scholarly journals Assessing the Feasibility of Replacing Standard-Dose Bacillus Calmette–Guérin Immunotherapy with Other Intravesical Instillation Therapies in Bladder Cancer Patients: A Network Meta-Analysis

2017 ◽  
Vol 41 (4) ◽  
pp. 1298-1312 ◽  
Author(s):  
Cheng Wu ◽  
Xunrong Zhou ◽  
Chunqing Miao ◽  
Jianzhong Zhang ◽  
Qingsheng Tang ◽  
...  
Keyword(s):  
Bladder Cancer ◽  
Tumor Recurrence ◽  
Standard Dose ◽  
Meta Analysis ◽  
Intravesical Instillation ◽  
Bacillus Calmette Guerin ◽  
Odds Ratios ◽  
Significant Difference ◽  
Intravesical Bcg ◽  
Equivalent Efficacy

Background: Bacillus Calmette–Guérin (BCG) immunotherapy plays a key role in patients with bladder cancer. The shortage of intravesical BCG has motivated researchers to seek alternatives with equivalent efficacy If other alternative intravesical agents have equivalent efficacy compared to BCG, then it may be feasible to replace standard BCG with alternative options. Methods: We searched all relevant evidence in multiple sources and key data was extracted from included studies. Conventional and network meta-analysis were conducted so that pooled odds ratios (ORs) for the event of tumor recurrence and progression can be computed. The relative efficacy of different intravesical instillation procedures was computed by pooled odds ratios and their 95% confidence or creditable intervals. Besides, several key model assumptions were evaluated in our analysis. Results: Three intravesical instillation procedures have the potential for preventing tumor recurrence: standard-dose BCG (BCG_SD), Epirubicin (EPI) and Mitomycin C (MMC) (ORs < 1). Patients with BCG SD also exhibited a decreased risk of tumor recurrence and progression compared to those with EPI. No significant difference in the risk of tumor recurrence or progression was detected between patients treated with BCG_ SD and those with low-dose BCG (BCG_LD). Results of SUCRA indicated that BCG_EPI, BCG_ MMC and BCG SD had higher rankings with respect to tumor recurrence and progression. Conclusions: BCG SD, EPI and MMC exhibited established efficacy for preventing tumor recurrence in postoperative BC patients. The efficacy of BCG may not be significantly reduced if standard dose was reduced to a lower level. However, there is no consensus suggesting that intravesical BCG with standard dose can be replaced by alternating or sequentially combined intravesical instillation therapies.

scholarly journals Disseminated Granulomatous Disease from Intravesical Instillation of Bacillus Calmette-Guerin

2018 ◽  
Vol 2018 ◽  
pp. 1-4 ◽  
Author(s):  
Sayed Ab. Reshad Ghafouri ◽  
Alexander Brun ◽  
Rohit Bhalla ◽  
Craig Margulies ◽  
Kevin Skole
Keyword(s):  
Bladder Cancer ◽  
Drug Toxicity ◽  
Standard Treatment ◽  
Superficial Bladder Cancer ◽  
Treatment Options ◽  
Intravesical Instillation ◽  
Granulomatous Disease ◽  
Bacillus Calmette Guerin ◽  
Intravesical Bcg ◽  
Bcg Instillation

Intravesical instillation of Bacillus Calmette-Guerin is one of the standard treatment options for superficial bladder cancer. While Bacillus Calmette-Guerin therapy is usually well tolerated with most patients experiencing only cystitis, in rare cases, it can lead to disseminated granulomatous disease. We present a case of a 72-year-old man with disseminated granulomatous disease from intravesical BCG instillation whose treatment was complicated by antimycobacterial drug toxicity.

scholarly journals A unique case of miliary pulmonary tuberculosis induced by bacillus Calmette-Guérin intravesical instillation with COVID-19 superinfection

2021 ◽  
Vol 25 (1) ◽  
Author(s):  
Nicolò Brandi ◽  
Laura Bartalena ◽  
Cristina Mosconi ◽  
Rita Golfieri
Keyword(s):  
Bladder Cancer ◽  
Pulmonary Tuberculosis ◽  
Miliary Tuberculosis ◽  
Pulmonary Involvement ◽  
Intravesical Instillation ◽  
Bacillus Calmette Guerin ◽  
Patient Death ◽  
Unique Case ◽  
Intravesical Bcg ◽  
Appropriate Therapy

Intravesical instillation of Bacillus Calmette-Guérin (BCG) is used as an adjuvant treatment of bladder cancer. Systemic BCG infection occurs in less than 1% of cases, and pulmonary involvement is even rarer (0.3% – 0.7%), with a favourable prognosis. A 78-year-old male developed miliary tuberculosis (TB) secondary to intravesical BCG treatment and subsequent coronavirus disease 2019 (COVID-19) superinfection that led to patient death. High awareness amongst clinicians is needed to proceed with immediate appropriate therapy in these patients, especially during the COVID-19 pandemic

scholarly journals Diagnostic Value of Telomerase Activity in Patients With Bladder Cancer: A Meta-Analysis of Diagnostic Test

2020 ◽  
Vol 10 ◽  
Author(s):  
Lei Peng ◽  
Jinze Li ◽  
Chunyang Meng ◽  
Jinming Li ◽  
Dandan Tang ◽  
...  
Keyword(s):  
Bladder Cancer ◽  
Subgroup Analysis ◽  
Meta Analysis ◽  
Negative Likelihood Ratio ◽  
High Specificity ◽  
Diagnostic Value ◽  
Telomerase Activity ◽  
Low Grade ◽  
Potential Biomarker ◽  
Significant Difference

