAPY FOR MUSCLE-INVASIVE BLADDER CANCER Ruiyang Xie, Jie Wu, Honglei Cui, Ping Tang, Sijing Zhong, Hongzhe Shi, Youyan Guan, Aiping Zhou, Yueping Liu, and Jianzhong Shou Ruiyang XieRuiyang Xie More articles by this author , Jie WuJie Wu More articles by this author , Honglei CuiHonglei Cui More articles by this author , Ping TangPing Tang More articles by this author , Sijing ZhongSijing Zhong More articles by this author , Hongzhe ShiHongzhe Shi More articles by this author , Youyan GuanYouyan Guan More articles by this author , Aiping ZhouAiping Zhou More articles by this author , Yueping LiuYueping Liu More articles by this author , and Jianzhong ShouJianzhong Shou More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003240.01AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: For highly selected patients with muscle-invasive bladder cancer (MIBC), a multidisciplinary protocol of bladder-preserving therapy includes radiotherapy with concomitant chemotherapy. Some patients confer intravesical nonmuscle-invasive (NMIBC) recurrence. A retrospective study was carried out to explore the tolerability of BCG administration after chemo-radiotherapy in these patients. METHODS: Patients with clinical stage T2-T4aN0M0 urothelial carcinoma of the bladder were enrolled in the analysis (some were enrolled in the clinical trial, NCT02861196). The bladder-preserving strategies were described as follows: 1) cT2 patients underwent a maximal transurethral resection (TURBT), while cT3-T4a patients underwent a biopsy; 2) All patients received neoadjuvant chemotherapy with a gemcitabine/cisplatin regimen; 3) patients then completed maximal TURBT, and those who with pT0 or downstaging to pT1/pTa received concurrent chemo-radiotherapy; 4) patients with intravesical NMIBC recurrence were recommended with TURBT followed by BCG administration. The BCG instillation schedules were as follows: 1) the induction therapy- BCG 120mg weekly for 6 cycles; 2) a 3 mo gap; 3) the maintenance therapy- BCG 120mg weekly for 3 cycles; 4) repeat the maintenance therapy every 6 mo for 1 yr to 3 yr. RESULTS: Between 2012 and 2021, 19 patients with NMIBC recurrence underwent BCG administration after bladder-preserving therapy. All patients completed the BCG induction therapy, and 11 of 19 (57.9%) patients started maintenance therapy. Median follow-up since the recurrence was 36.2 mo. The 1 yr/3 yr probabilities of disease-free survival (DFS) and overall survival (OS) were 71.1%/65.2% and 88.8%/81.4% respectively. The most frequent BCG-related adverse events were bladder irritation (17/19, 89.5%), followed by hematuria (3/19, 15.8%), fever (1/19,5.3%), arthritis (1/19,5.3%), and bladder tuberculosis (1/19,5.3%). None of them had bladder contracture post BCG instillation. CONCLUSIONS: In summary, the tolerability and efficacy of BCG instillation after chemo-radiotherapy in NMIBC recurrence are acceptable and controllable. This study provides an alternative strategy rather than radical cystectomy in the comprehensive bladder-preserving therapy for MIBC. Source of Funding: None © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e239 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Ruiyang Xie More articles by this author Jie Wu More articles by this author Honglei Cui More articles by this author Ping Tang More articles by this author Sijing Zhong More articles by this author Hongzhe Shi More articles by this author Youyan Guan More articles by this author Aiping Zhou More articles by this author Yueping Liu More articles by this author Jianzhong Shou More articles by this author Expand All Advertisement PDF downloadLoading ...