The study was published on researchsquare.com as a preprint and has not yet been peer reviewed.
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
Transurethral tumor resection followed by intravesical BCG therapy is standard treatment for patients with high-risk NMIBC.
However, up to 40% of patients experience relapse.
Intra-arterial chemotherapy, which delivers drugs directly to the tumor, has been shown to control micrometastasis in bladder cancer.
The study suggests that add-on intra-arterial chemotherapy reduces the recurrence risk with BCG, opening new avenues of treatment.
Investigators compared outcomes in the two groups.
Over a median follow-up of about 3 years, the recurrence rate was 22.2% in the BCG plus intra-arterial chemotherapy group, vs 35.8% with BCG alone.
The progression rate was 8.9% with combination therapy, vs 24.5% with stand-alone BCG.
On multivariate analysis, BCG plus intra-arterial chemotherapy was significantly better at preventing recurrence (P = .027) and progression (P = .024).
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.
Most patients in both groups had adverse reactions to BCG. There were with no significant differences in BCG complications between the groups.
It was a retrospective study with a small number of patients.
The follow-up period was relatively short.
The study was funded by the National Natural Science Foundation of China.
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 The study has not been peer reviewed.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: firstname.lastname@example.org.
Lead image: Science Source
Cite this: Intra-Arterial Chemo Improves Outcomes in High-Risk Bladder Cancer - Medscape - Aug 22, 2022.