Predictors of response to BCG therapy in non-muscle invasive bladder cancer

Abstract

Intravesical BCG (Bacillus Calmette–Guerin) therapy represents the therapy of choice for intermediaryand high-risk non-muscle invasive bladder cancers after transurethral resection. However, up to 40% of these patients do not show adequate response to the therapy (BCG failure) and 15% of them experience the progression of the disease to muscle-invasive bladder cancer. In such cases, radical cystectomy is indicated. Studies suggest that early radical cystectomy in patients with BCG failure is followed by better survival compared to delayed radical cystectomy. The prediction of response to BCG therapy could enable early identification of patients on which this therapy would have no effect and who should undergo early radical cystectomy.

Keywords: bladder cancer; intravesical BCG therapy; BCG failure; radical cystectomy