Adjuvant treatment with either chemotherapy or bacillus Calmette-Guérin (BCG) is recommended for patients with intermediate-risk (IR) non-muscle-invasive bladder cancer (NMIBC). In this multi-institutional retrospective review, we evaluated oncological outcomes for 182 patients with IR-NMIBC treated with BCG (n = 100) or intravesical sequential gemcitabine and docetaxel (Gem/Doce; n = 82).
Median follow-up was 48.6 mo (interquartile range 24.9-70.9). No patient had a previous diagnosis of high-grade disease. Recurrence rates were similar in the two treatment groups (hazard ratio [HR] 1.06, 95% confidence interval [CI] 0.65-1.73; p = 0.8). Results were consistent after adjusting for International Bladder Cancer Group (IBCG) risk subgroups, use of single-instillation postoperative chemotherapy, use of blue light cystoscopy, and receipt of maintenance therapy (HR 0.88, 95% CI 0.47-1.64; p = 0.7). Similarly, there was no difference in the rate of stage/grade progression between the treatment groups (HR 0.66, 95% CI 0.21-2.12; p = 0.5). Rates of progression to muscle-invasive disease/metastasis (2.2%) and cancer-specific mortality (1.7%) were low in the cohort. Our results support the use of Gem/Doce as an alternative to BCG in patients with IR-NMIBC. PATIENT SUMMARY: We compared cancer control outcomes for two different treatments for intermediate-risk non-muscle-invasive bladder cancer. Our results show that a chemotherapy combination of docetaxel and gemcitabine is as effective as the BCG (bacillus Calmette-Guérin) treatment traditionally used for this type of bladder cancer.
European urology oncology. 2023 Jul 18 [Epub ahead of print]
Wei Shen Tan, Ian M McElree, Facundo Davaro, Ryan L Steinberg, Kelly Bree, Neema Navai, Colin P Dinney, Michael A O'Donnell, Roger Li, Ashish M Kamat, Vignesh T Packiam
Department of Urology, University of Texas MD Anderson Cancer Center, Houston, TX, USA., Carver College of Medicine, University of Iowa, Iowa City, IA, USA., Department of Urology, Moffitt Cancer Center, Tampa, FL, USA., Department of Urology, University of Iowa, Iowa City, IA, USA., Department of Urology, University of Texas MD Anderson Cancer Center, Houston, TX, USA. Electronic address: .
PubMed http://www.ncbi.nlm.nih.gov/pubmed/37468392