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Intravesical BCG

Shlomi Tapiero, Alexander Helfand, Daniel Kedar, Ofer Yossepowitch, Andrei Nadu, Jack Baniel, David Lifshitz, David Margel
OBJECTIVE: To assess patient adherence to intravesical instillation therapy for non-muscle invasive urothelial carcinoma outside of clinical trials. METHODS: We reviewed the records of patients from 2000-2013 who received intravesical therapy for non-muscle invasive urothelial carcinoma. Patients with evidence of tumor recurrence or progression were excluded. We performed univariable and multivariable regression analysis to predict adherence to intravesical therapy...
May 21, 2018: Urology
J W M Yuen, D S Y Mak, E S Chan, M D I Gohel, C F Ng
ETHNOPHARMACOLOGICAL RELEVANCE: Ganoderma lucidum (GL) has been traditionally used in oriental medicine as superior health tonic, and there are numerous scientific evidences of its antitumorigenic activities. AIM OF THE STUDY: To evaluate the intravesical chemopreventive effects of ethanol extract of GL (GLe) on bladder cancer. MATERIALS AND METHODS: Intravesical therapy is defined as the direct instillation of a liquid drug into bladder through a catheter...
May 18, 2018: Journal of Ethnopharmacology
Manu P Bilsen, Krista E van Meijgaarden, Hanna K de Jong, Simone A Joosten, Corine Prins, Lucia J M Kroft, Jacqueline T Jonker, Stijn Crobach, Rob C Pelger, Tom H M Ottenhoff, Sandra M Arend
Intravesical Bacillus Calmette-Guérin (BCG) is widely used for high-risk, non-muscle-invasive bladder cancer. We describe four cases which illustrate the spectrum of BCG-induced complications, varying from granulomatous prostatitis to sepsis. Considerable debate exists whether inflammation or infection is the predominant mechanism in the pathogenesis of BCG-disease. In two patients with systemic illness symptoms resolved first after adding prednisone, indicating a principle role for inflammation in systemic disease...
May 17, 2018: International Journal of Infectious Diseases: IJID
Karen Tran-Harding, Rashmi T Nair, Halemane Ganesh
Intravesical Bacillus Calmette-Guerin (BCG) immunotherapy is a proven, effective treatment for intermediate- and high-risk non-muscle-invasive bladder cancer. Minor side effects are common and expected but systemic effects can occur in <5% of treated patients. We present a rare case of a 49-year-old male that presented with fever and chills after 3 weeks of intravesical BCG therapy post transurethral resection of bladder tumor. New renal lesions were present on contrast-enhanced computed tomography scan which was histologically proven to be necrotizing renal granulomatosis...
2018: Journal of Clinical Imaging Science
Masato Baba, Susumu Kageyama, Tetsuya Yoshida, Ryo Fujiwara, Chul Jang Kim, Keita Takimoto, Masayuki Nagasawa, Hiroki Soga, Yukihiro Nagatani, Zenkai Nishikawa, Akihiro Kawauchi
BACKGROUND: To evaluate the effect of intravesical bacillus Calmette-Guerin (BCG) instillation therapy after second transurethral resection (TUR) on primary T1 bladder cancer. METHODS: The subjects were 180 patients diagnosed with T1 bladder cancer at our university and at affiliated hospitals between January 1990 and December 2015. Tumor residual rate, intravesical recurrence rate, and risk factors for intravesical recurrence were investigated. RESULTS: The median follow-up period was 26 (1-175) months...
May 14, 2018: International Journal of Clinical Oncology
Venancio Chantada-Abal, Cristina Chantada-Tirado, Leticia Lamas-Díaz, Francisco Caramés-Masana, Anselmo Damián Villegas-Piguave, Nuria Villar-Vázquez
Bacilus Calmette-Guerin (BCG) administered intravesical is an effective therapy in non muscle invasive bladder cancer (NMIBC), but it presents limitations regarding recurrence and toxicity. For years, many case series have been published where sequential therapy with BCG and Mitomycin C (MMC) was tried. In this article, we perform a review of the data supplied by these articles with the aim to determine the safety and efficacy of combination, and what is the group of patients it should be indicated. Many studies show that combination therapy did not cause more toxicity and improved the interval free of disease with decrease of tumor progression compared to BCG or MMC monotherapy...
May 2018: Archivos Españoles de Urología
Juan León-Mata, José Luis Domínguez, Joan Palou Redorta, Daniel Sousa González, María Alvarez Casal, Alejandro Sousa Escandón, Eva Piñeiro Vázquez
OBJECTIVES: The treatment of non muscle invasive bladder cancer (NMIBC) continues to be a challenge. Hyperthermia (HT) combined with intravesical chemotherapy is used to enhance the effects of chemotherapy. METHODS: A review of the publications was carried out to synthesize the adverse effects (AE) reported by the use of chemohyperthermia (QHT) with Mitomycin-C (MMC). The most relevant data are exposed for each of the devices currently used in the QHT. RESULTS: SYNERGO®: The dropout rate varied between 3-40%, and the AE rate is up to 88%...
