Mp71-15 Cancer Control Rates in Adequate Versus Inadequate Treatment With Adjuvant Immunotherapy Instillations With BCG

You have accessJournal of UrologyBladder Cancer: Non-invasive IV (MP71)1 May 2024MP71-15 CANCER CONTROL RATES IN ADEQUATE VERSUS INADEQUATE TREATMENT WITH ADJUVANT IMMUNOTHERAPY INSTILLATIONS WITH BCG Mario de Angelis, Giuseppe Basile, Pietro Scilipoti, Mattia Longoni, Chiara Re, Giulio Avesani, Riccardo Leni, Daniele Robesti, Alessandro Bertini, Leonardo Quarta, Giusy Burgio, Giuseppe Rosiello, Andrea Necchi, Daniele Raggi, Roberta Lucianò, Giorgio Gandaglia, Umberto Capitanio, Renzo Colombo, Andrea Salonia, Francesco Montorsi, Alberto Briganti, and Marco Moschini Mario de AngelisMario de Angelis , Giuseppe BasileGiuseppe Basile , Pietro ScilipotiPietro Scilipoti , Mattia LongoniMattia Longoni , Chiara ReChiara Re , Giulio AvesaniGiulio Avesani , Riccardo LeniRiccardo Leni , Daniele RobestiDaniele Robesti , Alessandro BertiniAlessandro Bertini , Leonardo QuartaLeonardo Quarta , Giusy BurgioGiusy Burgio , Giuseppe RosielloGiuseppe Rosiello , Andrea NecchiAndrea Necchi , Daniele RaggiDaniele Raggi , Roberta LucianòRoberta Lucianò , Giorgio GandagliaGiorgio Gandaglia , Umberto CapitanioUmberto Capitanio , Renzo ColomboRenzo Colombo , Andrea SaloniaAndrea Salonia , Francesco MontorsiFrancesco Montorsi , Alberto BrigantiAlberto Briganti , and Marco MoschiniMarco Moschini View All Author Informationhttps://doi.org/10.1097/01.JU.0001009548.76580.ba.15AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Current guidelines recommend adjuvant bacillus Calmette-Guérin (BCG) immunotherapy for the treatment of intermediate risk (IR) and high-risk (HR) non-muscle invasive bladder cancer (NMIBC). However, optimal response to BCG is associated with an adequate treatment according to international guidelines. We investigated the impact of inadequate treatment on the risk of recurrence and progression. METHODS: We identified 311 patients treated with transurethral resection of bladder tumor (TURBT) and diagnosed with IR and HR NMIBC in a tertiary referral centre between 2012 and 2020. Patients were divided according to adequateness of BCG treatment, defined as at least five of six instillations of induction and at least two of three instillations of maintenance, as recommended by the International Bladder Cancer Group (IBCG). Endpoint of our study was to estimate the 5-year recurrence-free survival (RFS) and 5-year progression-free survival (PFS) among patients who received adequate vs inadequate BCG therapy. Kaplan-Meyer analysis (KM) and multivariable Cox-regression (MCR) models were fitted to test the effect of BCG treatment adequateness. RESULTS: Overall, 133 (43%) patients received an inadequate treatment according to IBCG. During a median follow-up of 35 months (IQR: 19,60), 98 (31.5%) patients experienced a disease recurrence, of which 50 (51%) were treated adequately vs. 48 (49%) who were not (p=0.1). Similarly, 25 patients (8%) showed a progression to muscle-invasive disease, of which 14 (56%) were not treated adequately (p=0.2). Five-year RFS estimates were 72.3% in those who received adequate treatment vs. 58.3% in those who did not (Δ=14%, p=0.02). In MCR models, inadequate treatment independently predicted disease recurrence (HR: 2.2, 95%CI: 1.327, 3.917,p=0.003), after adjusting for age, EAU risk category, eventual concomitant carcinoma in situ at first TURBT and eventual second look. Similarly, adequately treated patients have a lower five-year PFS compared to their counterparts (90.1% vs. 86.3%, respectively,p=0.04). CONCLUSIONS: Patients with adequate BCG treatment according to IBCG have a lower risk of recurrence and progression relative to those treated inadequately. Thus, patients unable to receive adequate BCG instillations have lower cancer control rates and are more likely to undergo RC. Download PPT Source of Funding: None © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e1166 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Mario de Angelis More articles by this author Giuseppe Basile More articles by this author Pietro Scilipoti More articles by this author Mattia Longoni More articles by this author Chiara Re More articles by this author Giulio Avesani More articles by this author Riccardo Leni More articles by this author Daniele Robesti More articles by this author Alessandro Bertini More articles by this author Leonardo Quarta More articles by this author Giusy Burgio More articles by this author Giuseppe Rosiello More articles by this author Andrea Necchi More articles by this author Daniele Raggi More articles by this author Roberta Lucianò More articles by this author Giorgio Gandaglia More articles by this author Umberto Capitanio More articles by this author Renzo Colombo More articles by this author Andrea Salonia More articles by this author Francesco Montorsi More articles by this author Alberto Briganti More articles by this author Marco Moschini More articles by this author Expand All Advertisement PDF downloadLoading ...