Sanjay G. Patel, MD, presented “BCG Unresponsive Disease” during the 3rd Annual International Bladder Cancer Update on January 23, 2019 in Beaver Creek, Colorado.

How to cite: Patel, Sanjay G. “BCG Unresponsive Disease” January 23, 2019. Accessed Jun 2024. https://grandroundsinurology.com/bcg-unresponsive-disease/

 

BCG Unresponsive Disease- Summary:

Sanjay G. Patel, MD, discusses various definitions of bacillus Calmette-Guérin (BCG)-unresponsive non-muscle invasive bladder cancer (NMIBC). He also outlines treatment options available for these patients and the clinical trials evaluating each approach.

Abstract:

The mainstay treatment for high-risk NMIBC relies on BCG intravesical therapy. Despite the efficacy of intravesical BCG induction and maintenance therapy, long-term, disease-free, and progression-free survival may be difficult to achieve. A subset of patients will fail BCG therapy. If left unidentified and untreated, BCG failure can be lethal.

Current European Association of Urology and American Urological Association Guidelines suggest these patients should undergo radical cystectomy with urinary diversion given the high risk for disease progression. Unfortunately, in those patients who are medically unfit or refuse cystectomy, there are no generally accepted treatment options.

This presentation will review the various definitions of BCG-unresponsive disease, including intolerant, resistant, relapsing, and refractory. The discussion will also outline treatment options available for these patients, namely valrubicin, gemcitabine, docetaxel, paclitaxel, thermochemotherapy, BCG with interferon, and other investigational agents, as well as the clinical trials evaluating each option.

About the International Bladder Cancer Update

The International Bladder Cancer Update (IBCU) is an annual one-day CME conference focused on bladder cancer treatment updates. IBCU takes place during its sister conference, the International Prostate Cancer Update (IPCU). The conference’s faculty consists of international experts, and the event caters to urologists, urologic oncologists, and other healthcare professionals. In addition to didactic lectures, IBCU features interactive discussions, a panel roundtable, debates, and case presentations. Dr. Patel presented this lecture during the 3rd IBCU in 2019. Please visit this page in order to learn more about future IBCU meetings.