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Bacillus Calmette-Guérin

All articles from this key word are listed below.

Volume 10, Number 4 Review Articles

Bacillus Calmette-Guérin Failures and Beyond: Contemporary Management of Non–Muscle-Invasive Bladder Cancer

Management Review

Michael A O'Donnell Thomas E Keane H Barton Grossman Richard E Greenberg Michael S Cookson

In the United States, bacillus Calmette-Guérin (BCG) is the treatment most used for superficial bladder cancer. Patients with carcinoma in situ (CIS) treated with intravesical BCG plus interferon have a 60% to 70% chance of a complete and durable response if they were never treated with BCG or if they failed only 1 prior induction or relapsed more than a year from induction. Intravesical gemcitabine is safe, but its usefulness for BCG-refractory patients is unclear. Valrubicin, approved for intravesical treatment of BCGrefractory CIS of the bladder, has efficacy and acceptable toxicity. Cystectomy should be considered in high-risk, non–muscle-invasive cancer, particularly if intravesical therapy failed. [Rev Urol. 2008;10(4):281-289]

Bacillus Calmette-Guérin Bladder cancer Cystectomy Gemcitabine

Volume 15, Number 4 Review Articles

Intracavitary Immunotherapy and Chemotherapy for Upper Urinary Tract Cancer: Current Evidence

Systematic Review

Sara Melegari Angelica Grasso Augusto Maggioni Elena Tondelli Marco Rosso Carlo Marenghi Nicola Macchione Gabriele Cozzi Roberto Bianchi Luca Carmignani

A review of the literature was performed to summarize current evidence regarding the efficacy of topical immunotherapy and chemotherapy for upper urinary tract urothelial cell carcinoma (UUT-UCC) in terms of post-treatment recurrence rates. A Medline database literature search was performed in March 2012 using the terms upper urinary tract, urothelial cancer, bacillus Calmette-Guérin (BCG), and mitomycin C. A total of 22 full-text articles were assessed for eligibility, and 19 studies reporting the outcomes of patients who underwent immunotherapy or chemotherapy with curative or adjuvant intent for UUT-UCC were chosen for quantitative analysis. Overall, the role of immunotherapy and chemotherapy for UUT-UCC is not firmly established. The most established practice is the treatment of carcinoma in situ (CIS) with BCG, even if a significant advantage has not yet been proven. The use of BCG as adjuvant therapy after complete resection of papillary UUT-UCC has been studied less extensively, even if recurrence rates are not significantly different than after the treatment of CIS. Only a few reports describe the use of mitomycin C, making it difficult to obtain significant evidence. [Rev Urol. 2013;15(4):145-153 doi: 10.3909/riu0579] © 2014 MedReviews®, LLC

Immunotherapy Chemotherapy Bacillus Calmette-Guérin Upper urinary tract Urothelial cell carcinoma Mitomycin C

Volume 16, Number 4 Case Review

The Use of Botulinum Neurotoxin Type A in a Patient With Refractory Urge Incontinence to Facilitate the Intravesical Treatment of Bladder Carcinoma

Patricia Gilhooly Mina Fam

Intravesical Bacillus Calmette-Guérin (BCG) has become the preferred initial treatment after resection of high-grade T1 urothelial carcinoma and carcinoma in situ (CIS). We report the case of a patient with high-grade T1 urothelial carcinoma and CIS who was treated with intravesical BCG. Due to the patient’s severe urge incontinence, however, the BCG solution leaked from the bladder immediately upon instillation. We describe our experience of using botulinum neurotoxin A intradetrusor injections to facilitate successful intravesical therapy by increasing bladder capacity to enable the BCG to remain in the patient’s bladder for the appropriate treatment duration. [Rev Urol. 2014;16(4):194-197 doi: 10.3909/riu0621] This article is a US Government work, and, as such, is in the public domain in the United States of America. Published by MedReviews®, LLC.

Bacillus Calmette-Guérin Bladder carcinoma Botulinum neurotoxin Gemcitabine

Volume 22, Number 2 Review Articles

Non–muscle-invasive Bladder Cancer: Overview and Contemporary Treatment Landscape of Neoadjuvant Chemoablative Therapies

Treatment Update

Richard S Matulewicz Gary D Steinberg

Non–muscle-invasive bladder cancer (NMIBC) is a heterogeneous subclassification of urothelial carcinoma with significant variation in individual risk of recurrence and progression to muscle-invasive disease. Risk stratification by American Urological Association (AUA) and European Association of Urology (EAU) guidelines or by using nomograms/risk calculators developed from clinical trial data can help inform patient treatment decisions but may not accurately classify all patients. Risk-adapted adjuvant (post–transurethral resection of bladder tumor [TURBT]) treatment strategies using intravesical therapies are an important means of balancing disease control with potential adverse effects. Adjuvant intravesical instillation with various chemotherapy agents and bacillus Calmette-Guérin (BCG) is well studied and associated with excellent outcomes for most patients. However, upwards of 40% of patients recur within 2 years and roughly 10% progress to muscle-invasive bladder cancer. Novel approaches and agents that aim to reduce the treatment burden associated with NMIBC are increasingly needed. We review the current landscape of NMIBC as it pertains to the use of and rationale for emerging neoadjuvant chemoablative therapies. [Rev Urol. 2020;22(2):43–51] © 2020 MedReviews®, LLC

Urothelial carcinoma Bacillus Calmette-Guérin Non-muscle invasive bladder cancer Mitomycin