Bacillus Calmette-Guérin Failures and Beyond: Contemporary Management of Non-Muscle-Invasive Bladder Cancer

[摘要] In the United States, bacillus Calmette-Guérin (BCG) is the treatment most used for superficial bladder cancer. Patients with carcinoma in situ (CIS) treated with intravesical BCG plus interferon have a 60% to 70% chance of a complete and durable response if they were never treated with BCG or if they failed only 1 prior induction or relapsed more than a year from induction. Intravesical gemcitabine is safe, but its usefulness for BCG-refractory patients is unclear. Valrubicin, approved for intravesical treatment of BCG-refractory CIS of the bladder, has efficacy and acceptable toxicity. Cystectomy should be considered in high-risk, non-muscle-invasive cancer, particularly if intravesical therapy failed.

[学科分类] 基础医学

[关键词] Bladder cancer;Bacillus Calmette-Guérin;Cystectomy;Gemcitabine;Valrubicin