Does bacillus Calmette-Guérin immunotherapy accelerate growth and cause metastatic spread of second primary malignancy?

Khanna, Om P.; Cottone, R. Rocco; Chou, Roger; Heeg, Michael M.; Son, Daniel L.; Rezvan, Masoud; Mazer, Howard; Vier, N.; Read, John; Uhlman, Richard C.; Nugent, Dennis; Friedmann, Marvin

doi:10.1016/0090-4295(88)90208-7

Cited by 13 publications

(2 citation statements)

References 34 publications

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“…Quarterly maintenance treat ment was administered on the assumption that this would enhance the antitumor activity of BCG despite the relatively recent reports which claim that mainte nance therapy has no apparent benefit in terms of recur rence [15,21], Recent reports have raised anxiety regarding a re markable incidence of cancer in other sites than the blad der amongst patients receiving BCG treatment [22], Al though BCG therapy on a patient with primary carci noma is expected to eliminate this tumor, animal and human studies of BCG use for treatment of several malignancies have shown in some instances a rapid development and spread of these malignancies when BCG was administered apparently before the tumors were well established, while second primary malignan cies were seen to develop and progress with variable speed [8,[22][23][24][25][26]. Khanna et al [22] suggest that the tem poral relationship between the starting point of tumor development and the starting point of BCG treatment could be crucial in determining whether BCG will eradi cate or exacerbate the tumor. In the present series a metachronous carcinoma of the lungs was developed in 1 patient 9 months after the completion of BCG therapy, while a distal ureteric papillary carcinoma appeared in another patient and a progression of the disease was demonstrated in some others after the end of BCG treat ment.…”

Section: Discussionmentioning

confidence: 99%

Intravesical Bacillus Calmette-Guérin Prophylactic Treatment for Superficial Bladder Tumors: Results of a Controlled Prospective Study

Melekos¹

1990

Urol Int

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A controlled prospective study in 100 patients evaluated the efficacy of intravesical bacillus Calmette-Guérin (BCG) administration as prophylactic treatment on tumor recurrence and tumor progression rate after endoscopic resection of superficial transitional cell carcinoma of the bladder. There were 27 recurrences in 22 of 67 evaluable patients (33%) who received BCG, compared to 27 recurrences in 19 of 33 control patients (58%) (p < 0.05). The mean follow-up periods for the tumor-free patients in the BCG and control groups were 29 and 30 months, respectively, while the mean times to tumor recurrences for the above groups were 13.36 ± 6 and 9.94 ± 5 months, respectively (p < 0.05). The recurrence rates per 100 patient months for the BCG and control patients were 1.69 and 4.41 recurrences, respectively (p < 0.05), while 7 patients of the BCG group showed recurrent tumors of higher stage or grade, compared to 13 of the controls (p < 0.05). This study confirms that Pasteur strain BCG is safe and efficacious in the prevention of superficial bladder tumor recurrence and tumor progression.

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Section: Discussionmentioning

confidence: 99%

Intravesical Bacillus Calmette-Guérin Prophylactic Treatment for Superficial Bladder Tumors: Results of a Controlled Prospective Study

Melekos¹

1990

Urol Int

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“…Controlled animal experiments have demonstrated that BCG can, in some exceptional circumstances, result in enhanced tumour growth [8], and induction or promotion of tumour growth has been suspected in some patients [9]. However, the Southwest Oncology Group (SWOG) ran domized comparison of BCG and doxorubicin therapy found no statistically significant difference in the incidence of secondary tumour growth between patients receiving the different therapies, and no evidence to support a role for intravesical BCG as a stimulus for the development of sec ondary malignancies [1].…”

Section: Allergic Reactions and Rare Complicationsmentioning

confidence: 99%

BCG Therapy in Superficial Bladder Tumours - Complications and Precautions

Steg

Adjiman²,

Debré³

1992

Eur Urol

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Intravesical bacillus Calmette-Guérin administration in the prophylaxis of superficial bladder cancer

Melekos

Pantazakos

Markou

et al. 1990

International Urology and Nephrology

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A total of 68 patients received prophylactic/adjuvant intravesical Pasteur strain bacillus Calmette-Guérin (BCG) instillations following transurethral resection for superficial bladder carcinoma. An induction phase consisting of 6 weekly instillations was followed by a maintenance phase consisting of 1 instillation given every 3 months. A second 6-week course of BCG was administered to initial failure followed again by a quarterly maintenance therapy. The response rate for patients treated with one 6-week course was 56%, while complete response was achieved in 72% when both treatment courses were considered. Follow-up period lasted at least 2 years after each course of BCG. These results suggest that additional courses of BCG increase the prophylactic efficacy of intracavitary BCG. Regarding the purified protein derivative (PPD) skin test and granulomatous response in the bladder, it has been shown in the present study that, although favourable results occurred more frequently among patients with either PPD conversion from negative to positive or vesical granuloma formation, neither of these indices should be considered reliable prognostic indicators.

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Does bacillus Calmette-Guérin immunotherapy accelerate growth and cause metastatic spread of second primary malignancy?

Cited by 13 publications

References 34 publications

Intravesical Bacillus Calmette-Guérin Prophylactic Treatment for Superficial Bladder Tumors: Results of a Controlled Prospective Study

Intravesical Bacillus Calmette-Guérin Prophylactic Treatment for Superficial Bladder Tumors: Results of a Controlled Prospective Study

BCG Therapy in Superficial Bladder Tumours - Complications and Precautions

Intravesical bacillus Calmette-Guérin administration in the prophylaxis of superficial bladder cancer

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