BackgroundThis study aimed to evaluate the diagnostic value of telomerase activity (TA) for bladder cancer (BC) by meta-analysis.MethodsWe conducted a systematic search of studies published on PubMed, Embase, and Web of Science up to June 1, 2019. We used Stata 15 and Review Manager 5.3 for calculations and statistical analysis.ResultsTo evaluate the diagnostic value of TA for BC, we performed a meta-analysis on 22 studies, with a total of 2,867 individuals, including sensitivity, specificity, positive and negative likelihood ratio (PLR, NLR), diagnostic odds ratio (DOR), and 95% confidence intervals (CIs). The pooled parameters were calculated from all studies, and we found a sensitivity of 0.79 (95% CI: 0.72–0.84), a specificity of 0.91 (95% CI: 0.87–0.94), a PLR of 8.91 (95% CI: 5.91–13.43), an NLR of 0.24 (95% CI: 0.15–0.37), a DOR of 37.90 (95% CI: 23.32–61.59), and an AUC of 0.92 (95% CI: 0.90–0.94). We also conducted a subgroup analysis based on the different stages and grades of BC. Results from the subgroup analysis showed that there was no significant difference in TA in either high and low stages of BC, but that low-grade tumors had a lower TA than high-grade tumours.ConclusionsTA can be used as a potential biomarker for the diagnosis of bladder cancer with its high specificity. Rigorous and high-quality prospective studies are required to verify our conclusion.

scholarly journals Disseminated Bacillus Calmette–Guérin (BCG) infection and acute exacerbation of interstitial pneumonitis: an autopsy case report and literature review

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Gen Shimizu ◽  
Ryota Amano ◽  
Itaru Nakamura ◽  
Akane Wada ◽  
Masanobu Kitagawa ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Bladder Cancer ◽  
Acute Exacerbation ◽  
Interstitial Pneumonitis ◽  
Giant Cells ◽  
Epithelioid Cell ◽  
Bacillus Calmette Guerin ◽  
Antituberculosis Drugs ◽  
First Case ◽  
Intravesical Bcg

Abstract Background Intravesical administration of Bacillus Calmette–Guérin (BCG) has proven useful for treatment and prevention of recurrence of superficial bladder cancer and in situ carcinoma. However, fatal side effects such as disseminated infections may occur. Early diagnosis and accurate therapy for interstitial pneumonitis (IP) are important because exacerbation of IP triggered by infections is the major cause of death. Although some fatality reports have suggested newly appeared IP after intravesical BCG treatment, to our knowledge, there are no reports which have demonstrated acute exacerbation of existing IP. Moreover, autopsy is lacking in previous reports. We report the case of a patient with fatal IP exacerbation after BCG instillation and the pathological findings of the autopsy. Case presentation A 77-year-old man with a medical history of IP was referred to our hospital because of fever and malaise. He had received an intravesical injection of BCG 1 day before the admission. His fever reduced after the use of antituberculosis drugs, so he was discharged home. He was referred to our hospital again because of a high fever 7 days after discharge. On hospitalisation, he showed high fever and systemic exanthema. Hepatosplenomegaly and myelosuppression were also observed. Biopsies revealed multiple epithelioid cell granulomas with Langhans giant cells of the liver and bone marrow. Biopsy DNA analyses of Mycobacterium bovis in the bone marrow, sputum, and blood were negative. His oxygen demand worsened drastically, and the ground-glass shadow expanded on the computed tomography scan. He was diagnosed with acute exacerbation of existing IP. We recommenced the antituberculosis drugs with steroid pulse therapy, but he died on day 35 because of respiratory failure. The autopsy revealed a diffuse appearance of multiple epithelioid cell granulomas with Langhans giant cells in multiple organs, although BCG was not evident. Conclusions We report the first case of acute exacerbation of chronic IP by BCG infection. This is also the first case of autopsy of a patient with acute exacerbation of existing IP induced by intravesical BCG treatment. Whether the trigger of acute IP exacerbation is infection or hypersensitivity to BCG is still controversial, because pathological evidence confirming BCG infection is lacking. Physicians who administer BCG against bladder cancer should be vigilant for acute exacerbation of IP.

scholarly journals Bacillus Calmette-Guérin (BCG) Infection Following Intravesical BCG Administration as Adjunctive Therapy For Bladder Cancer

Medicine ◽  
2014 ◽  
Vol 93 (17) ◽  
pp. 236-254 ◽  
Author(s):  
María Asunción Pérez-Jacoiste Asín ◽  
Mario Fernández-Ruiz ◽  
Francisco López-Medrano ◽  
Carlos Lumbreras ◽  
Ángel Tejido ◽  
...  
Keyword(s):  
Bladder Cancer ◽  
Adjunctive Therapy ◽  
Bacillus Calmette Guerin ◽  
Intravesical Bcg

Prospective randomized comparison of intravesical BCG therapy with standard dose versus low doses in superficial bladder cancer

1998 ◽  
Vol 30 (1) ◽  
pp. 41-44 ◽  
Author(s):  
F. Yalçinkaya ◽  
L. Kamiş ◽  
O. Özteke ◽  
B. Günlüsoy ◽  
O. Yiĝitbasi ◽  
...  
Keyword(s):  
Bladder Cancer ◽  
Superficial Bladder Cancer ◽  
Standard Dose ◽  
Low Doses ◽  
Bcg Therapy ◽  
Intravesical Bcg ◽  
Intravesical Bcg Therapy
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