Cancers (Feb 2022)
Compared Efficacy of Adjuvant Intravesical BCG-TICE vs. BCG-RIVM for High-Risk Non-Muscle Invasive Bladder Cancer (NMIBC): A Propensity Score Matched Analysis
- Francesco Del Giudice,
- Rocco Simone Flammia,
- Benjamin I. Chung,
- Marco Moschini,
- Benjamin Pradere,
- Andrea Mari,
- Francesco Soria,
- Simone Albisinni,
- Wojciech Krajewski,
- Tomasz Szydełko,
- Ekaterina Laukhtina,
- David D’Andrea,
- Andrea Gallioli,
- Laura S. Mertens,
- Martina Maggi,
- Alessandro Sciarra,
- Stefano Salciccia,
- Matteo Ferro,
- Carlo Maria Scornajenghi,
- Vincenzo Asero,
- Susanna Cattarino,
- Mario De Angelis,
- Giovanni E. Cacciamani,
- Riccardo Autorino,
- Savio Domenico Pandolfo,
- Ugo Giovanni Falagario,
- Nicola D’Altilia,
- Vito Mancini,
- Marco Chirico,
- Francesco Cinelli,
- Carlo Bettocchi,
- Luigi Cormio,
- Giuseppe Carrieri,
- Ettore De Berardinis,
- Gian Maria Busetto,
- on behalf of European Association of Urology (EAU)—Young Academic Urologists (YAU) Urothelial Cancer Working Party
Affiliations
- Francesco Del Giudice
- Department of Maternal-Infant and Urological Sciences, Policlinico Umberto I Hospital, “Sapienza” Rome University, 00185 Rome, Italy
- Rocco Simone Flammia
- Department of Maternal-Infant and Urological Sciences, Policlinico Umberto I Hospital, “Sapienza” Rome University, 00185 Rome, Italy
- Benjamin I. Chung
- Department of Urology, Stanford Medical Center, Stanford, CA 94305, USA
- Marco Moschini
- Department of Urology, San Raffaele Hospital and Scientific Institute, 20132 Milan, Italy
- Benjamin Pradere
- Department of Urology, Medical University of Vienna, 1090 Vienna, Austria
- Andrea Mari
- Unit of Oncologic Minimally-Invasive Urology and Andrology, Department of Experimental and Clinical Medicine, Careggi Hospital, University of Florence, 50134 Florence, Italy
- Francesco Soria
- Urology Division, Department of Surgical Sciences, University of Studies of Torino, 10126 Turin, Italy
- Simone Albisinni
- Urology Department, Erasme Hospital, Université Libre de Bruxelles, 1070 Brussels, Belgium
- Wojciech Krajewski
- Department of Urology and Oncological Urology, Wrocław Medical University, 50-556 Wrocław, Poland
- Tomasz Szydełko
- Department of Urology and Oncological Urology, Wrocław Medical University, 50-556 Wrocław, Poland
- Ekaterina Laukhtina
- Department of Urology, Medical University of Vienna, 1090 Vienna, Austria
- David D’Andrea
- Department of Urology, Medical University of Vienna, 1090 Vienna, Austria
- Andrea Gallioli
- Unit of Urology, Fundacio Puigvert, 08025 Barcelona, Spain
- Laura S. Mertens
- Department of Urology, The Netherlands Cancer Institute, 1066 Amsterdam, The Netherlands
- Martina Maggi
- Department of Maternal-Infant and Urological Sciences, Policlinico Umberto I Hospital, “Sapienza” Rome University, 00185 Rome, Italy
- Alessandro Sciarra
- Department of Maternal-Infant and Urological Sciences, Policlinico Umberto I Hospital, “Sapienza” Rome University, 00185 Rome, Italy
- Stefano Salciccia
- Department of Maternal-Infant and Urological Sciences, Policlinico Umberto I Hospital, “Sapienza” Rome University, 00185 Rome, Italy
- Matteo Ferro
- Division of Urology, European Institute of Oncology (IEO)-IRCCS, 20141 Milan, Italy
- Carlo Maria Scornajenghi
- Department of Maternal-Infant and Urological Sciences, Policlinico Umberto I Hospital, “Sapienza” Rome University, 00185 Rome, Italy
- Vincenzo Asero
- Department of Maternal-Infant and Urological Sciences, Policlinico Umberto I Hospital, “Sapienza” Rome University, 00185 Rome, Italy
- Susanna Cattarino
- Department of Maternal-Infant and Urological Sciences, Policlinico Umberto I Hospital, “Sapienza” Rome University, 00185 Rome, Italy
- Mario De Angelis
- Department of Urology, San Raffaele Hospital and Scientific Institute, 20132 Milan, Italy
