Safety and Efficacy of Intravesical Bacillus Calmette-Guérin Immunotherapy in Patients with Non-Muscle-Invasive Bladder Cancer Presenting with Asymptomatic Bacteriuria: A Systematic Review

Poletajew, Sławomir; Zapała, Piotr; Radziszewski, Piotr

doi:10.1159/000477673

Cited by 22 publications

(15 citation statements)

References 24 publications

(21 reference statements)

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“…To reduce the risk of recurrence and Urol Int 2019;102:60-68 DOI: 10.1159/000491642 progression various strategies are proposed by literature and uro-oncological guidelines [1,5]. One of them is the restaging transurethral resection of bladder tumor (re-TURB) between primary resection (TURB) and intravesical immunotherapy [6]. However, despite the well documented reTURB position in NMIBC treatment, reTURB optimal timing remains unsettled.…”

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confidence: 99%

The Optimal Timing of Restaging Resection before Introduction of Bacillus Calmette-Guerin Immunotherapy in Patients with High-Risk Non-Muscle-Invasive Bladder Cancer

et al. 2018

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Introduction: The study aimed to analyze the influence of restaging transurethral resection of bladder tumor (reTURB) timing on outcomes in patients receiving Bacillus Calmette-Guerin (BCG) immunotherapy. Material and Methods: This retrospective study enrolled 491 patients with bladder cancer receiving BCG intravesical therapy between 1998 and 2016. All patients were followed up for at least 12 months and received at least 7 BCG instillations. The patients were analyzed in terms of recurrence free, progression free, and cancer specific survival (CSS). Results: Median follow-up was 57 months (12–257 months). The risk for all analyzed clinical events was higher in patients who underwent reTURB after 6 weeks from primary TURB. After the change point of 57 days after primary resection, further delay was not associated with increased risk of recurrence and progression. The time limit for CSS was 76 days. With every 1 more day of time interval between TURB and reTURB, the risk of each clinical event in follow-up increased by 4%. Conclusions: There is no benefit of the reTURB performed after 8 weeks from primary TURB. Optimal timing of reTURB is from 2 to 6 weeks after initial TURB. However, even within this time frame, the sooner the procedure is performed, the risk of recurrence, progression, or cancer-specific death is lower.

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The Optimal Timing of Restaging Resection before Introduction of Bacillus Calmette-Guerin Immunotherapy in Patients with High-Risk Non-Muscle-Invasive Bladder Cancer

et al. 2018

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“…In this study, we found no difference between the intravesical treatment group and the no-treatment group with respect to the rate of pyuria and bacteriuria. Poletajew et al [ 20 ] have reported in their systematic review that ASBU does not negatively affect the safety and efficacy of intravesical BCG immunotherapy. The authors suggested that there is no evidence to support routine screening for and treatment of ASBU in patients scheduled for intravesical BCG instillations in those diagnosed with bladder cancer.…”

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Rate and association of lower urinary tract infection with recurrence after transurethral resection of bladder tumor

Kim

Tae

et al. 2018

Investig Clin Urol

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PurposeTo evaluate the rate of pyuria and bacteriuria after transurethral resection of bladder tumor (TURBT).Materials and MethodsWe retrospectively evaluated data obtained from 363 patients who underwent TURBT between October 2012 and December 2013 at Seoul National University Hospital. Urinalysis and urine culture were assessed at 3, 6, 12, and 24 months postoperatively. Primary endpoint was the rate of bacteriuria (≥105/mL in a midstream) and pyuria (white blood cells ≥5/high-power field).ResultsWe analyzed 306 patients who were eligible for the study. Pyuria was present in 23.5% of patients in the 3rd postoperative month and in 31.7% of patients in the 24th postoperative month. Bacteriuria was present in 1.3% of patients in the 3rd postoperative month and in 2.6% of patients in the 24th postoperative month. Among urothelial carcinoma patients (n=220), 24.1% showed pyuria and 1.8% showed bacteriuria at the 3rd postoperative month. We found that 31.8% showed pyuria and 3.2% showed bacteriuria at the 24th postoperative month. There was no significant difference in the rate of pyuria and bacteriuria between the intravesical treatment group and the no-treatment group. Multivariate analysis demonstrated that pyuria in the 3rd postoperative month (odd ratio [OR], 2.254; p=0.039), tumor multiplicity (OR, 3.331; p=0.001), and the absence of intravesical treatment (OR, 4.927; p=0.001) increases the risk of tumor recurrence.ConclusionsA significant proportion of patients showed pyuria after TURBT during the follow-up period. Additionally, presence of pyuria in the short-term follow-up period after TURBT constitutes a risk factor for recurrence of bladder cancer.

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“…As previously mentioned, BCG is considered the standard treatment for NMIBC. However, BCG immunotherapy is associated with frequent induction of adverse effects in patients (Poletajew et al, 2017 ) leading researchers to investigate novel alternatives to increase their effectiveness (Begnini et al, 2013 ). Delivery systems and nanotechnological approaches are interesting tools to improve currently available BCG therapies and prolong exposure of the bladder tissue.…”

Section: Nano-bcg: Optimizing Bcg Immunotherapy Using Nanotechnology mentioning

confidence: 99%

Nano-BCG: A Promising Delivery System for Treatment of Human Bladder Cancer

et al. 2018

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Mycobacterium bovis bacillus Calmette–Guerin (BCG) remains at the forefront of immunotherapy for treating bladder cancer patients. However, the incidence of recurrence and progression to invasive cancer is commonly observed. There are no established effective intravesical therapies available for patients, whose tumors recur following BCG treatment, representing an important unmet clinical need. In addition, there are very limited options for patients who do not respond to or tolerate chemotherapy due to toxicities, resulting in poor overall treatment outcomes. Within this context, nanotechnology is an emergent and promising tool for: (1) controlling drug release for extended time frames, (2) combination therapies due to the ability to encapsulate multiple drugs simultaneously, (3) reducing systemic side effects, (4) increasing bioavailability, (5) and increasing the viability of various routes of administration. Moreover, bladder cancer is often characterized by high mutation rates and over expression of tumor antigens on the tumor cell surface. Therapeutic targeting of these biomolecules may be improved by nanotechnology strategies. In this mini-review, we discuss how nanotechnology can help overcome current obstacles in bladder cancer treatment, and how nanotechnology can facilitate combination chemotherapeutic and BCG immunotherapies for the treatment of non-muscle invasive urothelial bladder cancer.

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Safety and Efficacy of Intravesical Bacillus Calmette-Guérin Immunotherapy in Patients with Non-Muscle-Invasive Bladder Cancer Presenting with Asymptomatic Bacteriuria: A Systematic Review

Cited by 22 publications

References 24 publications

The Optimal Timing of Restaging Resection before Introduction of Bacillus Calmette-Guerin Immunotherapy in Patients with High-Risk Non-Muscle-Invasive Bladder Cancer

The Optimal Timing of Restaging Resection before Introduction of Bacillus Calmette-Guerin Immunotherapy in Patients with High-Risk Non-Muscle-Invasive Bladder Cancer

Rate and association of lower urinary tract infection with recurrence after transurethral resection of bladder tumor

Nano-BCG: A Promising Delivery System for Treatment of Human Bladder Cancer

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