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The study was published on researchsquare.com as a preprint and has not yet been peer reviewed.
Key Takeaway
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Adding intra-arterial chemotherapy to bacillus Calmette-Guérin (BCG) immunotherapy decreases rates of recurrence and progression in high-risk non–muscle-invasive bladder cancer (NMIBC), with little additional toxicity.
Why This Matters
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Transurethral tumor resection followed by intravesical BCG therapy is standard treatment for patients with high-risk NMIBC.
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However, up to 40% of patients experience relapse.
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Intra-arterial chemotherapy, which delivers drugs directly to the tumor, has been shown to control micrometastasis in bladder cancer.
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The study suggests that add-on intra-arterial chemotherapy reduces the recurrence risk with BCG, opening new avenues of treatment.
Study Design
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Overall, 98 patients received intravesical BCG after resection; 45 also received four courses of intra-arterial cisplatin and epirubicin, which were delivered to local blood vessels.
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Investigators compared outcomes in the two groups.
Key Results
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Over a median follow-up of about 3 years, clopidogrel bisulfate 75 mg side effects the recurrence rate was 22.2% in the BCG plus intra-arterial chemotherapy group, vs 35.8% with BCG alone.
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The progression rate was 8.9% with combination therapy, vs 24.5% with stand-alone BCG.
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On multivariate analysis, BCG plus intra-arterial chemotherapy was significantly better at preventing recurrence (P = .027) and progression (P = .024).
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Intra-arterial chemotherapy led to adverse events in 10 patients (22%). All of the events were mild, and no patients withdrew before completing the four courses.
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Most patients in both groups had adverse reactions to BCG. There were with no significant differences in BCG complications between the groups.
Limitations
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It was a retrospective study with a small number of patients.
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The follow-up period was relatively short.
Disclosures
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The study was funded by the National Natural Science Foundation of China.
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The authors have disclosed no relevant financial relationships.
This is a summary of a preprint research study, “Intra-Arterial Chemotherapy Plus BCG, a Promising Combination Adjuvant Treatment for High-Risk NMIBC,” led by Shuhang Luo of Sun Yat-Sen University, China. The study has not been peer reviewed. The full text can be found at researchsquare.com.
M. Alexander Otto is a physician assistant with a master’s degree in medical science and a journalism degree from Newhouse. He is an award-winning medical journalist who has worked for several major news outlets before joining Medscape and also an MIT Knight Science Journalism fellow. Email: [email protected].
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