- Giovanni E. Cacciamani
- USC Institute of Urology, University of Southern California, Los Angeles, CA 90089, USA
- Riccardo Autorino
- Division of Urology, Department of Surgery, Virginia Commonwealth University, Richmond, VA 23284, USA
- Savio Domenico Pandolfo
- Division of Urology, Department of Surgery, Virginia Commonwealth University, Richmond, VA 23284, USA
- Ugo Giovanni Falagario
- Department of Neurosciences, Sciences of Reproduction, and Odontostomatology, Fderico II University, 80131 Naples, Italy
- Nicola D’Altilia
- Department of Urology and Renal Transplantation, Policlinico Riuniti di Foggia, University of Foggia, 71122 Foggia, Italy
- Vito Mancini
- Department of Urology and Renal Transplantation, Policlinico Riuniti di Foggia, University of Foggia, 71122 Foggia, Italy
- Marco Chirico
- Department of Urology and Renal Transplantation, Policlinico Riuniti di Foggia, University of Foggia, 71122 Foggia, Italy
- Francesco Cinelli
- Department of Urology and Renal Transplantation, Policlinico Riuniti di Foggia, University of Foggia, 71122 Foggia, Italy
- Carlo Bettocchi
- Department of Urology and Renal Transplantation, Policlinico Riuniti di Foggia, University of Foggia, 71122 Foggia, Italy
- Luigi Cormio
- Department of Urology and Renal Transplantation, Policlinico Riuniti di Foggia, University of Foggia, 71122 Foggia, Italy
- Giuseppe Carrieri
- Department of Urology and Renal Transplantation, Policlinico Riuniti di Foggia, University of Foggia, 71122 Foggia, Italy
- Ettore De Berardinis
- Department of Maternal-Infant and Urological Sciences, Policlinico Umberto I Hospital, “Sapienza” Rome University, 00185 Rome, Italy
- Gian Maria Busetto
- Department of Urology and Renal Transplantation, Policlinico Riuniti di Foggia, University of Foggia, 71122 Foggia, Italy
- on behalf of European Association of Urology (EAU)—Young Academic Urologists (YAU) Urothelial Cancer Working Party
- DOI
- https://doi.org/10.3390/cancers14040887
- Journal volume & issue
-
Vol. 14,
no. 4
p. 887
Abstract
Background: Intravesical immunotherapy with bacillus Calmette–Guerin (BCG) is the standard therapy for high-risk non-muscle invasive bladder cancer (NMIBC). The superiority of any BCG strain over another could not be demonstrated yet. Methods: Patients with NMIBCs underwent adjuvant induction ± maintenance schedule of intravesical immunotherapy with either BCG TICE or RIVM at two high-volume tertiary institutions. Only BCG-naïve patients and those treated with the same strain over the course of follow-up were included. One-to-one (1:1) propensity score matching (PSM) between the two cohorts was utilized to adjust for baseline demographic and tumor characteristics imbalances. Kaplan–Meier estimates and multivariable Cox regression models according to high-risk NMIBC prognostic factors were implemented to address survival differences between the strains. Sub-group analysis modeling of the influence of routine secondary resection (re-TUR) in the setting of the sole maintenance adjuvant schedule for the two strains was further performed. Results: 852 Ta-T1 NMIBCs (n = 719, 84.4% on TICE; n = 133, 15.6% on RIVM) with a median of 53 (24–77) months of follow-up were reviewed. After PSM, no differences at 5-years RFS, PFS, and CSS at both Kaplan–Meier and Cox regression analyses were detected for the whole cohort. In the sub-group setting of full adherence to European/American Urology Guidelines (EAU/NCCN), BCG TICE demonstrated longer 5-years RFS compared to RIVM (68% vs. 43%, p = 0.008; HR: 0.45 95% CI 0.25–0.81). Conclusion: When routinely performing re-TUR followed by a maintenance BCG schedule, TICE was superior to RIVM for RFS outcomes. However, no significant differences were detected for PFS and CSS, respectively.
Keywords
