Long-term Outcome of Patients with Frequently Recurrent Non–muscle-invasive Bladder Carcinoma Treated with One Perioperative Plus Four Weekly Instillations of Mitomycin C Followed by Monthly Bacillus Calmette-Guérin (BCG) or Alternating BCG and Interferon-α2b Instillations: Prospective Randomised FinnBladder-4 Study
“…Baseline characteristics of all eligible studies were shown in Table 1. Among 25 included studies, 16 were randomized controlled trials (RCTs) 10–13, 15–21, 24, 28, 31, 33, 34 , 4 were retrospective comparative trials 14, 26, 27, 29 , 1 was retrospective cohort study 30 and remaining 4 were clinical series 22, 23, 32, 25 .Figure 1Flow diagram of the systematic review.
…”
This systematic review and cumulative analysis aimed to explore the efficacy and safety of the combination of intravesical mitomycin C (MMC) plus bacillus Calmette-Guerin (BCG) for non-muscle-invasive bladder cancer (NMIBC) patients. A comprehensive literature search using Pubmed, Embase, Medline, Cochrane Library, CBM, CNKI and VIP databases was performed to identify studies applying intravesical MMC plus BCG therapy on NMIBC patients up to June 2016. Summarized unadjusted odds ratios (ORs) with 95% confidence intervals (CIs) were calculated to assess the efficacy and safety of the combination therapy. A total of 25 studies containing 2749 NMIBC patients were included in this systematic review. Compared with BCG monotherapy, the combination therapy could significantly reduce the tumor recurrence rate (OR = 0.64, 95% CI: 0.44–0.94, P = 0.02) and cancer-specific mortality (OR = 0.54, 95% CI: 0.34–0.87, P = 0.01), without more toxicities (OR = 0.58, 95% CI: 0.17–1.94, P = 0.37). The combination therapy could also lead to significant lower tumor recurrence rate than MMC monotherapy (OR = 0.41, 95% CI: 0.24–0.69, P = 0.0009). Our study indicates that the combination of MMC plus BCG instillation is an effective and safe adjuvant treatment for NMIBC patients.
“…Baseline characteristics of all eligible studies were shown in Table 1. Among 25 included studies, 16 were randomized controlled trials (RCTs) 10–13, 15–21, 24, 28, 31, 33, 34 , 4 were retrospective comparative trials 14, 26, 27, 29 , 1 was retrospective cohort study 30 and remaining 4 were clinical series 22, 23, 32, 25 .Figure 1Flow diagram of the systematic review.
…”
This systematic review and cumulative analysis aimed to explore the efficacy and safety of the combination of intravesical mitomycin C (MMC) plus bacillus Calmette-Guerin (BCG) for non-muscle-invasive bladder cancer (NMIBC) patients. A comprehensive literature search using Pubmed, Embase, Medline, Cochrane Library, CBM, CNKI and VIP databases was performed to identify studies applying intravesical MMC plus BCG therapy on NMIBC patients up to June 2016. Summarized unadjusted odds ratios (ORs) with 95% confidence intervals (CIs) were calculated to assess the efficacy and safety of the combination therapy. A total of 25 studies containing 2749 NMIBC patients were included in this systematic review. Compared with BCG monotherapy, the combination therapy could significantly reduce the tumor recurrence rate (OR = 0.64, 95% CI: 0.44–0.94, P = 0.02) and cancer-specific mortality (OR = 0.54, 95% CI: 0.34–0.87, P = 0.01), without more toxicities (OR = 0.58, 95% CI: 0.17–1.94, P = 0.37). The combination therapy could also lead to significant lower tumor recurrence rate than MMC monotherapy (OR = 0.41, 95% CI: 0.24–0.69, P = 0.0009). Our study indicates that the combination of MMC plus BCG instillation is an effective and safe adjuvant treatment for NMIBC patients.
“…107 Moreover, the intravesical administration of IFN-a2b after mitomycin Cbased chemotherapy was associated with an increased frequency of recurrence among patients with non-muscle-invasive bladder carcinoma as compared to the post-chemotherapy instillation of the Bacillus Calmette-Gu erin (BCG). 106 These findings indicate that the use of IFN-a2a and IFN-a2b as immunological adjuvants may not be optimal for all oncological indications.…”
Section: Update On the Development Of Recombinant Cytokines As Immunomentioning
confidence: 90%
“…Of note, 16 of these studies assessed the safety and efficacy of FDA-approved cytokines (i.e., G-CSF, GM-CSF, IFN-a2a, IFN-a2b and IL-2) as off-label immunostimulatory interventions, [98][99][100][101][102][103][104][105][106][107][108][109][110][111][112][113] while only one trial tested the clinical profile of a hitherto experimental cytokine (i.e., IL-15). 114 The safety and efficacy of G-CSF have been assessed in 11 breast carcinoma patients, who were treated with subcutaneous G-CSF in combination with 5-fluorouracil (5-FU), epirubicin, cyclophosphamide and paclitaxel (NCT02225652).…”
Section: Update On the Development Of Recombinant Cytokines As Immunomentioning
During the past decade, great efforts have been dedicated to the development of clinically relevant interventions that would trigger potent (and hence potentially curative) anticancer immune responses. Indeed, developing neoplasms normally establish local and systemic immunosuppressive networks that inhibit tumor-targeting immune effector cells, be them natural or elicited by (immuno)therapy. One possible approach to boost anticancer immunity consists in the (generally systemic) administration of recombinant immunostimulatory cytokines. In a limited number of oncological indications, immunostimulatory cytokines mediate clinical activity as standalone immunotherapeutic interventions. Most often, however, immunostimulatory cytokines are employed as immunological adjuvants, i.e., to unleash the immunogenic potential of other immunotherapeutic agents, like tumor-targeting vaccines and checkpoint blockers. Here, we discuss recent preclinical and clinical advances in the use of some cytokines as immunostimulatory agents in oncological indications.
“…In frequently recurrent NMIBC, another RCT demonstrated a significantly higher efficacy of weekly MMC followed by monthly BCG in reduction of the recurrence rate when compared with BCG and interferon [106]. 8.2.4.…”
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