Management of bacillus Calmette-Guerin (BCG) refractory superficial XXXX : results with intravesical BCG and Interferon combination therapy.

@entity1 @entity137 @entity686 @entity5 @entity1606 @entity150
INTRODUCTION AND OBJECTIVE: BCG is the most efficacious intravesical treatment for superficial @entity150 . However, 30%-40% of @entity5 are refractory. BCG failure is an indication for cystectomy but several salvage intravesical (IVe) strategies have been proposed. Early results with reduced dose BCG in combination with @entity686 in @entity1 are currently the most promising. We have adopted this approach and now report our preliminary results. This is the first report of this salvage therapy from Canada, the birthplace of IVe BCG therapy for superficial @entity150 . METHODS: The "O'Donnell protocol" of reduced dose IVe BCG plus @entity686 was followed in 12 @entity1 with BCG refractory superficial @entity1606 . A retrospective review of the efficacy and @entity137 of the treatment was conducted. RESULTS: One year from induction therapy with salvage BCG/ @entity686 , 6 of the 12 (50%) of @entity1 were @entity5 free. Of the six recurrences, 3(50%) did not respond to the IVe therapy and had residual/recurrent @entity5 at the first follow-up visit. Risk factors for treatment failure were identified. The combinative therapy was well tolerated with minimal @entity137 compared to previous full dose BCG. CONCLUSION: Our 12 month data with reduced dose IVe BCG plus @entity686 salvage therapy for BCG refractory superficial TCC confirm previous reports of >50% complete response rates. We need longer follow up in a larger @entity1 population to determine the durability of this promising therapy in @entity1 who would otherwise undergo radical cystectomy.
