Adjuvant therapies for non-muscle-invasive bladder cancer: advances during BCG shortage

Balasubramanian, Adithya; Gunjur, Ashray; Weickhardt, Andrew; Papa, Nathan; Bolton, Damien; Lawrentschuk, Nathan; Perera, Marlon

doi:10.1007/s00345-021-03908-x

Cited by 28 publications

(14 citation statements)

References 85 publications

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“…Even though Bacillus Calmette–Guérin (BCG) remains as an effective intravesical agent for treating NMIBC after 40 years of practice, new modalities have emerged demonstrating at least comparable prophylactic effectiveness but fewer toxicities, and circumvent the need for radical cystectomy in progressed cases that may improve patients’ QoL [ 25 , 26 ]. Aside from modifying the treatment schedule and dosage of current intravesical agents, current boosting strategies include sequential and combination therapy [ 19 , 20 ], hyperthermia [ 27 , 28 , 29 ], and EMDA [ 22 , 30 ] that required devices to assisted drug delivery, priming immune checkpoint blockade [ 31 ], and novel photodynamic approaches [ 32 , 33 ].…”

Section: Introductionmentioning

confidence: 99%

Impact of Effective Intravesical Therapies on Quality of Life in Patients with Non-Muscle Invasive Bladder Cancer: A Systematic Review

Yuen

Ching

et al. 2022

IJERPH

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Background: Conventional and newly emerged intravesical modalities have demonstrated prophylactic effectiveness that may improve quality of life (QoL) in non-muscle invasive bladder cancer. The purpose of this study is to analyze existing QoL evidence in patients receiving any form of intravesical therapy. Methods: A PubMed search without time restriction was conducted to identify all relevant studies in accordance with the PICOT question. Additionally, a search was also performed in the Cochrane library database, Internet, and citation. The CONSORT 2010 checklist and STROBE statement checklist were used to evaluate the risk of bias of the included studies. Results: A total of 24 eligible articles were included, which consisted of 11 interventional and 13 observational studies. Intravesical therapy with Bacillus Calmette–Guérin (BCG) or certain chemotherapeutic agents worsens symptom burdens and functional performance during the initial induction phase while continuous improved is observed throughout the maintenance treatment and beyond. Hyperthermia has shown a positive trend in enhancing QoL of patients receiving intravesical chemotherapy, which requires more investigations. However, QoL data were unavailable for other forms of immunotherapy, immune checkpoint inhibitors, electromotive drug administration, and photodynamic therapy. Conclusions: Limited studies suggested the long-term positive impact of intravesical BCG immunotherapy and chemotherapy. However, existing evidence was lacking to clarify the impact of many emerging intravesical therapies that have suggested to be effective and safe, which demands treatment-specific QoL studies.

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Section: Introductionmentioning

confidence: 99%

Impact of Effective Intravesical Therapies on Quality of Life in Patients with Non-Muscle Invasive Bladder Cancer: A Systematic Review

Yuen

Ching

et al. 2022

IJERPH

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“…Induction and maintenance of intravesical BCG remain the historical gold standard for patients with intermediate or high-risk NMIBC. Several meta-analyses have demonstrated superiority of BCG treatment over intravesical chemotherapy for recurrence [13]. Furthermore, BCG reduces or delays progression to muscle invasive bladder cancer (MIBC) [14].…”

Section: Molecular Classification and Other Predictors Of Bacillus Ca...mentioning

confidence: 99%

Nonmuscle-invasive bladder cancer, old problems, new insights

Compérat

Wasinger

Oszwald

et al. 2022

Current Opinion in Urology

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Purpose of reviewNonmuscle-invasive bladder cancer (NMIBC) is the most frequent bladder cancer and represents around 75% of bladder cancers. This review will discuss known challenges and recent advances in staging, grading and treatment stratification based on pathology.Recent findingsPathological staging and grading in NMIBC remains challenging and different techniques exist. Substaging has been shown to be of prognostic relevance and to help predict treatment response in patients receiving Bacillus Calmette-Guérin (BCG) therapy, which is the treatment of choice for high-grade NMIBC. Recent advances in molecular classification and artificial intelligence were also able to show promising results in the stratification of patients.SummaryMany challenges in the diagnosis of NMIBC are still unresolved and ask for more prospective research. New technologies, molecular insights and AI will help in the upcoming years to better stratify and manage these patients.

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“…The objective of TURB is to make the correct histological diagnosis, perform local staging, and completely remove all visible lesions [ 5 ]. Transurethral resection of bladder (TURB) can eradicate a Ta/T1 tumor completely, although these lesions commonly recur and progress to muscle-invasive cancers, which makes intravesical adjuvant therapy a key intervention in this setting [ 6 , 7 ].…”

Section: Introductionmentioning

confidence: 99%

Oral Preparation of Hyaluronic Acid, Chondroitin Sulfate, Curcumin, and Quercetin (Ialuril® Soft Gels) for the Prevention of LUTS after Intravesical Chemotherapy

et al. 2022

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Intravesical chemotherapy may cause chemical cystitis and related lower urinary tract symptoms (LUTS). The aims of this study were to evaluate the efficacy and safety of an oral preparation of hyaluronic acid (HA), chondroitin sulfate (CS), curcumin, and quercetin (Ialuril® Soft Gels) to reduce the severity of LUTS in patients with a history of bladder cancer (BCa) undergoing intravesical chemotherapy. We designed a monocentric, randomized, double-blind, placebo-controlled pilot trial. Patients referred to our institute between November 2016 and March 2018 were enrolled. All subjects had non-muscle-invasive BCa and received intravesical chemotherapy with mitomycin C (MMC). Patients were randomized 1:1 in two groups (intervention vs. control). All subjects underwent oral administration (Ialuril® Soft Gels or placebo) starting one week before the first weekly instillation and ending 30 days after the last one, subsequently starting one week before each monthly instillation and ending 14 days after it. International prostate symptom score (IPSS) and 0-100 visual analogue scale (VAS) were used to assess the efficacy of the treatment. Adverse events were also described. Patients were evaluated at baseline and after 1, 4, 7, and 13 months of intravesical chemotherapy. A total of 34 patients were enrolled. The median IPSS score was significantly lower in the intervention group compared to the control group at 4 (13 vs. 17 points; p = 0.038), 7 (10 vs. 18 points; p < 0.001), and 13 (10 vs. 17 points; p = 0.002) months. The median VAS score was significantly lower in the intervention group compared to the control group at 7 (22 vs. 37 points; p = 0.021) and 13 (20 vs. 35 points; p = 0.024) months. No AE specifically related to supplement or placebo was recorded. Oral formulation of HA, CS, quercetin, and curcumin could be an effective and safe supportive therapy against chemical cystitis in patients receiving intravesical chemotherapy for BCa.

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Adjuvant therapies for non-muscle-invasive bladder cancer: advances during BCG shortage

Cited by 28 publications

References 85 publications

Impact of Effective Intravesical Therapies on Quality of Life in Patients with Non-Muscle Invasive Bladder Cancer: A Systematic Review

Impact of Effective Intravesical Therapies on Quality of Life in Patients with Non-Muscle Invasive Bladder Cancer: A Systematic Review

Nonmuscle-invasive bladder cancer, old problems, new insights

Oral Preparation of Hyaluronic Acid, Chondroitin Sulfate, Curcumin, and Quercetin (Ialuril® Soft Gels) for the Prevention of LUTS after Intravesical Chemotherapy

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