Patient Preferences for Treatment of Bacillus Calmette-Guérin–unresponsive Non–muscle-invasive Bladder Cancer: A Cross-country Choice Experiment

Collacott, Hannah; Krucien, Nicolas; Heidenreich, Sebastian; Catto, James W.F.; Ghatnekar, Ola

doi:10.1016/j.euros.2022.12.016

Cited by 6 publications

(2 citation statements)

References 29 publications

(30 reference statements)

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“…Most of the 107 participants never selected RC (89%) as their preferred choice of therapy. 18 In a survey of 105 urologists, 81% of respondents were still reluctant to refer patients with HG disease with BCG failure to immediate cystectomy. 19 Otherwise, there is a paucity of data that reflects the real-world scenario of physician choice for BCG-unresponsive disease and their adherence to guidelines in this setting.…”

Section: Discussionmentioning

confidence: 99%

US Clinical Practice Patterns of Intravesical Chemotherapy for Bacillus Calmette-Guérin–Unresponsive and Bacillus Calmette-Guérin–Exposed Nonmuscle-Invasive Bladder Cancer

Abou Chakra,

Shore,

Dillon

et al. 2024

Urology Practice

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Introduction:The goal of this survey was to evaluate the treatment and practice pattern of patients with high-grade papillary Ta, T1 nonmuscle-invasive bladder cancer (NMIBC), and carcinoma in situ (CIS) in bacillus Calmette-Guérin (BCG)eunresponsive (with adequate BCG exposure ¼ adequate BCG) and those with less than adequate BCG exposure (BCG-exposed).Methods: An internet-based survey with a target duration of 5 minutes was sent to US urologists who manage patients with NMIBC. Respondents were recruited from the Sesen Bio target list based upon BCG utilization.Results: In 2022, 100 urologists who manage patients with papillary tumors and 159 urologists who manage patients with CIS tumors filled out the survey. Most (78%) were community-based urologists. Study respondents managed an average of 33 (range: 6-158) CIS patients and 44 (range: 10-200) high-grade patients with papillary disease (without CIS) over the past 6 months. Approximately 70% of physicians identified either gemcitabine (w40%) or mitomycin C (w30%) as the most often used intravesical chemotherapies for BCG unresponsive and BCG exposed groups. Most physicians reported the use of gemcitabine 2 g or mitomycin C 40 mg in a specific regimen for induction (once a week Â 6 weeks) and maintenance (once a month Â 12 months). Responses were consistent across groups of BCG therapy (adequate vs BCG-exposed). Physicians were slightly more likely to use a maintenance regimen for the adequate BCG patient. Conclusions:The most common treatments received by patients with BCG-unresponsive and BCG-exposed NMIBC were intravesical chemotherapy (single-agent gemcitabine or mitomycin C), regardless of whether CIS or papillary disease was present.

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Section: Discussionmentioning

confidence: 99%

US Clinical Practice Patterns of Intravesical Chemotherapy for Bacillus Calmette-Guérin–Unresponsive and Bacillus Calmette-Guérin–Exposed Nonmuscle-Invasive Bladder Cancer

Abou Chakra,

Shore,

Dillon

et al. 2024

Urology Practice

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“…Despite the favorable quality-of-life outcomes after radical cystectomy [56], many patients desire a bladder-sparing option in this circumstance. A study in which patients with BCG-unresponsive NMIBC were asked to make hypothetical choices regarding treatment options showed that to increase the time until radical cystectomy from 1 to 6 years, patients were willing to accept an almost 44% increased risk of cancer progression and approximately 66% increased risk of serious side effects [57]. A study of United States practice patterns showed that only 25% of surveyed urologists would consider radical cystectomy for BCG-unresponsive high-grade papillary disease.…”

Section: Bcg-unresponsivementioning

confidence: 99%

Treatment Modalities for Non-Muscle Invasive Bladder Cancer: An Updated Review

McNall,

Hooper,

Sullivan

et al. 2024

Cancers

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The landscape of treatment for non-muscle invasive bladder cancer is rapidly changing. A complete and careful transurethral resection is the mainstay of initial treatment and is followed by intravesical therapy in intermediate or high-risk cases. The standard of care is intravesical BCG. Many alternative or additive approaches to this are being explored. We divided this review into three relevant spaces to consider these novel treatment approaches: (1) low-risk disease, for which intravesical therapy is not usually considered, (2) BCG-naïve disease (i.e., considering alternatives to the standard therapy), and (3) BCG-unresponsive disease. We performed a review of published literature and summarized ongoing trials in the United States. Novel approaches that we explored include surgical techniques for resection, alterations in dwell time for intravesical therapy, delivery method and schedule of intravesical therapies, new intravesical therapy agents, and systemic therapies (especially immunotherapy). These are thoroughly outlined throughout this review article, and the numerous modalities being studied demonstrate significant promise for the future treatment of the expanding space of NMIBC.

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Selecting the right treatment: Health outcome priorities in older patients with bladder cancer

Rutten,

Al,

Festen

et al. 2024

Journal of Geriatric Oncology

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Patient Preferences for Treatment of Bacillus Calmette-Guérin–unresponsive Non–muscle-invasive Bladder Cancer: A Cross-country Choice Experiment

Cited by 6 publications

References 29 publications

US Clinical Practice Patterns of Intravesical Chemotherapy for Bacillus Calmette-Guérin–Unresponsive and Bacillus Calmette-Guérin–Exposed Nonmuscle-Invasive Bladder Cancer

US Clinical Practice Patterns of Intravesical Chemotherapy for Bacillus Calmette-Guérin–Unresponsive and Bacillus Calmette-Guérin–Exposed Nonmuscle-Invasive Bladder Cancer

Treatment Modalities for Non-Muscle Invasive Bladder Cancer: An Updated Review

Selecting the right treatment: Health outcome priorities in older patients with bladder cancer

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