Compared Efficacy of Adjuvant Intravesical BCG-TICE vs. BCG-RIVM for High-Risk Non-Muscle Invasive Bladder Cancer (NMIBC): A Propensity Score Matched Analysis.

BCG strain BCG-RIVM BCG-TICE bladder cancer cancer-specific survival progression-free survival re-TUR recurrence-free survival

Journal

Cancers
ISSN: 2072-6694
Titre abrégé: Cancers (Basel)
Pays: Switzerland
ID NLM: 101526829

Informations de publication

Date de publication:
10 Feb 2022
Historique:
received: 06 01 2022
revised: 01 02 2022
accepted: 06 02 2022
entrez: 25 2 2022
pubmed: 26 2 2022
medline: 26 2 2022
Statut: epublish

Résumé

Intravesical immunotherapy with bacillus Calmette-Guerin (BCG) is the standard therapy for high-risk non-muscle invasive bladder cancer (NMIBC). The superiority of any BCG strain over another could not be demonstrated yet. Patients with NMIBCs underwent adjuvant induction ± maintenance schedule of intravesical immunotherapy with either BCG TICE or RIVM at two high-volume tertiary institutions. Only BCG-naïve patients and those treated with the same strain over the course of follow-up were included. One-to-one (1:1) propensity score matching (PSM) between the two cohorts was utilized to adjust for baseline demographic and tumor characteristics imbalances. Kaplan-Meier estimates and multivariable Cox regression models according to high-risk NMIBC prognostic factors were implemented to address survival differences between the strains. Sub-group analysis modeling of the influence of routine secondary resection (re-TUR) in the setting of the sole maintenance adjuvant schedule for the two strains was further performed. 852 Ta-T1 NMIBCs ( When routinely performing re-TUR followed by a maintenance BCG schedule, TICE was superior to RIVM for RFS outcomes. However, no significant differences were detected for PFS and CSS, respectively.

Sections du résumé

BACKGROUND BACKGROUND
Intravesical immunotherapy with bacillus Calmette-Guerin (BCG) is the standard therapy for high-risk non-muscle invasive bladder cancer (NMIBC). The superiority of any BCG strain over another could not be demonstrated yet.
METHODS METHODS
Patients with NMIBCs underwent adjuvant induction ± maintenance schedule of intravesical immunotherapy with either BCG TICE or RIVM at two high-volume tertiary institutions. Only BCG-naïve patients and those treated with the same strain over the course of follow-up were included. One-to-one (1:1) propensity score matching (PSM) between the two cohorts was utilized to adjust for baseline demographic and tumor characteristics imbalances. Kaplan-Meier estimates and multivariable Cox regression models according to high-risk NMIBC prognostic factors were implemented to address survival differences between the strains. Sub-group analysis modeling of the influence of routine secondary resection (re-TUR) in the setting of the sole maintenance adjuvant schedule for the two strains was further performed.
RESULTS RESULTS
852 Ta-T1 NMIBCs (
CONCLUSION CONCLUSIONS
When routinely performing re-TUR followed by a maintenance BCG schedule, TICE was superior to RIVM for RFS outcomes. However, no significant differences were detected for PFS and CSS, respectively.

Identifiants

pubmed: 35205635
pii: cancers14040887
doi: 10.3390/cancers14040887
pmc: PMC8869903
pii:
doi:

Types de publication

Journal Article

Langues

eng

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Auteurs

Francesco Del Giudice (F)

Department of Maternal-Infant and Urological Sciences, Policlinico Umberto I Hospital, "Sapienza" Rome University, 00185 Rome, Italy.
Department of Urology, Stanford Medical Center, Stanford, CA 94305, USA.

Rocco Simone Flammia (RS)

Department of Maternal-Infant and Urological Sciences, Policlinico Umberto I Hospital, "Sapienza" Rome University, 00185 Rome, Italy.

Benjamin I Chung (BI)

Department of Urology, Stanford Medical Center, Stanford, CA 94305, USA.

Marco Moschini (M)

Department of Urology, San Raffaele Hospital and Scientific Institute, 20132 Milan, Italy.

Benjamin Pradere (B)

Department of Urology, Medical University of Vienna, 1090 Vienna, Austria.

Andrea Mari (A)

Unit of Oncologic Minimally-Invasive Urology and Andrology, Department of Experimental and Clinical Medicine, Careggi Hospital, University of Florence, 50134 Florence, Italy.

Francesco Soria (F)

Urology Division, Department of Surgical Sciences, University of Studies of Torino, 10126 Turin, Italy.

