BCG unresponsive in patients with NMIBC: what the urologists must know. A review of the current literature.

BCG unresponsive in patients with NMIBC: what the urologists must know. A review of the current literature. Minerva Urol Nefrol. 2018 Nov 07;: Authors: Moschini M, Zamboni S, Mattei A, Amparore D, Fiori C, De Dominicis C, Esperto F Abstract Transurethral resection of bladder (TURB) with adjuvant intravesical bacillus Calmette-Guerin (BCG) remains the gold standard therapy for intermediate and high risk non-muscle invasive bladder cancer (NMIBC). However, this disease is burdened with a high risk of recurrence or progression. For this reason, we sought to review and summarize the current evidence with a non-systematic Medline/Pubmed literature search, regarding optimal treatment in BCG-failure patients. Radical cystectomy (RC) should be considered as the preferred option in patients who experience a BCG-failure, especially in case of Ta or T1 high grade recurrence which occurred within 3 months of start-date of induction or in early-intermediate BCG relapsing tumors or in case of recurrence after ≥ 1 maintenance course with a maintenance exposure ≥ 6 months. However, in BCG intolerant patients and in patients unfit or who refuse RC, alternative treatments can be proposed. In particular in BCG intolerant patients a reduction of dwell-time, an increase of length of intervals between the doses, use of anti-inflammatory drugs and antibiotics can be practiced for reducing symptoms. In patients with a low-intermediate grade recurrence f...
Source: Minerva Urologica e Nefrologica - Category: Urology & Nephrology Tags: Minerva Urol Nefrol Source Type: research