TY - JOUR
T1 - Seminal papers in urology:
T2 - maintenance Bacillus Calmette-Guerin (BCG) immunotherapy for recurrent Ta, T1 and carcinoma in situ transitional cell carcinoma of the bladder: a randomized southwest oncology group study (SWOG-8507)
AU - Tempo, Jake
AU - Bolton, Damien
AU - O’Callaghan, Michael
PY - 2023/12
Y1 - 2023/12
N2 - The South West Oncology Group’s 2000 randomised-control trial investigated the addition of maintenance intravesical bacillus Calmette-Guerin (BCG) to non-muscle invasive urothelial carcinoma (NMIUC) treatment. The results were published when the efficacy of BCG immunotherapy maintenance was unclear. Randomisation produced two arms, each containing 192 patients assessed to be at high risk of recurrence following induction BCG therapy for NMIUC. The treatment arm went on to receive three successive weekly intravesical and percutaneous BCG administrations at three months, six months and then six monthly for three years from the start of induction therapy. Recurrence free-survival (RFS), was higher in the maintenance arm with 41% (95%CI 35–49) RFS at five years in the control arm and 60% RFS (53–67 95% CI) in the maintenance arm (p < 0.0001). Only 16% of patients in the treatment arm received all of the scheduled maintenance courses of BCG. The study’s seminal results correlate with contemporary systematic review and have guided international guidelines.
AB - The South West Oncology Group’s 2000 randomised-control trial investigated the addition of maintenance intravesical bacillus Calmette-Guerin (BCG) to non-muscle invasive urothelial carcinoma (NMIUC) treatment. The results were published when the efficacy of BCG immunotherapy maintenance was unclear. Randomisation produced two arms, each containing 192 patients assessed to be at high risk of recurrence following induction BCG therapy for NMIUC. The treatment arm went on to receive three successive weekly intravesical and percutaneous BCG administrations at three months, six months and then six monthly for three years from the start of induction therapy. Recurrence free-survival (RFS), was higher in the maintenance arm with 41% (95%CI 35–49) RFS at five years in the control arm and 60% RFS (53–67 95% CI) in the maintenance arm (p < 0.0001). Only 16% of patients in the treatment arm received all of the scheduled maintenance courses of BCG. The study’s seminal results correlate with contemporary systematic review and have guided international guidelines.
KW - BCG
KW - Bladder Cancer
KW - Randomised Controlled Trial
UR - http://www.scopus.com/inward/record.url?scp=85177588276&partnerID=8YFLogxK
U2 - 10.1186/s12894-023-01352-0
DO - 10.1186/s12894-023-01352-0
M3 - Comment/debate
C2 - 37996890
AN - SCOPUS:85177588276
SN - 1471-2490
VL - 23
JO - BMC Urology
JF - BMC Urology
IS - 1
M1 - 194
ER -