Simone Albisinni (S)

Urology Department, Erasme Hospital, Université Libre de Bruxelles, 1070 Brussels, Belgium.

Wojciech Krajewski (W)

Department of Urology and Oncological Urology, Wrocław Medical University, 50-556 Wrocław, Poland.

Tomasz Szydełko (T)

Department of Urology and Oncological Urology, Wrocław Medical University, 50-556 Wrocław, Poland.

Ekaterina Laukhtina (E)

Department of Urology, Medical University of Vienna, 1090 Vienna, Austria.
Institute for Urology and Reproductive Health, Sechenov University, 19435 Moscow, Russia.

David D'Andrea (D)

Department of Urology, Medical University of Vienna, 1090 Vienna, Austria.

Andrea Gallioli (A)

Unit of Urology, Fundacio Puigvert, 08025 Barcelona, Spain.

Laura S Mertens (LS)

Department of Urology, The Netherlands Cancer Institute, 1066 Amsterdam, The Netherlands.

Martina Maggi (M)

Department of Maternal-Infant and Urological Sciences, Policlinico Umberto I Hospital, "Sapienza" Rome University, 00185 Rome, Italy.

Alessandro Sciarra (A)

Department of Maternal-Infant and Urological Sciences, Policlinico Umberto I Hospital, "Sapienza" Rome University, 00185 Rome, Italy.

Stefano Salciccia (S)

Department of Maternal-Infant and Urological Sciences, Policlinico Umberto I Hospital, "Sapienza" Rome University, 00185 Rome, Italy.

Matteo Ferro (M)

Division of Urology, European Institute of Oncology (IEO)-IRCCS, 20141 Milan, Italy.

Carlo Maria Scornajenghi (CM)

Department of Maternal-Infant and Urological Sciences, Policlinico Umberto I Hospital, "Sapienza" Rome University, 00185 Rome, Italy.

Vincenzo Asero (V)

Department of Maternal-Infant and Urological Sciences, Policlinico Umberto I Hospital, "Sapienza" Rome University, 00185 Rome, Italy.

Susanna Cattarino (S)

Department of Maternal-Infant and Urological Sciences, Policlinico Umberto I Hospital, "Sapienza" Rome University, 00185 Rome, Italy.

Mario De Angelis (M)

Department of Urology, San Raffaele Hospital and Scientific Institute, 20132 Milan, Italy.

Giovanni E Cacciamani (GE)

USC Institute of Urology, University of Southern California, Los Angeles, CA 90089, USA.

Riccardo Autorino (R)

Division of Urology, Department of Surgery, Virginia Commonwealth University, Richmond, VA 23284, USA.

Savio Domenico Pandolfo (SD)

Division of Urology, Department of Surgery, Virginia Commonwealth University, Richmond, VA 23284, USA.
Department of Neurosciences, Sciences of Reproduction, and Odontostomatology, Fderico II University, 80131 Naples, Italy.

Ugo Giovanni Falagario (UG)

Department of Neurosciences, Sciences of Reproduction, and Odontostomatology, Fderico II University, 80131 Naples, Italy.

Nicola D'Altilia (N)

Department of Urology and Renal Transplantation, Policlinico Riuniti di Foggia, University of Foggia, 71122 Foggia, Italy.

Vito Mancini (V)

Department of Urology and Renal Transplantation, Policlinico Riuniti di Foggia, University of Foggia, 71122 Foggia, Italy.

Marco Chirico (M)

Department of Urology and Renal Transplantation, Policlinico Riuniti di Foggia, University of Foggia, 71122 Foggia, Italy.

Francesco Cinelli (F)

Department of Urology and Renal Transplantation, Policlinico Riuniti di Foggia, University of Foggia, 71122 Foggia, Italy.

Carlo Bettocchi (C)

Department of Urology and Renal Transplantation, Policlinico Riuniti di Foggia, University of Foggia, 71122 Foggia, Italy.

Luigi Cormio (L)

Department of Urology and Renal Transplantation, Policlinico Riuniti di Foggia, University of Foggia, 71122 Foggia, Italy.

Giuseppe Carrieri (G)

Department of Urology and Renal Transplantation, Policlinico Riuniti di Foggia, University of Foggia, 71122 Foggia, Italy.

Ettore De Berardinis (E)

Department of Maternal-Infant and Urological Sciences, Policlinico Umberto I Hospital, "Sapienza" Rome University, 00185 Rome, Italy.

Gian Maria Busetto (GM)

Department of Urology and Renal Transplantation, Policlinico Riuniti di Foggia, University of Foggia, 71122 Foggia, Italy.

Classifications MeSH