Causes of Bacillus Calmette-Guerin Therapy Failure in Patients With Superficial Bladder Tumors

By GU Oncology Now Editors - Last Updated: January 17, 2022

Researchers examined potential causes for failure of Bacillus Calmette-Guerin (BCG) therapy in patients with non-muscle invasive bladder cancers (NMIBC), particularly those originating from the healthcare provider and/or patient. Their report, published in International Urology and Nephrology, identified potentially modifiable factors on the patient and tumor end.

Additionally, the study’s lead author, Enis Mert Yorulmaz, reported that the team “further determined that the time until micturition after BCG administration is an important parameter to be considered in the prevention of application deficiencies.”

The investigators retrospectively reviewed the demographic and histopathologic data of 115 patients who underwent transurethral resection of the bladder (TUR-B) for primary bladder tumors and who then underwent intracavitary BCG in the period after the TUR-B operation. After treatment, patients were divided into BCG-refractory and non-refractory groups for comparison.

According to the report, the extent of the tumor and the involvement of the tumor in the bladder trigone or bladder neck areas were both indicators that significantly increased the likelihood of BCG therapy failure. Micturition after instillation was significantly different between the two groups, with a shorter time until micturition in the BCG-refractory patient group “due to the tumor involvement in the trigone/bladder neck.”

Yorulmaz and the study’s contributors reemphasized the effect of tumor extent and location on BCG failure, and suggested that time until micturition after BCG administration is also a potentially effective indicator. They concluded with the recommendation that “these factors should be subjected to careful consideration during patient selection and follow-up.”