Compliance With Intravesical Bacillus Calmette-Guérin Therapy for Nonmuscle-Invasive Bladder Cancer

Area of Science:

• Urology
• Oncology
• Clinical Research

Background:

• Non-muscle invasive bladder cancer (NMIBC) requires intravesical Bacillus Calmette-Guérin (BCG) therapy for treatment.
• Optimizing BCG therapy compliance is crucial for improving patient outcomes and reducing cancer recurrence.
• Factors influencing adherence to BCG treatment in NMIBC patients require further investigation.

Purpose of the Study:

• To identify demographic and clinical factors associated with non-compliance to intravesical BCG therapy in NMIBC patients.
• To analyze adherence rates to both induction and maintenance phases of BCG treatment.
• To explore the impact of clinical trial participation on BCG compliance.

Main Methods:

• Retrospective chart review of 209 NMIBC patients treated with BCG between 2012 and 2020.
• Assessment of adequate BCG receipt based on FDA guidelines for induction and SWOG protocols for maintenance.
• Statistical analysis to determine associations between compliance and patient demographics, disease risk, and clinical trial status.

Main Results:

• Adequate BCG therapy was received by 90.4% of patients.
• Male patients (82%) showed higher maintenance compliance than female patients (68%).
• Clinical trial participation (97.8%) and high-risk disease status were strongly associated with improved maintenance compliance.

Conclusions:

• High rates of BCG compliance and low recurrence (13.3%) are feasible in academic-community settings.
• Strategies to enhance BCG delivery can be informed by factors like clinical trial participation, disease risk, and patient sex.
• Optimizing BCG adherence is key to improving treatment efficacy for NMIBC.