PD29-03 COMPARISON OF REDUCED AND FULL BCG DOSING IN THE TREATMENT OF NON-MUSCLE INVASIVE BLADDER CANCER

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You have accessJournal of UrologyCME1 Apr 2023PD29-03 COMPARISON OF REDUCED AND FULL BCG DOSING IN THE TREATMENT OF NON-MUSCLE INVASIVE BLADDER CANCER Matthew Buck, Andrew Salib, Edward Kloniecke, Rishabh Simhal, Anne Calvaresi, Costas Lallas, Leonard Gomella, and Joseph Izes Matthew BuckMatthew Buck More articles by this author , Andrew SalibAndrew Salib More articles by this author , Edward KlonieckeEdward Kloniecke More articles by this author , Rishabh SimhalRishabh Simhal More articles by this author , Anne CalvaresiAnne Calvaresi More articles by this author , Costas LallasCostas Lallas More articles by this author , Leonard GomellaLeonard Gomella More articles by this author , and Joseph IzesJoseph Izes More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003315.03AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: The BCG shortage era has prompted the need for rethinking of the classic treatment paradigm for non-muscle invasive bladder cancer (NMIBC). Among other approaches, reduced BCG dosage protocols have been implemented across various institutions with conflicting evidence on their efficacy. We retrospectively evaluated patients at out institution with NMIBC and hypothesized that reduced dose protocols would have no significant impact on the development of BCG-relapsing disease, BCG-refractory disease, or progression to muscle invasive bladder cancer. METHODS: We evaluated 300 patients treated at our institution during the BCG shortage era (01/2017–05-2021). After obtaining institutional IRB approval, we retrospectively reviewed the charts of 300 patients and recorded pathology at diagnosis, size of tumor at initial resection, BCG induction dose (25 mg vs. 50 mg), BCG maintenance dose (25 mg vs 50 mg), pathology and date of recurrence. We evaluated baseline differences between full and reduced dose groups utilizing chi-squared tests, t-test, and ANOVA where appropriate. We then compared time to recurrence between the two dosing strategies with log-rank tests and Cox proportional hazards models. RESULTS: 203 patients with complete data were treated with BCG during the period of the study (115 high risk, 73 intermediate risk). Patients who received a lower induction dose of were more likely to develop a recurrence during the study period (log-rank test, p<0.001, Figure 1). On multivariable Cox proportional-hazards modelling, those who received reduced dose BCG were more likely to experience a recurrence during the study period (HR: 1.88, 95% CI 1.08–3.26) while adjusting for number of inductions, maintenance dosing, and AUA risk category. CONCLUSIONS: In this cohort of mainly high-risk NMIBC patients, those treated with reduced induction dose of BCG were more likely to experience a recurrence within the study period. Additional research and prospective trials can shed light on which patients are able to safely be treated with reduced dose BCG in the shortage era. Source of Funding: Institutional funding. © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e824 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Matthew Buck More articles by this author Andrew Salib More articles by this author Edward Kloniecke More articles by this author Rishabh Simhal More articles by this author Anne Calvaresi More articles by this author Costas Lallas More articles by this author Leonard Gomella More articles by this author Joseph Izes More articles by this author Expand All Advertisement PDF downloadLoading ...