Very interesting paper on bladder sparing treatments
Dr. Kamat retweeted this one.
Sounds favorable to a treatment like ours. We could blow any competition on one more favorable aspect.
No wonder TLT positionn RUVIDAR as the next SOC in bladder sparing treatment!
Bladder-sparing treatments show noninferior OS vs radical cystectomy in BCG-unresponsive NMIBC
https://www.urologytimes.com/view/bladder-sparing-treatments-show-noninferior-os-vs-radical-cystectomy-in-bcg-unresponsive-nmibc
Patients who underwent RC were more likely to have T1 disease, with 52.6% of RC patients presenting with T1 disease compared with 35.0% of patients who underwent BST.
Patients who underwent bladder-sparing treatment (BST) for Bacillus Calmette-Guerin (BCG) unresponsive non-muscle invasive bladder cancer (NMIBC) were not found to have inferior long-term survival outcomes compared with those who underwent early radical cystectomy (RC). The data were presented at the 2023 American Urological Association Annual Meeting in Chicago, Illinois.
“Radical cystectomy is the recommended treatment for BCG-unresponsive non muscle invasive bladder cancer. However, a lot of patients are quite reluctant to undergo radical cystectomy, and sometimes they seek alternatives such as bladder-sparing approaches… What we wanted to evaluate is, “Are we sacrificing cancer outcomes in our attempts to preserve the bladder?” said lead author Wei Shen Tan, MD, during a presentation on the results. Tan is a urologic oncology fellow at MD Anderson Cancer Center in Houston, Texas.
In total, 118 patients who were diagnosed with BCG-unresponsive NMIBC at MD Anderson Cancer Center between January 2000 and September 2021 were retrospectively identified for analysis. Of these, 76 underwent BST and 38 underwent early RC. In the BST group, treatments included additional BCG (36.8%), BCG interferon (28.9%), gemcitabine/docetaxel (21.1%), and other (13.2%).
Patients who underwent RC were more likely to have T1 disease, with 52.6% of RC patients presenting with T1 disease compared with 35.0% of patients who underwent BST (P = .048). Further, 10.5% of patients who were treated with RC had lymphovascular invasion, compared with 0% of patients who were treated with bladder-sparing options (P = .003). Patients receiving BST had more prior BCG instillations, with 93.4% of this group having received ≥10 instillations vs 34.2% in the RC group (P < .001). Patients in the BST arm were more likely to be ex- or current smokers at 73.7% vs 50% in the RC group (P = .012).
“Our results suggest that bladder-sparing treatments may be a safe approach in selected patients. Survival outcomes were not inferior compared to early radical cystectomy. Some of our results may be useful in counseling patients and physicians and allaying fears that the bladder-sparing approach may be appropriate in selected patients,” Tan concluded.