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Comparison of BCG Tokyo172 Strain Induction Therapy Between Low Dose and Standard Dose for Non-Muscle Invasive Bladder Cancer: Intravesical Instillation of BCG Tokyo172 Strain

  • 0Department of Urology, Juntendo Tokyo Koto Geriatric Medical Center, Tokyo 136-0075, Japan.
Biomedicines +

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January 25, 2025

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January 25, 2025

View abstract on PubMed

Summary

This summary is machine-generated.

Low-dose Bacillus Calmette-Guérin (BCG) therapy for bladder cancer increases recurrence risk, particularly in younger patients. Standard-dose BCG is more effective, suggesting age-related immune responses influence outcomes.

Area Of Science

  • Oncology
  • Urology
  • Immunotherapy

Background

  • Non-muscle invasive bladder cancer (NMIBC) requires effective intravesical therapies.
  • Bacillus Calmette-Guérin (BCG) is a standard treatment for NMIBC.
  • Optimizing BCG dosage is crucial for improving treatment efficacy and reducing recurrence.

Purpose Of The Study

  • To identify predictors of recurrence in NMIBC patients treated with low-dose versus standard-dose BCG.
  • To compare the efficacy of low-dose (40 mg) and standard-dose (80 mg) BCG induction therapy.

Main Methods

  • Analysis of 273 NMIBC patients receiving intravesical BCG between 2004 and 2023.
  • Kaplan-Meier analysis and log-rank tests assessed recurrence-free survival (RFS).
  • Univariate and multivariate Cox regression identified independent recurrence predictors (CUETO criteria).

Main Results

  • Older age, low BCG dose, multiple tumors (>3), and prior recurrence history predicted higher recurrence risk.
  • Recurrence rates were similar between BCG doses in older patients.
  • Younger patients showed significantly lower recurrence with standard-dose BCG compared to low-dose BCG.

Conclusions

  • Low-dose BCG induction therapy is linked to increased relapse rates versus standard doses, especially in younger NMIBC patients.
  • Age-related variations in immune response to BCG may impact recurrence patterns.
  • Standard-dose BCG appears more effective in preventing recurrence, particularly for younger individuals.

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