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[Immunotherapy in superficial bladder carcinoma]
E Ríos González1, L Martínez-Piñeiro Lorenzo, J A Martínez-Piñeiro Caramés
1Servicio de Urología, Hospital Universitario La Paz, Paseo de la Castellano no. 261, 28046 Madrid, España.
Objective:
To review the current status of superficial bladder cancer treatment with several immune response modifiers.
Methods:
A review of the advances in the treatment of superficial bladder cancer with BCG, interferon, interleukin-2, bropirimine and keyhole-limpet hemocyanin was performed.
Results:
Treatment with BCG has been demonstrated to be superior to intravesical chemotherapy and other immune response modifiers in the trials reviewed. BCG therapy, however, carries a higher toxicity. Several trials have demonstrated that in low and medium risk patients, it is better to administer low BCG doses to reduce the toxicity. Furthermore, the trials confirm the utility of maintenance schedules with BCG.
Conclusion:
The Calmette-Guérin Bacillus is the most effective adjuvant treatment in superficial bladder cancer, especially in the high risk patients. The other immune response modifiers are an alternative to this treatment.