Results at 43 months' follow-up of a doubleblind, randomized, prospective clinical trial using intravesical interferon alpha-2b in the prophylaxis of stage pt1 transitional cell carcinoma of the bladder

Portillo, J.A.; Martín, Bernardo; Hernández, R.; Correas, M.; Gutiérrez, José Luis Sandoval; Valle, José del; Roca, A. Planas; Vega, A. Vega; Villanueva, A. R.; Gutiérrez, R. Martín

doi:10.1016/s0090-4295(96)00455-4

Cited by 40 publications

(15 citation statements)

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“…Jak bylo již výše popsáno, antiproliferační a imunomodulační efekt IFN-α se nabízel pro kombinaci s BCG léčbou. Klinické využití kombinace IFN-α2b a BCG bylo zpočátku zkoumáno u BCG refraktorních pa cientů a následně i u BCG naivních pa cientů [26][27][28][29][30].…”

Section: S97unclassified

Immunotherapy of Urothelial Carcinoma of the Bladder – from BCG Vaccines to Targeted Therapy

Matoušková¹

2015

Klin Onkol

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SouhrnZhoubné nádory močového měchýře postihují muže i ženy s vysokou prevalencí. Obvykle vycházejí z urotelu a více než 3/ 4 z nich bývají neinvazivní nádory močového měchýře. Základní léčebnou modalitu představuje transuretrální resekce tumoru. Její role je nezastupitelná při léčbě, ale i při stagingu nádorů močového měchýře. I u neinvazivních nádorů je standardem pokračovat lokální profylaxí s cílem snížení pravděpodobnosti rizika recidivy. Zatímco u nemocných s nízkým či středním rizikem bývá dostatečná lokální chemoprofylaxe, u vysoce rizikových neinvazivních nádorů preferujeme podání lokální imunoterapie pomocí Mycobacterium bovis bacillus Calmette-Guerin (BCG) vakcíny. U pokročilých nádorů spočívá farmakologické ovlivnění v chemoterapii samostatně nebo v kombinaci s lokoregionální léčbou. Výsledky klinických studií dokládají účinnost nových přípravků z oblasti imunoterapie i pro pokročilé ná-dory močového měchýře. Klíčová slova nádory močového měchýře -imunoterapie -BCG vakcína -kontrolní body imunitní reakce SummaryBladder cancer has high prevalence in men and women. Bladder cancer usually originates from urothelium. More than 75% of cases are classifi ed as non-muscle-invasive bladder cancer. Urothelial bladder carcinoma is usually managed by transurethral resection of the bladder tumor. Role of transurethral resection of the bladder tumor is also essential in bladder cancer staging. Local prophylaxis is used in non-muscle-invasive bladder cancer to reduce risk of recurrence. While local chemoprophylaxis is suffi cient in low and middle risk patients, intravesical instillation of Mycobacterium bovis bacillus Calmette-Guerin (BCG) is preferred in high risk bladder cancer. Chemotherapy alone or in combination with locoregional treatment is used in advanced bladder cancer. New immunotherapy modalities have proven their effi cacy in several clinical studies in advanced bladder cancer.

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Section: S97unclassified

Immunotherapy of Urothelial Carcinoma of the Bladder – from BCG Vaccines to Targeted Therapy

Matoušková¹

2015

Klin Onkol

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“…IFNs are glycoproteins that mediate host immune response in a dosedependent manner by increasing antibody responsiveness, stimulating natural killer cells, and inducing expression of class I major histocompatibility complex antigens [17]. The results of early investigations of IFN as monotherapy to prevent disease recurrence have been disappointing, demonstrating no benefit or inferior recurrence rates when compared with placebo controls [18] or other intravesical agents (BCG, MMC, MMC/IFN) [19]. In contrast, results from initial trials investigating the combination of IFN and BCG have been more promising.…”

Section: Interferonmentioning

confidence: 99%

Investigational therapies for non-muscle invasive bladder cancer

Smaldone

Casella²,

Welchons³

et al. 2010

Expert Opinion on Investigational Drugs

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Despite recent enthusiasm for novel agents, radical cystectomy remains the treatment of choice for patients with NMIBC who have failed intravesical therapy. However, evidence is accumulating that novel agents provide an efficacious alternative in patients refractory or intolerable to BCG or unfit for cystectomy. Further randomized prospective data are required to demonstrate a recurrence- and progression-free benefit compared with BCG.

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“…Furthermore, one study of IFN-α found it to be no better than water placebo at 43 months of follow-up, which suggests that it has no role in recurrent stage T1 disease [50]. However, over the subsequent decade, sufficient experience with both agents accumulated to suggest using them together as salvage therapy in patients with recurrence after intravesical BCG.…”

Section: Radical Cystectomymentioning

confidence: 99%

Management of BCG Failures in Non-Muscle-Invasive Bladder Cancer

Han

Hong

2009

Korean J Urol

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Purpose: Bacillus Calmette-Guérin (BCG) intravesical therapy is the standard treatment in high-risk patients with non-muscle-invasive bladder cancer, but a significant number of patients experience recurrence after BCG therapy. Although several treatment options are available for recurrence after BCG therapy, the optimal treatment strategy is still controversial. We reviewed current and promising treatment options after BCG failure. Materials and Methods: A search of published literature using PubMed and meeting abstracts was performed. Results: BCG failures are further subdefined as BCG refractory, BCG resistant, BCG relapsing, and BCG intolerance. Several predictors for BCG response have been studied, but prediction or stratification before therapy seems to be difficult in clinical practice. Novel biomarkers associated with immunologic mechanisms appear to be promising to predict BCG failure. Radical cystectomy is the standard treatment for BCG-refractory disease, but the timing of cystectomy is controversial. BCG maintenance or combination with interferon-α is a promising therapy for BCG resistance or relapse. Some salvage therapies or device-assisted instillations have been also promising, but the efficacy and safety of these novel therapies should be confirmed by large prospective studies before their clinical use in BCG failure. Conclusions: Patients with BCG failure are not a homogeneous group and need to be stratified. Radical cystectomy should be performed without delay in patients with BCG-refractory status, but salvage intravesical therapies may be an alternative in cases without true refractory status. Although BCG and interferon intravesical therapy is promising, more efficient salvage therapy after BCG failure is required. (Korean J Urol 2009;50:1037-1047)

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Results at 43 months' follow-up of a doubleblind, randomized, prospective clinical trial using intravesical interferon alpha-2b in the prophylaxis of stage pt1 transitional cell carcinoma of the bladder

Cited by 40 publications

References 15 publications

Immunotherapy of Urothelial Carcinoma of the Bladder – from BCG Vaccines to Targeted Therapy

Immunotherapy of Urothelial Carcinoma of the Bladder – from BCG Vaccines to Targeted Therapy

Investigational therapies for non-muscle invasive bladder cancer

Management of BCG Failures in Non-Muscle-Invasive Bladder Cancer

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