Comparative Effectiveness of Intravesical BCG-Tice and BCG-Moreau in Patients With Non-muscle-invasive Bladder Cancer
Comparative Effectiveness of Intravesical BCG-Tice and BCG-Moreau in Patients With Non-muscle-invasive Bladder Cancer
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DOI：
10.1016/j.clgc.2019.10.021
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发表时间：
2020-02-01
影响因子：
3.2
通讯作者：
Chade, Daher C.
中科院分区：
文献类型：
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作者：
D'Andrea, David;Soria, Francesco;Chade, Daher C.
我们使用逆概率生存分析比较了卡介苗 (BCG)-Tice 与 BCG-Moreau 治疗的非肌层浸润性膀胱癌患者的肿瘤学结果，发现菌株之间的复发和无进展生存没有显着差异。然而，维持周期的使用与改善无复发和无进展生存率显着相关。鉴于 BCG 短缺，需要前瞻性设计的试验来证实这些发现。 背景：本研究的目的是比较 2 种卡介苗 (BCG) 菌株（BCG-Tice 和 BCG-Moreau）在治疗非肌层浸润性膀胱癌 (NMIBC) 中的疗效。材料和方法：我们回顾性评价了 3 个学术中心接受 BCG 治疗的 NMIBC 患者的临床数据。使用治疗加权逆概率（IPTW）调整的Kaplan-Meier曲线和Cox比例风险回归分析来比较2个治疗组中患者的无复发（RFS）和无进展生存（PFS）。此外，我们根据接受足够的卡介苗治疗、高危疾病、年龄、性别、吸烟状况、病理分期和病理分级对治疗效果进行了探索性分析。结果：共有 321 名患者（48.6%）接受了 BCG-Tice 治疗，339 名患者（51.4%）接受了 BCG-Moreau 治疗。 IPTW 调整的 Cox 比例风险回归分析未显示 BCG-Tice 和 BCG-Moreau 之间的 RFS（风险比，0.88；95% 置信区间，0.56-1.38；P = .58）或 PFS（风险比，0.55；95% 置信区间，0.25-1.21，P = .14）存在差异。在亚组分析中，我们无法确定 BCG 菌株与结果之间的关联。结论：BCG-Tice 和 BCG-Moreau 株辅助治疗 NMIBC 的 RFS 和 PFS 无差异。然而，我们证实了维持治疗对于中危和高危 NMIBC 患者实现可持续缓解的重要性。 (C) 2019 Elsevier Inc. 保留所有权利。
We compared the oncologic outcomes of patients treated with bacillus Calmette-Guerin (BCG)-Tice versus BCG-Moreau for non-muscle-invasive bladder cancer using inverse-probability survival analyses and found no significant difference in recurrence- and progression-free survival between strains. However, the use of maintenance cycles was significantly associated with improved recurrence- and progression-free survival. Prospective designed trials are required to confirm these findings in light of the BCG shortage.Background: The purpose of this study was to compare the efficacy of 2 bacillus Calmette-Guerin (BCG) strains, BCG-Tice and BCG-Moreau, in the treatment of non-muscle-invasive bladder cancer (NMIBC). Materials and Methods: We retrospectively reviewed clinical data from patients treated with BCG for NMIBC at 3 academic centers. Inverse probability of treatment weighting (IPTW)-adjusted Kaplan-Meier curves and Cox proportional hazards regression analyses were used to compare recurrence-free (RFS) and progression-free survival (PFS) of patients in the 2 treatment groups. In addition, we performed exploratory analyses of treatment effect according to the receipt of adequate BCG treatment, high-risk disease, age, gender, smoking status, pathologic stage, and pathologic grade. Results: A total of 321 (48.6%) patients were treated with BCG-Tice and 339 (51.4%) with BCG-Moreau. IPTW-adjusted Cox proportional hazard regression analysis did not show a difference in RFS (hazard ratio, 0.88; 95% confidence interval, 0.56-1.38; P = .58) or PFS (hazard ratio, 0.55; 95% confidence interval, 0.25-1.21, P = .14) between BCG-Tice and BCG-Moreau. On subgroup analyses, we could not identify an association of BCG strain with outcomes. Conclusions: There was no difference in RFS and PFS between BCG-Tice and BCG-Moreau strains in the adjuvant treatment of NMIBC. However, we confirmed the importance of maintenance therapy for achieving a sustainable response in patients with intermediate- and high-risk NMIBC. (C) 2019 Elsevier Inc. All rights reserved.