Combination Intravesical Therapy

Urol Clin North Am. 2020 Feb;47(1):83-91. doi: 10.1016/j.ucl.2019.09.010.

Abstract

After Bacillus Calmette-Guerin (BCG) failure, there is likely a 6- to 24-month window whereby salvage intravesical therapy might allow for preservation of the bladder without disease worsening. Combination intravesical, salvage therapy for nonmuscle invasive bladder cancer represents a promising avenue for treatment in patients unfit or unwilling to undergo cystectomy. BCG with concomitant immune stimulating agents or immune checkpoint inhibitors, combination chemotherapy regimens, such as gemcitabine and docetaxol, and novel agents currently in clinical trials provide hope for a bladder-sparing alternative for patients after BCG failure.

Keywords: BCG failure; Intravesical therapy; Nonmuscle invasive bladder cancer; Salvage therapy.

Publication types

  • Review

MeSH terms

  • Adjuvants, Immunologic
  • Administration, Intravesical
  • Antimetabolites, Antineoplastic / administration & dosage
  • Antineoplastic Agents / administration & dosage
  • BCG Vaccine / administration & dosage*
  • Deoxycytidine / administration & dosage
  • Deoxycytidine / analogs & derivatives*
  • Docetaxel / administration & dosage*
  • Drug Therapy, Combination
  • Gemcitabine
  • Humans
  • Neoplasm Invasiveness
  • Salvage Therapy / methods*
  • Treatment Outcome
  • Urinary Bladder Neoplasms / drug therapy*
  • Urinary Bladder Neoplasms / pathology

Substances

  • Adjuvants, Immunologic
  • Antimetabolites, Antineoplastic
  • Antineoplastic Agents
  • BCG Vaccine
  • Deoxycytidine
  • Docetaxel
  • Gemcitabine