Journal article
Factors Affecting Response to Bacillus Calmette-Guérin Plus Interferon for Urothelial Carcinoma in Situ
The Journal of urology, Vol.186(3), pp.817-823
2011
DOI: 10.1016/j.juro.2011.04.073
PMID: 21788050
Abstract
Purpose: The unpredictable behavior of carcinoma in situ and its high potential for recurrence and progression make identifying patient characteristics predicting a poor prognosis a priority. We assessed which factors affect the response to bacillus Calmette-Guérin plus interferon-α therapy in patients with urothelial carcinoma in situ.
Materials and methods: We analyzed data on a subset of 231 patients with carcinoma in situ enrolled in a multicenter, phase II trial of bacillus Calmette-Guérin plus interferon-α therapy for nonmuscle invasive bladder cancer. Analysis included patients who were bacillus Calmette-Guérin naïve and those with previous exposure to failed bacillus Calmette-Guérin therapy. We evaluated factors potentially affecting the bacillus Calmette-Guérin plus interferon-α response, including patient age, gender, tumor stage, multifocality, prior tumor stage, the previous bacillus Calmette-Guérin failure pattern, courses and maintenance, and prior chemotherapy.
Results: The complete response rate at 3 and 6 months in naïve vs previously failed bacillus Calmette-Guérin cases was 76% and 70% vs 76% and 66%, respectively. The 24-month disease-free rate was decreased in the 53 patients with a history of 2 or more failed bacillus Calmette-Guérin courses vs that in the 71 with a history of 1 failed course and bacillus Calmette-Guérin naïve patients (23% vs 57% and 60%, respectively). The 22 patients with refractory carcinoma in situ had the worst outcome of a 23% disease-free rate at 24 months while the 59 with relapse within 1 year had an intermediate outcome of 42% vs 59% in the 33 with relapse after 1 year. Patients with a history of papillary disease did better than those without such a history (p=0.019).
Conclusions: Factors associated with a poor response to bacillus Calmette-Guérin plus interferon-α therapy in patients with carcinoma in situ are prior tumor stage, 2 or more prior bacillus Calmette-Guérin failures and a bacillus Calmette-Guérin failure pattern.
Details
- Title: Subtitle
- Factors Affecting Response to Bacillus Calmette-Guérin Plus Interferon for Urothelial Carcinoma in Situ
- Creators
- Henry M ROSEVEAR - Department of Urology, University of Iowa, Iowa City, Iowa, United StatesAndrew J LIGHTFOOT - Department of Urology, University of Iowa, Iowa City, Iowa, United StatesKevin K BIRUSINGH - Department of Urology, University of Iowa, Iowa City, Iowa, United StatesJosé L MAYMI - Department of Urology, University of Iowa, Iowa City, Iowa, United StatesKenneth G NEPPLE - Department of Urology, University of Iowa, Iowa City, Iowa, United StatesMichael A O'DONNELL - Department of Urology, University of Iowa, Iowa City, Iowa, United States
- Resource Type
- Journal article
- Publication Details
- The Journal of urology, Vol.186(3), pp.817-823
- Publisher
- Elsevier; New York, NY
- DOI
- 10.1016/j.juro.2011.04.073
- PMID
- 21788050
- ISSN
- 0022-5347
- eISSN
- 1527-3792
- Language
- English
- Date published
- 2011
- Academic Unit
- Urology
- Record Identifier
- 9984051537002771
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