Mp71-16 Survey on Clinical Practice Patterns in the United States for Using Intravesical Chemotherapy in the Management of Bacillus Calmette-Guérin Unresponsive Non-Muscle Invasive Bladder Cancer

You have accessJournal of UrologyBladder Cancer: Non-invasive IV (MP71)1 May 2024MP71-16 SURVEY ON CLINICAL PRACTICE PATTERNS IN THE UNITED STATES FOR USING INTRAVESICAL CHEMOTHERAPY IN THE MANAGEMENT OF BACILLUS CALMETTE-GUÉRIN UNRESPONSIVE NON-MUSCLE INVASIVE BLADDER CANCER Mohamad Abou Chakra, Neal D. Shore, Rachelle Dillon, and Michael A. O'Donnell Mohamad Abou ChakraMohamad Abou Chakra , Neal D. ShoreNeal D. Shore , Rachelle DillonRachelle Dillon , and Michael A. O'DonnellMichael A. O'Donnell View All Author Informationhttps://doi.org/10.1097/01.JU.0001009548.76580.ba.16AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: It is unknown how patients with non-muscle-invasive bladder cancer (NMIBC) who are BCG-unresponsive are treated in a real-world setting. When giving intravesical chemotherapy to these patients, it is critical to understand the therapeutic choices that are made and if the selection of therapy is dependent on tumor type. The goal of this survey was to evaluate the treatment and practice patterns of urologists treating high-grade papillary-only tumors and CIS in the BCG-unresponsive setting. METHODS: US urologists who treat NMIBC cases were provided with a 5-minute online survey to complete. A target list of respondents was established based on their high BCG use. One survey, which was conducted from January 6–19, 2022, inquired about the treatment given to patients with CIS. The second one was fielded from April 12–18, 2022, and inquired about the treatment for patients with papillary-only tumors. The use of intravesical chemotherapy in BCG-unresponsive cases was the main focus of both surveys. RESULTS: The survey was completed by 159 and 100 urologists who managed CIS and papillary-only tumors, respectively. The majority (78%) were community-based, and slightly more than half reported that chemotherapy was their preferred course of treatment, followed by radical cystectomy (one third) and systemic immune therapy (15%). For perceived clinical benefit, the median 1-year minimum effectiveness was 35%. 40% Gemcitabine (Gem), 28% Mitomycin-C (MMC), 19% Valrubicin (Val), 8% Gemcitabine/Docetaxel (Gem/Doce), and 5% others were the rank order for CIS patients with adequate BCG. The rank order was slightly different for BCG-unresponsive papillary-only disease: Gem 49%, MMC 23%, Gem/Doce 15%, Val 11%, and other 2%. For CIS and papillary tumors with inadequate BCG exposure, a very similar profile was observed as for adequate exposure in each type (Fig. 1). CONCLUSIONS: This recent poll of US urologists revealed that intravesical single-agent chemotherapy was the most often recommended treatment for BCG-unresponsive NMIBC, with Gem or MMC making up about 70% of the chemotherapy regimens. Whether therapy was for papillary-only or CIS tumors, regardless of BCG exposure, this practice pattern remained consistent. Download PPT Source of Funding: None © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e1167 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Mohamad Abou Chakra More articles by this author Neal D. Shore More articles by this author Rachelle Dillon More articles by this author Michael A. O'Donnell More articles by this author Expand All Advertisement PDF downloadLoading ...