Partial Versus Complete Bacillus Calmette-Guérin Intravesical Therapy and Bladder Cancer Outcomes in High-risk Non–muscle-invasive Bladder Cancer: Is NIMBUS the Full Story?

Rezaee, Michael E.; Ismail, Abdol Aziz Ould; Okorie, Chiamaka L.; Seigne, John D.; Lynch, Kristine E.; Schroeck, Florian R.

doi:10.1016/j.euros.2021.01.009

Cited by 2 publications

(2 citation statements)

References 24 publications

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“…According to the recent study, patients with high-risk NMIBC who underwent partial and complete induction of BCG experienced similar outcomes. 26 These results are comparable with our findings in continuing or discontinuing the maintenance therapy. Lamm et al 10 evaluated 550 patients with transitional cell carcinoma of the bladder with carcinoma in situ or an increased risk of recurrence after TURT.…”

Section: Discussionsupporting

confidence: 90%

Evaluating the Effectiveness of Intravesical Instillation of BCG by Modified Maintenance Method in Patients With High-Risk Ta and T1 Bladder Cancer: A Randomized Clinical Trial

Shakhssalim,

Dadpour,

Sharifiaghdas

et al. 2023

Clin Med Insights Oncol

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Background: It is estimated that 75% of urothelial bladder cancers are non–muscle-invasive cancers (NMIBCs). The development of more effective methods for optimizing the management of this subset of patients is of paramount importance. This study aimed to evaluate the effectiveness and side effects of modified maintenance Bacillus Calmette-Guérin (BCG) therapy in patients with high-risk NMIBC. Methods: A total of 84 patients with NMIBC who met the inclusion criteria were randomly divided into 2 groups of 42 patients after receiving intravesical BCG weekly, 1 month after transurethral resection of the bladder tumor (TURT) for 6 weeks as the induction. In group I, patients continued monthly intravesical instillation of BCG for 6 months as maintenance, whereas group II patients did not. All patients were followed up for recurrence and progression for 2 years. Results: Although the recurrence rate was lower in group I (16.7% vs 31%), there was no significant difference among groups (P = .124). Pathology progression was also lower in group I (7.1% vs 11.9%) with no significant difference among groups (P = .713). Complications were not statistically different among groups (P = .651). A statistically significant difference was not observed between the groups in the acceptance rate of patients (97.6% in group I vs 100% in group II). Conclusions: The recurrence rate and progression rate in NMIBC patients with maintenance-free induction therapy after TURT were almost twice as high as those with 6-month maintenance therapy; however, it was not statistically significant. Modified BCG maintenance protocol made favorable compliance for patients. Trial registration: This study was retrospectively registered at Iranian Registery of Clinical Trials with the code IRCT20220302054165N1.

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Section: Discussionsupporting

confidence: 90%

Evaluating the Effectiveness of Intravesical Instillation of BCG by Modified Maintenance Method in Patients With High-Risk Ta and T1 Bladder Cancer: A Randomized Clinical Trial

Shakhssalim,

Dadpour,

Sharifiaghdas

et al. 2023

Clin Med Insights Oncol

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“…The activation of the immune system with BCG (Bacille Calmette-Guérin) has been shown to be beneficial for turning on the immune system in bladder cancer when installed intravesically [ 414 ]. This treatment led to the appearance of neutrophils that express membrane-bound TRAIL and secrete large quantities of TRAIL important for the anti-tumor action [ 415 ].…”

Section: Therapeutic Strategies For Targeting Neutrophils To Strengthen the Anti-tumor Functionmentioning

confidence: 99%

Leveling Up the Controversial Role of Neutrophils in Cancer: When the Complexity Becomes Entangled

Sionov

2021

Cells

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Neutrophils are the most abundant immune cell in the circulation of human and act as gatekeepers to discard foreign elements that have entered the body. They are essential in initiating immune responses for eliminating invaders, such as microorganisms and alien particles, as well as to act as immune surveyors of cancer cells, especially during the initial stages of carcinogenesis and for eliminating single metastatic cells in the circulation and in the premetastatic organs. Since neutrophils can secrete a whole range of factors stored in their many granules as well as produce reactive oxygen and nitrogen species upon stimulation, neutrophils may directly or indirectly affect carcinogenesis in both the positive and negative directions. An intricate crosstalk between tumor cells, neutrophils, other immune cells and stromal cells in the microenvironment modulates neutrophil function resulting in both anti- and pro-tumor activities. Both the anti-tumor and pro-tumor activities require chemoattraction towards the tumor cells, neutrophil activation and ROS production. Divergence is seen in other neutrophil properties, including differential secretory repertoire and membrane receptor display. Many of the direct effects of neutrophils on tumor growth and metastases are dependent on tight neutrophil–tumor cell interactions. Among them, the neutrophil Mac-1 interaction with tumor ICAM-1 and the neutrophil L-selectin interaction with tumor-cell sialomucins were found to be involved in the neutrophil-mediated capturing of circulating tumor cells resulting in increased metastatic seeding. On the other hand, the anti-tumor function of neutrophils was found to rely on the interaction between tumor-surface-expressed receptor for advanced glycation end products (RAGE) and Cathepsin G expressed on the neutrophil surface. Intriguingly, these two molecules are also involved in the promotion of tumor growth and metastases. RAGE is upregulated during early inflammation-induced carcinogenesis and was found to be important for sustaining tumor growth and homing at metastatic sites. Cathepsin G was found to be essential for neutrophil-supported lung colonization of cancer cells. These data level up the complexity of the dual role of neutrophils in cancer.

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Partial Versus Complete Bacillus Calmette-Guérin Intravesical Therapy and Bladder Cancer Outcomes in High-risk Non–muscle-invasive Bladder Cancer: Is NIMBUS the Full Story?

Cited by 2 publications

References 24 publications

Evaluating the Effectiveness of Intravesical Instillation of BCG by Modified Maintenance Method in Patients With High-Risk Ta and T1 Bladder Cancer: A Randomized Clinical Trial

Evaluating the Effectiveness of Intravesical Instillation of BCG by Modified Maintenance Method in Patients With High-Risk Ta and T1 Bladder Cancer: A Randomized Clinical Trial

Leveling Up the Controversial Role of Neutrophils in Cancer: When the Complexity Becomes Entangled

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