Skip to main content
Top
Published in: World Journal of Urology 10/2019

01-10-2019 | Topic Paper

Emerging therapies in the management of high-risk non-muscle invasive bladder cancer (HRNMIBC)

Authors: Ryan P. Werntz, Brittany Adamic, Gary D. Steinberg

Published in: World Journal of Urology | Issue 10/2019

Login to get access

Abstract

Purpose

BCG is the gold standard in management of high-risk non-muscle invasive bladder cancer (HRNMIBC). However, in patients who fail BCG, there are few effective intrasvesical options. This review aims to explore standard and emerging therapies in HRNMIBC.

Methods

A non-systematic literature review was performed using Medline and PubMed. Literature focused on HRNMIBC and BCG failure studies, with particular attention to Phase II and III clinical trials.

Results

The only FDA approved therapy for BCG failure patients in Valrubicin. Patients with HRNMIBC and BCG failure patients are at increased risk for progression and death from bladder cancer. There are a variety of clinical trials exploring different therapeutic approaches such as immunotherapy, vaccines, radiotherapy, and gene therapy. These trials are showing some promise in the early reporting phase.

Conclusion

Despite limited intravesical treatment options in BCG failure patients, there are several promising therapies currently being developed and several with promising early results.
Literature
1.
go back to reference Siegel RL, Miller KD, Jemal A (2015) Cancer statistics, 2015. CA: A Cancer J Clin 65:5–29 Siegel RL, Miller KD, Jemal A (2015) Cancer statistics, 2015. CA: A Cancer J Clin 65:5–29
20.
go back to reference Lamm DL, Blumenstein BA, Crissman JD et al (2000) Maintenance bacillus Calmette–Guerin immunotherapy for recurrent TA, T1 and carcinoma in situ transitional cell carcinoma of the bladder: a randomized Southwest Oncology Group Study. J Urol 163:1124–1129CrossRef Lamm DL, Blumenstein BA, Crissman JD et al (2000) Maintenance bacillus Calmette–Guerin immunotherapy for recurrent TA, T1 and carcinoma in situ transitional cell carcinoma of the bladder: a randomized Southwest Oncology Group Study. J Urol 163:1124–1129CrossRef
21.
go back to reference Oddens J, Brausi M, Sylvester R et al (2013) Final results of an EORTC-GU cancers group randomized study of maintenance bacillus Calmette–Guérin in intermediate- and high-risk Ta, T1 papillary carcinoma of the urinary bladder: one-third dose versus full dose and 1 year versus 3 years of maintenance. Eur Urol 63:462–472. https://doi.org/10.1016/j.eururo.2012.10.039 CrossRefPubMed Oddens J, Brausi M, Sylvester R et al (2013) Final results of an EORTC-GU cancers group randomized study of maintenance bacillus Calmette–Guérin in intermediate- and high-risk Ta, T1 papillary carcinoma of the urinary bladder: one-third dose versus full dose and 1 year versus 3 years of maintenance. Eur Urol 63:462–472. https://​doi.​org/​10.​1016/​j.​eururo.​2012.​10.​039 CrossRefPubMed
24.
go back to reference Nadler RB, Catalona WJ, Hudson MA, Ratliff TL (1994) Durability of the tumor-free response for intravesical bacillus Calmette–Guerin therapy. J Urol 152:367–373CrossRef Nadler RB, Catalona WJ, Hudson MA, Ratliff TL (1994) Durability of the tumor-free response for intravesical bacillus Calmette–Guerin therapy. J Urol 152:367–373CrossRef
25.
go back to reference Lamm DL (1992) Long-term results of intravesical therapy for superficial bladder cancer. Urol Clin N Am 19:573–580 Lamm DL (1992) Long-term results of intravesical therapy for superficial bladder cancer. Urol Clin N Am 19:573–580
30.
go back to reference Steinberg G, Bahnson R, Brosman S et al (2000) Efficacy and safety of valrubicin for the treatment of Bacillus Calmette–Guerin refractory carcinoma in situ of the bladder. The Valrubicin Study Group. J Urol 163:761–767CrossRef Steinberg G, Bahnson R, Brosman S et al (2000) Efficacy and safety of valrubicin for the treatment of Bacillus Calmette–Guerin refractory carcinoma in situ of the bladder. The Valrubicin Study Group. J Urol 163:761–767CrossRef
32.
go back to reference Lam JS, Benson MC, O’Donnell MA et al (2003) Bacillus Calmete-Guérin plus interferon-alpha2B intravesical therapy maintains an extended treatment plan for superficial bladder cancer with minimal toxicity. Urol Oncol 21:354–360CrossRef Lam JS, Benson MC, O’Donnell MA et al (2003) Bacillus Calmete-Guérin plus interferon-alpha2B intravesical therapy maintains an extended treatment plan for superficial bladder cancer with minimal toxicity. Urol Oncol 21:354–360CrossRef
33.
go back to reference O’Donnell MA, Krohn J, DeWolf WC (2001) Salvage intravesical therapy with interferon-alpha 2b plus low dose bacillus Calmette–Guerin is effective in patients with superficial bladder cancer in whom bacillus Calmette–Guerin alone previously failed. J Urol 166:1300–1304 (discussion 1304–5) CrossRef O’Donnell MA, Krohn J, DeWolf WC (2001) Salvage intravesical therapy with interferon-alpha 2b plus low dose bacillus Calmette–Guerin is effective in patients with superficial bladder cancer in whom bacillus Calmette–Guerin alone previously failed. J Urol 166:1300–1304 (discussion 1304–5) CrossRef
34.
go back to reference Punnen SP, Chin JL, Jewett MAS (2003) Management of bacillus Calmette–Guerin (BCG) refractory superficial bladder cancer: results with intravesical BCG and Interferon combination therapy. Can J Urol 10:1790–1795PubMed Punnen SP, Chin JL, Jewett MAS (2003) Management of bacillus Calmette–Guerin (BCG) refractory superficial bladder cancer: results with intravesical BCG and Interferon combination therapy. Can J Urol 10:1790–1795PubMed
Metadata
Title
Emerging therapies in the management of high-risk non-muscle invasive bladder cancer (HRNMIBC)
Authors
Ryan P. Werntz
Brittany Adamic
Gary D. Steinberg
Publication date
01-10-2019
Publisher
Springer Berlin Heidelberg
Published in
World Journal of Urology / Issue 10/2019
Print ISSN: 0724-4983
Electronic ISSN: 1433-8726
DOI
https://doi.org/10.1007/s00345-018-2592-0

Other articles of this Issue 10/2019

World Journal of Urology 10/2019 Go to the issue