非筋肉侵襲性膀がんにおけるBCG不耐性 - 系統的レビュー

Claris Oh¹, Georgia Bourlotos^1,2, Michael O'Callaghan^1,3,4

¹College of Medicine and Public Health, Flinders University, Adelaide, Australia.

ANZ journal of surgery

|August 20, 2025

まとめ

BCGの不耐性により,非筋肉侵襲性膀がん患者の12. 8%が治療を中止する. 治療の成功には副作用を管理する戦略を策定することが重要です

科学分野:

泌尿器科
腫瘍学
臨床試験

背景:

内視切除は局所的な膀癌の標準です
腸内バチルス・カルメット・ゲーリン (BCG) は高度非筋肉侵襲性膀がん (NMIBC) の黄金基準です.
NMIBC患者の30〜40%は,反応の欠如,再発,または不耐性のためにBCG治療に失敗する.

研究の目的:

成人NMIBC患者におけるBCG不耐症の発生率と原因を決定する.
NMIBCのBCG治療に関連する脱落率を分析する.

主な方法:

Embase,MEDLINE,およびコクラン・セントラル・レジスター・オブ・コントロールド・トライアル (1974-2023) の体系的なレビュー.
NMIBC患者におけるBCGの中止率と理由を報告した 28件の英語研究が含まれています.
データの抽出は,体系的なレビューとメタ分析 (PRISMA) のガイドラインに従って行われました.

主要な成果:

不耐性によるBCGの離脱率は0%から52%で,概要比率は12. 8%と推定されています.
研究設計において顕著な異質性が見られた.
離脱率は用量に依存しており (3. 3% vs. 20%) BCG株によって変化していた (コナット:21.1%,パステル:2%).

結論:

BCG不耐症は,NMIBC患者で平均12. 8%の脱落率をもたらします.
治療を中止すると,疾患の進行または再発の危険性が高まります.
BCG不耐性に対する緩和策は,患者のアウトカムを改善するために必要である.

キーワード:

NMIBC について膀がん免疫療法耐性がない副作用について毒性について尿路がんバチルカルメット・ゲーリン (BCG)

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