Diminished efficacy of bacille Calmette-Guérin among elderly patients with nonmuscle invasive bladder cancer

Margel, David; Alkhateeb, S.S.; Finelli, Antonio; Fleshner, Neil

doi:10.1590/s1677-55382011000500031

Cited by 4 publications

(4 citation statements)

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“…Of the patients who were aged 61–70 years versus patients older than 80 years, cancer‐free survival was 39 versus 61%, respectively, at a median follow‐up of 24 months ( P = 0·002). In analyses of aged patients receiving BCG for non‐muscle invasive bladder cancer, age was an independent risk for progression and the 2‐year progression‐free survival was 87% among patients aged less than 75 years compared to 65% among patients aged greater than 75 years . In a large ( n = 805) cohort of patients with bladder cancer age was found to have a small but measurable association with response to BCG therapy .…”

Section: Toll‐like Receptor (Tlr) Agonistsmentioning

confidence: 95%

Considerations for successful cancer immunotherapy in aged hosts

Hurez

Padrón

Svatek

et al. 2016

Clinical and Experimental Immunology

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Summary Immunotherapy is now experiencing unprecedented successes in treating various cancers based on new understandings of cancer immunopathogenesis. Nonetheless, although ageing is the biggest risk factor for cancer, the majority of cancer immunotherapy preclinical studies are conducted in young hosts. This review will explore age‐related changes in immunity as they relate to cancer immune surveillance, immunopathogenesis and responses to immunotherapy. Although it is recognized that declining T cell function with age poses a great challenge to developing effective age‐related cancer immunotherapies, examples of successful approaches to overcome this hurdle have been developed. Further, it is now recognized that immune functions do not simply decline with age, but rather change in ways than can be detrimental. For example, with age, specific immune cell populations with detrimental functions can become predominant (such as cells producing proinflammatory cytokines), suppressive cells can become more numerous or more suppressive (such as myeloid‐derived suppressor cells), drugs can affect aged immune cells distinctly and the aged microenvironment is becoming recognized as a significant barrier to address. Key developments in these and other areas will be surveyed as they relate to cancer immunotherapy in aged hosts, and areas in need of more study will be assessed with some speculations for the future. We propose the term ‘age‐related immune dysfunction’ (ARID) as best representative of age‐associated changes in immunity.

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Section: Toll‐like Receptor (Tlr) Agonistsmentioning

confidence: 95%

Considerations for successful cancer immunotherapy in aged hosts

Hurez

Padrón

Svatek

et al. 2016

Clinical and Experimental Immunology

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“…Margel ve ark. ise BCG alan hastalarda rekürrensin yaşla değişmediğini, ancak progresyon riskinin yaşla çok güçlü bir şekilde artığını bildirmişlerdir (10). Oddens ve ark.…”

Section: Tartişma Ki̇omk Hastalarda Rekürrens Ve Progresyonu öNgörmede Kullanılan Popüler Iki Nomogram Vardırunclassified

İleri Yaş Kas İnvaziv Olmayan Mesane Kanserli Hastalarda Rekürens ve Progresyon Gelişimine Etkilidir

Bayar¹,

Kılınç²

2020

Yeni Üroloji Dergisi

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Primer ve kas invaziv olmayan mesane kanserli (KİOMK) hastalarda rekürrens ve progresyona yaşın etkisini incelemeyi amaçladık.Gereç ve Yöntemler: Kliniğimizde 2005-2010 yılları arasında primer mesane tümörü nedeniyle transüretral mesane tümörü rezeksiyonu (TUR-BT) uygulanan hastaların dosyaları geriye doğru incelendi. İlk TUR-BT sonucu KİOMK olan ve mesane dışı tutulumu olmayan hastalar çalışmaya dahil edildi. Hastalar yaş (60 yaşın altında, 60-70 yaş arası, 70 yaşın üstündekiler), cinsiyet, tümör boyutu (3 cm'nin altında ve üstünde); tümör sayısı (1, 2-7 arası ve >7 olarak); evre (Ta ve T1) ve greydine (G1, G2 ve G3) göre gruplandırıldı.Bulgular: Çalışmaya toplam 316 hasta dahil edildi. Çalışmaya alınan hastalardan 226'sında (%71,5) rekürrens ve 71'inde (%22,5) progresyon izlendi. Univariete analizde hastanın yaşı (> 70), tümörün sayısı (>1), boyutu (>3 cm), evresi (T1) ve greydinin (G3) rekürrens ve progresyon gelişiminde etkili olduğu görülmüştür. Kaplan-Meier analizinde yaş grupları arasında rekürrense kadar geçen süre açısından anlamlı bir fark olduğunu gördük (p= 0,001), yaş artıkça rekürrens olasılığı artmakta ve rekürrense kadar geçen süre azalmaktadır. Progresyon analizinde de aynı şekilde gruplar arasında anlamlı fark olduğunu ve yaşın artıkça progresyon riskinin arttığını ve progresyona kadar geçen sürenin kısaldığını gördük (p= 0,004).Sonuç: KİOMK hastalarda yaş arttıkça, özellikle 70 yaşın üstünde, rekürrens ve progresyon ihtimalinin belirgin şekilde arttığını tespit ettik.

