Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2016 Sep;17(9):68.
doi: 10.1007/s11934-016-0625-z.

High-Risk Non-Muscle-Invasive Bladder Cancer-Therapy Options During Intravesical BCG Shortage

Rajan Veeratterapillay  1 , Rakesh Heer  2 , Mark I Johnson  1 , Raj Persad  3 , Christian Bach  1
Affiliations
Review

High-Risk Non-Muscle-Invasive Bladder Cancer-Therapy Options During Intravesical BCG Shortage

Rajan Veeratterapillay et al. Curr Urol Rep. 2016 Sep.

Abstract

Bladder cancer is the second commonest urinary tract malignancy with 70-80 % being non-muscle invasive (NMIBC) at diagnosis. Patients with high-risk NMIBC (T1/Tis, with high grade/G3, or CIS) represent a challenging group as they are at greater risk of recurrence and progression. Intravesical Bacilli Calmette-Guerin (BCG) is commonly used as first line therapy in this patient group but there is a current worldwide shortage. BCG has been shown to reduce recurrence in high-risk NMIBC and is more effective that other intravesical agents including mitomycin C, epirubicin, interferon-alpha and gemcitabine. Primary cystectomy offers a high change of cure in this cohort (80-90 %) and is a more radical treatment option which patients need to be counselled carefully about. Bladder thermotherapy and electromotive drug administration with mitomycin C are alternative therapies with promising short-term results although long-term follow-up data are lacking.

Keywords: Bacilli Calmette-Guerin; Bladder cancer; Intravesical Therapy; Mitomycin C; Surgery.

PubMed Disclaimer

References

    1. Burger M, Catto JW, Dalbagni G, et al. Epidemiology and risk factors of urothelial bladder cancer. Eur Urol. 2013;63(2):234–41. doi: 10.1016/j.eururo.2012.07.033. - DOI - PubMed
    1. Chavan S, Bray F, Lorter-Tieulent J, et al. International variations in bladder cancer incidence and mortality. Eur Urol. 2014;66(1):59–73. doi: 10.1016/j.eururo.2013.10.001. - DOI - PubMed
    1. Sobin LH, Gospodariwicz M, Wittekind C, editors. TNM classification of malignant tumours. UICC International Union Against Cancer. 7th edn. Hoboken, NJ: Wiley-Blackwell; 2009. pp. 262-265.
    1. Pan CC, Chang YH, Chen KK, et al. Prognostic significance of the 2004 WHO/ISUP classification for prediction of recurrence, progression, and cancer-specific mortality of non-muscle-invasive urothelial tumors of the urinary bladder: a clinic pathologic study of 1,515 cases. Am J Clin Pathol. 2010;133(5):788–95. doi: 10.1309/AJCP12MRVVHTCKEJ. - DOI - PubMed
    1. Sylvester RJ, van der Meijden AP, Oosterlinck W, et al. Predicting recurrence and progression in individual patients with stage Ta, T1 bladder cancer using EORTC risk tables: a combined analysis of 2596 patients from seven EORTC trials. Eur Urol. 2006;49(3):466–5. doi: 10.1016/j.eururo.2005.12.031. - DOI - PubMed

LinkOut - more resources