The efficacy of sequential intravesical gemcitabine and docetaxel versus BCG for the treatment of European association of urology very-high risk non-muscle invasive bladder cancer.

Autor: Abou Chakra M; Department of Urology, University of Iowa, Iowa City, Iowa, USA., Packiam VT; Section of Urologic Oncology, Rutgers Cancer Institute of New Jersey, New Jersey, USA., McElree IM; Carver College of Medicine, University of Iowa, Iowa City, Iowa, USA., Mott SL; Holden Comprehensive Cancer Center, University of Iowa, Iowa City, Iowa, USA., O'Donnell MA; Department of Urology, University of Iowa, Iowa City, Iowa, USA. Electronic address: michael-odonnell@uiowa.edu.
Jazyk: angličtina
Zdroj: Urologic oncology [Urol Oncol] 2024 Nov 25. Date of Electronic Publication: 2024 Nov 25.
DOI: 10.1016/j.urolonc.2024.10.012
Abstrakt: Background: The European Association of Urology (EAU) recommends early radical cystectomy (RC) for very-high-risk (VHR) nonmuscle invasive bladder cancer (NMIBC), in part due to suboptimal efficacy from BCG in this setting. Effective bladder-sparing alternatives are needed. We compared the oncological outcomes of Gemcitabine/Docetaxel (Gem/Doce) to BCG therapy in patients with VHR NMIBC.
Methods: Retrospective analysis of oncological outcomes in 129 treatment naïve VHR NMIBC patients receiving intravesical Gem/Doce (n = 65) was compared to BCG (n = 64) using Cox regression.
Results: Recurrence-free survival (RFS) at 12- and 24-months was 63% and 54% for BCG compared to 79% and 73% for Gem/Doce. Progression-free survival (PFS) at 24-months for BCG was 88% compared to 97% for Gem/Doce. Gem/Doce showed a decreased risk of tumor recurrence compared to BCG (hazard ratio, 0.55; 95% confidence interval, 0.30-0.99; P = 0.05). Moreover, patients in the Gem/Doce group were less prone to discontinue therapy (3.1% vs. 14.1%; P = 0.03).
Conclusions: Gem/Doce provides a level of efficacy in terms of RFS and PFS at least as good as BCG for treatment naïve VHR NMIBC. Prospective validation is needed.
Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
(Copyright © 2024 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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