To evaluate the treatment and practice pattern of patients with high-grade papillary Ta, T1 non-muscle invasive bladder cancer (NMIBC) and carcinoma in situ (CIS) in BCG unresponsive (with adequate BCG exposure=Adequate BCG) and those with less than adequate BCG exposure=BCG-Exposed.
An internet-based survey with a target duration of 5 minutes was sent to US urologists who manage patients with non-muscle invasive bladder cancer (NMIBC). Respondents were recruited from the Sesen Bio target list based upon BCG utilization.
In 2022, 100 urologists who manage patients with papillary tumors and 159 urologists who manage patients with CIS tumors filled out the survey. Most (78%) were community-based urologists. Study respondents managed an average of 33 (range: 6 to 158) CIS patients and 44 (range: 10 to 200) high-grade patients with papillary disease (without CIS) over the past 6 months. Approximately 70% of physicians identified either gemcitabine (∼40%) or mitomycin-C (∼30%) as the most often used intravesical chemotherapies for BCG unresponsive and BCG exposed groups. Most physicians reported the use of gemcitabine 2 g or mitomycin C 40 mg, in a specific regimen for induction (q weekly x 6 weeks) and maintenance (q monthly x 12 months). Responses were consistent across groups of BCG therapy (adequate vs BCG-exposed). Physicians were slightly more likely to use a maintenance regimen for the adequate BCG patient.
The most common treatments received by patients with BCG-unresponsive and BCG-exposed NMIBC were intravesical chemotherapy (single-agent gemcitabine or mitomycin C), regardless of whether CIS or papillary disease was present.
Urology practice. 2023 Oct 30 [Epub ahead of print]
Mohamad Abou Chakra, Neal D Shore, Rachelle Dillon, Michael A O'Donnell
Urology, University of Iowa Hospitals and Clinics, Iowa City, Iowa.
PubMed http://www.ncbi.nlm.nih.gov/pubmed/37903746