Nonspecific immunotherapy with BCG vaccine in bladder tumors: a preliminary report

The therapeutic and prophylactic value of nonspecific immunological stimulation with BCG vaccine against papillary bladder carcinomas has been evaluated. Nine patients were treated and followed for periods of 4-9 months. Attempts have been made to compare the effects of BCG vaccine administered via dermal scarifications, or by means of direct intralesional injection into the tumor and/or its base. The initial results obtained so far show the advantages of the intralesional injection method, with perceptible regressions observed in 2 cases. Nonetheless, it is not considered an adequate procedure, since repeated cystoscopies are necessary, and it is not devoid of risks. One patient suffered a severe hypersensitivity reaction. Dermal administration proved a failure in 3 cases where it was used with curative purpose. Sufficient time has not elapsed to allow us to estimate its full prophylactic value in preventing recurrences, although as yet, none of the 4 patients who have been stimulated have shown any signs of recurrence. More time and more cases are required before one can draw valid conclusions, but we consider that dermal scarifications may be useful to patients who have undergone surgery, helping their immunological system to destroy small remnants of malignant cells in the bladder wall, the regional lymph nodes or distant structures, as well as to prevent recurrences in patients with dysplastic urothelium.