May 2018: Archivos Españoles de Urología
Jacqueline J M J H Coenen, F Johannes P van Valenberg, Tom J H Arends, J Alfred Witjes
In an effort to decrease recurrence and progression rates in non-muscle-invasive bladder cancer (NMIBC), transurethral resection of a bladder tumor is followed by intravesical instillations using Mitomycin-C (MMC) and Bacillus Calmette-Guérin (BCG). In spite of these adjuvant treatment modalities, recurrence and progression rates remain high. Because of these limitations of current standard therapy and the shortage of BCG, there is a search for alternative forms of treatment in NMIBC. Intravesical MMC combined with hyperthermia, especially RF-induced QHT being most extensively investigated in the past 20 years, is one of these alternatives for intermediate- and high-risk NMIBC...
May 2018: Archivos Españoles de Urología
Joaquín A Carballido, María Rodríguez Monsalve
The therapeutic approaches developed around immune system modulation find the therapeutic contribution of intravesical Bacillus Calmette Guerin (BCG) for transitional cell bladder cancer an unquestionable example as a proof of concept of antitumor immunotherapy since more than 30 years ago. Intravesical immunotherapy for urothelial carcinomas is considered with periodic intravesical instillations schedules, and the one with longer historic development and wider diffusion is BCG in the form of suspension. BCG is a unique strain obtained from Mycobacterium bovis at the end of the first third of the XX century and represents the historically most successful immunotherapeutic modality of all tumors with a high level body of evidence...
May 2018: Archivos Españoles de Urología
Álvaro Sánchez González, Oscar Rodríguez Faba, Lucía Mosquera, Laia Sabiote, Alberto Breda, Joan Palou Redorta
BCG has been used in the treatment of NMIBC for more than 40 years. Nevertheless, its exact working mechanisms have not been completely discovered. Clinical and basic research done over all these years has generated much information but it could be summarized in a few simple statements. It has been demonstrated the best route of administration is intravesical, BCG is superior than intracavitary chemotherapy to prevent recurrence but its adverse events are worse. Recently, it has been demonstrated that BCG could delay or prevent progression to infiltrative cancer...
May 2018: Archivos Españoles de Urología
Marc-Etienne Parent, Maxime Richer, Patrick Liang
To present an unrecognized vascular complication of bacillus Calmette-Guérin (BCG) therapy administered for superficial bladder carcinoma. We also review the potential mimickers for primary angiitis of the central nervous system (PACNS) as well as complications of intravesical BCG therapy. An 89-year-old Caucasian man with a history of relapsing high-grade bladder carcinoma treated with intravesical BCG presented with recurring episodes of right upper limb paresthesia with clumsiness and dysarthria. Magnetic resonance imaging of the head revealed multiple predominantly left-sided frontotemporal micronodular peri-vascular lesions...
May 9, 2018: Clinical Rheumatology
Wakako Yorozuya, Naotaka Nishiyama, Tetsuya Shindo, Yuki Kyoda, Naoki Itoh, Shintaro Sugita, Tadashi Hasegawa, Naoya Masumori
Objectives: To clarify the efficacy of intravesical Bacillus Calmette-Guérin (BCG) instillation for non-muscle invasive bladder (NMIBC) cancer with variant histology, especially glandular differentiation or squamous differentiation. Materials and methods: From May 1991 through June 2016, 53 patients were diagnosed retrospectively as having NMIBC with variant histology. Among these patients, 47 NMIBC patients with squamous differentiation or glandular differentiation were analyzed for this study...
May 4, 2018: Japanese Journal of Clinical Oncology
Jasper Crijnen, Theo M de Reijke
Bladder cancer (BC) is a severe health burden: it is the fifth most common malignancy in the world and has high recurrence and progression rates. Standard treatment starts with TURB followed by intravesical chemotherapy with Mitomycin C or immunotherapy with BCG. However, successful management still remains a challenge, because approximately 30% of patients have recurrence or progression within 5 years, and treatment has considerable side effects. Anticipating on the upcoming BCG shortage emphasizes, moreover, the necessity to develop and study novel treatments...
May 5, 2018: Expert Opinion on Emerging Drugs
Samuel Alvarez-Arguedas, Santiago Uranga, Manuel Martín, Javier Elizalde, Ana Belen Gomez, Esther Julián, Denise Nardelli-Haefliger, Carlos Martín, Nacho Aguilo
Intravesical instillation of bacillus Calmette-Guérin (BCG) has been a first-line therapy for non-muscle-invasive bladder cancer for the last 4 decades. However, this treatment causes serious adverse events in a significant number of patients and a substantial percentage of recurrence episodes. MTBVAC is a live-attenuated vaccine derived from a Mycobacterium tuberculosis clinical isolate and is currently under evaluation in clinical trials to replace BCG as a tuberculosis vaccine. Here, we describe for the first time the potential of MTBVAC as a bladder cancer therapy in vitro and in vivo in a preclinical model...
