TY - JOUR
T1 - Treatment patterns and prognosis in patients with Bacillus Calmette–Guérin-exposed high-risk non-muscle invasive bladder cancer
T2 - a real-world data analysis
AU - Nishimura, Nobutaka
AU - Miyake, Makito
AU - Iida, Kota
AU - Miyamoto, Tatsuki
AU - Tomida, Ryotaro
AU - Numakura, Kazuyuki
AU - Inokuchi, Junichi
AU - Yoneyama, Takahiro
AU - Okajima, Eijiro
AU - Yajima, Shugo
AU - Masuda, Hitoshi
AU - Terada, Naoki
AU - Taoka, Rikiya
AU - Kobayashi, Takashi
AU - Kojima, Takahiro
AU - Matsui, Yoshiyuki
AU - Nishiyama, Naotaka
AU - Kitamura, Hiroshi
AU - Nishiyama, Hiroyuki
AU - Fujimoto, Kiyohide
N1 - Publisher Copyright:
© The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature 2024.
PY - 2024/12
Y1 - 2024/12
N2 - Purpose: The International Bladder Cancer Group designated the subgroup that is resistant to Bacillus Calmette–Guérin (BCG) but does not meet the criteria for BCG-unresponsive NMIBC as “BCG-exposed high-risk NMIBC” to guide optimal trial design. We aimed to investigate the treatment patterns and prognoses of patients with BCG-exposed NMIBC. Methods: We conducted a retrospective chart review of 3283 patients who received intravesical BCG therapy for NMIBC at 14 participating institutions between January 2000 and December 2019. Patients meeting the criteria for BCG-exposed and BCG-unresponsive NMIBC, as defined by the Food and Drug Administration and International Bladder Cancer Group, were selected. To compare treatment patterns and outcomes, high-risk recurrence occurring more than 24 months after the last dose of BCG was defined as “BCG-treated NMIBC.” In addition, we compared prognoses between BCG rechallenge and early cystectomy in patients with BCG-exposed NMIBC. Results: Of 3283 patients, 108 (3.3%), 150 (4.6%), and 391 (11.9%) were classified as having BCG-exposed, unresponsive, and treated NMIBC, respectively. BCG-exposed NMIBC demonstrated intermediate survival curves for intravesical recurrence-free and progression-free survival, falling between those of BCG-unresponsive and treated NMIBC. Among patients with BCG-exposed NMIBC, 48 (44.4%) received BCG rechallenge, which was the most commonly performed treatment, and 19 (17.6%) underwent early cystectomy. No significant differences were observed between BCG rechallenge and early cystectomy in patients with BCG-exposed NMIBC. Conclusions: The newly proposed definition of BCG-exposed NMIBC may serve as a valuable disease subgroup for distinguishing significant gray areas, except in cases of BCG-unresponsive NMIBC.
AB - Purpose: The International Bladder Cancer Group designated the subgroup that is resistant to Bacillus Calmette–Guérin (BCG) but does not meet the criteria for BCG-unresponsive NMIBC as “BCG-exposed high-risk NMIBC” to guide optimal trial design. We aimed to investigate the treatment patterns and prognoses of patients with BCG-exposed NMIBC. Methods: We conducted a retrospective chart review of 3283 patients who received intravesical BCG therapy for NMIBC at 14 participating institutions between January 2000 and December 2019. Patients meeting the criteria for BCG-exposed and BCG-unresponsive NMIBC, as defined by the Food and Drug Administration and International Bladder Cancer Group, were selected. To compare treatment patterns and outcomes, high-risk recurrence occurring more than 24 months after the last dose of BCG was defined as “BCG-treated NMIBC.” In addition, we compared prognoses between BCG rechallenge and early cystectomy in patients with BCG-exposed NMIBC. Results: Of 3283 patients, 108 (3.3%), 150 (4.6%), and 391 (11.9%) were classified as having BCG-exposed, unresponsive, and treated NMIBC, respectively. BCG-exposed NMIBC demonstrated intermediate survival curves for intravesical recurrence-free and progression-free survival, falling between those of BCG-unresponsive and treated NMIBC. Among patients with BCG-exposed NMIBC, 48 (44.4%) received BCG rechallenge, which was the most commonly performed treatment, and 19 (17.6%) underwent early cystectomy. No significant differences were observed between BCG rechallenge and early cystectomy in patients with BCG-exposed NMIBC. Conclusions: The newly proposed definition of BCG-exposed NMIBC may serve as a valuable disease subgroup for distinguishing significant gray areas, except in cases of BCG-unresponsive NMIBC.
KW - Adequate BCG therapy
KW - BCG-exposed NMIBC
KW - BCG-unresponsive NMIBC
KW - Delayed relapse after adequate BCG
KW - Delayed relapse after inadequate BCG
UR - http://www.scopus.com/inward/record.url?scp=85188302430&partnerID=8YFLogxK
U2 - 10.1007/s00345-024-04834-4
DO - 10.1007/s00345-024-04834-4
M3 - 学術論文
C2 - 38512511
AN - SCOPUS:85188302430
SN - 0724-4983
VL - 42
JO - World Journal of Urology
JF - World Journal of Urology
IS - 1
M1 - 185
ER -