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“…Effect of age was analyzed both dichotomously (<70 or ≥70 years) as well as by 10-year increments (<50, 50-59, 60-69, ≥70 years) with regard to previous trials (6,11). Cox univariate and multivariate proportional hazards regression models were fit with end points, time to recurrence and time to progression.…”

Section: Introductionmentioning

confidence: 99%

Effect of Age on Outcome of High-Risk Non-Muscle-Invasive Bladder Cancer Patients Treated with Second Transurethral Resection and Maintenance Bacillus Calmette-Guerin Therapy

Baltacı¹,

Bozlu²,

Yıldırım³

et al. 2016

jus

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What's known on the subject? and What does the study add? ÖZ ABSTRACT AmaçBu çalışmada yüksek riskli kasa invaze olmayan mesane kanseri (KİOMK) nedeniyle ikinci transüretral rezeksiyon (TUR) yapılan ve idame Bacillus Calmette-Guerin (BCG) tedavisi alan hastalarda nüks ve progresyon oranlarına yaşın etkisinin değerlendirilmesi amaçlandı. gereç ve yöntemBu çok merkezli çalışmada 2005-2012 yılları arasında yüksek riskli KİOMK nedeniyle tedavi edilen hastaların verileri incelendi. İkinci TUR da kasa invaziv olmayan, indüksiyon sonrası en az 1 yıl süre ile idame BCG tedavisi alan ve en az 12 ay tedavi alan hastalar dahil edildi. Yaşın etkisi hem iki grup olarak (<70 vs ≥70 yaş) hem de on yıllık artan gruplarda incelendi. Ki-kare, Student T-test ve ANOVA testi grupların karşılaştırılması için objective To determine the effect of age on recurrence and progression rates in a population of high-risk non-muscle invasive bladder cancer (NMIBC) patients treated with a second transurethral resection (TUR) and at least 1 year of maintenance Bacillus Calmette-Guerin (BCG) therapy. Materials and MethodsIn this multicenter study, we reviewed the data of patients treated for high-risk NMIBC between 2005 and 2012. Patients without a muscleinvasive cancer on second TUR and received induction BCG and at least one year of maintenance BCG therapy and at least 12 months of follow-up after completion of maintenance BCG were included. Effect of age was analyzed both dichotomously (<70 or ≥70 years) as well as High risk non-muscle invasive bladder cancer patients should be treated with maintenance Bacillus Calmette-Guerin (BCG) to obtain a reduce the risk of progression. The exact mechanism of action of BCG has not been clearly understood. However, there is clearly an action of immune system. Capacity of immune system decreases with advanced age and age has been shown to be associated with increased progression rates and decreased survival rates in patients receiving BCG. Previous studies are heterogeneous with respect to their population and they did not evaluate the effect of age on maintenance BCG response with the definition of progression involving Ta upstaging to T1.

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Diminished efficacy of bacille Calmette-Guérin among elderly patients with nonmuscle invasive bladder cancer

Cited by 4 publications

References 1 publication

Considerations for successful cancer immunotherapy in aged hosts

Considerations for successful cancer immunotherapy in aged hosts

İleri Yaş Kas İnvaziv Olmayan Mesane Kanserli Hastalarda Rekürens ve Progresyon Gelişimine Etkilidir

Effect of Age on Outcome of High-Risk Non-Muscle-Invasive Bladder Cancer Patients Treated with Second Transurethral Resection and Maintenance Bacillus Calmette-Guerin Therapy

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