April 6, 2018: Translational Research: the Journal of Laboratory and Clinical Medicine
Yuhui He, Ning Wang, Xiaofeng Zhou, Jianfeng Wang, Zhenshan Ding, Xing Chen, Yisen Deng
OBJECTIVES: The aim of this study was to explore the prognostic value of ki67 as a marker in patients with non-muscle invasive bladder cancer (NMIBC) treated with BCG. METHODS: Studies were systematically retrieved from the relevant databases (Web of Science, PubMed, Cochrane Library and Embase), and the expiry date was May 2017. The research steps referred to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis statement. RESULTS: A total of 11 studies that complied with the inclusion criteria were included...
April 17, 2018: BMJ Open
Michael E Autenrieth, Christof Seidl, Frank Bruchertseifer, Thomas Horn, Florian Kurtz, Benedikt Feuerecker, Calogero D'Alessandria, Christian Pfob, Stephan Nekolla, Christos Apostolidis, Saed Mirzadeh, Jürgen E Gschwend, Markus Schwaiger, Klemens Scheidhauer, Alfred Morgenstern
PURPOSE: Patients with carcinoma in situ (CIS) of the bladder refractory to bacillus Calmette-Guérin (BCG) treatment are usually treated with cystectomy. Therefore, new treatment options with preservation of the urinary bladder are needed. The objective of the study was to investigate the feasibility, safety and efficacy of a novel targeted alpha-emitter immunotherapy for CIS after BCG treatment failure. METHODS: A pilot study was conducted in 12 patients (age range 64-86 years, ten men, two women) with biopsy-proven CIS of the bladder refractory to BCG treatment...
April 11, 2018: European Journal of Nuclear Medicine and Molecular Imaging
Maaike van de Kamp, Richard Meijer, Floris Pos, Martijn Kerst, Eric van Werkhoven, Bas van Rhijn, Simon Horenblas, Axel Bex
INTRODUCTION: Small cell carcinoma of the bladder (SCCB) is a rare and lethal disease. Previously, we and others have reported a bladder sparing strategy with platinum-etoposide-based chemotherapy followed by radiotherapy of the bladder. Little is known on frequency and treatment of intravesical recurrence following this approach. The objective of this study is to describe the incidence of intravesical recurrences and their management. MATERIALS AND METHODS: Retrospective study including all patients with SCCB treated at a single institution from 1993 until 2016...
March 23, 2018: Urologic Oncology
Andrew T Lenis, Kian Asanad, Maher Blaibel, Nicholas M Donin, Karim Chamie
Introduction: Intravesical bacillus Calmette-Guérin (BCG) therapy is the gold standard adjuvant treatment for patients with high-grade non-muscle-invasive bladder cancer (NMIBC). Despite the association between metabolic syndrome (MetS) and bladder cancer, the association between MetS and BCG failure is unknown. The objective of this study was to characterize disease recurrence following BCG in patients with and without MetS. Methods: We retrospectively evaluated the records of patients undergoing TURBT at our institution in 2012-2015 for NMIBC and identified those who received adjuvant BCG therapy...
March 2018: Urology Practice
Antonio Lopez-Beltran, Rodolfo Montironi, Maria R Raspollini, Liang Cheng, George J Netto
Intravesical immunotherapy, chemotherapy, and neoadjuvant systemic chemotherapy are among the most frequent therapeutic procedures to treat malignancies of the urinary bladder. These treatment modalities produce reactive morphologic changes in the urothelium that can mimic urothelial carcinoma in situ, urothelial dysplasia or true invasive urothelial neoplasia. Mitomycin C used after transurethral resection of bladder tumor to reduce recurrences, BCG intravesical immunotherapy to treat high risk non-muscle invasive bladder cancer and urothelial carcinoma in situ, and platinum-based systemic chemotherapy to improve post-cystectomy disease-specific survival some of the causes of therapy related atypia in urinary bladder...
March 14, 2018: Seminars in Diagnostic Pathology
Naotaka Nishiyama, Hiroshi Hotta, Atsushi Takahashi, Masahiro Yanase, Naoki Itoh, Hitoshi Tachiki, Noriomi Miyao, Masanori Matsukawa, Yasuharu Kunishima, Keisuke Taguchi, Hiroshi Kitamura, Naoya Masumori
OBJECTIVES: The aim of this study was to clarify the prognostic indicators for upper tract urothelial carcinoma (UTUC) following intravesical bacillus Calmette-Guérin (BCG) therapy for nonmuscle-invasive bladder cancer (NMIBC). METHODS: Data from 402 patients who received intravesical BCG therapy between January 1990 and November 2011 were collected from 10 institutes. The median follow-up interval from transurethral resection of the bladder tumor (TURBT) followed by BCG treatment was 50...
June 2018: Urologic Oncology
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