BCG INDUCTION WITH GEMCITABINE/DOCETAXEL MAINTENANCE VS. GEMCITABINE/DOCETAXEL INDUCTION AND MAINTENANCE AS ADJUVANT THERAPY IN NON-MUSCLE INVASIVE BLADDER CANCER

• Published in: Urologic oncology 2024-03, Vol.42, p.S56-S56
• Main Authors: David, Reuben Ben, Tillu, Neeraja, Alerasool, Parissa, Mehrazin, Reza, Wiklund, Peter, Sfakianos, John P.
• Format: Article
• Language: English
• ISSN: 1078-1439; 1873-2496
• DOI: 10.1016/j.urolonc.2024.01.168

The combination of; gemcitabine and docetaxel (Gem/Doce) as intravesical chemotherapy has been considered as a possible alternative in the adjuvant setting of treating patients with non-muscle invasive bladder cancer (NIMBC), the Gem/Doce combination gained popularity in 2021 due to worldwide BCG shortage. Lately, several research articles assessed the efficacy of this therapy in different settings.; We seek to determine the efficacy of the treatment with 2 different protocols using BCG induction with Gem/Doce maintenance versus Gem/Doce induction with maintenance. Our single institution prospectively maintained database identified consecutive patients who were diagnosed with NIMBC during 2020-2023, included patients with non-muscle invasive bladder cancer, patients who had received;Gem/Doce maintenance course with either a BCG or Gem/Doce induction. Patients were stratified according to the treatment protocol. Bladder cancer risk-group stratification was performed using AUA guidelines 2016. Baseline characteristics, prior exposure to BCG, pathology, cystoscopy and cytology reports were collected from electronic medical charts. Kaplan-Mayer survival analysis was performed to detect Recurrence-free survival (RFS), study findings were reported using descriptive statistics. R programming language version 4.3;were used for all statistical analyses. A total of 55 patients were included in the study, the median age was 75 (IQR 71-81).; Eleven patients (20%) were females. The median follow-up time was 15 months (IQR 8-25), risk-group stratification yielded 2 patients with low-risk disease (4%), 18 patients with Intermediate-risk disease (33%) and 35 patients had high-risk disease (64%), CIS was present in 14% of the patients. Seven (17%) had prior BCG exposure. Overall, 12 patients (22%) had recurrences at any point. None of the patients underwent radical cystectomy. In the Gem/Doce induction + maintenance arm 2 patients (5%) developed metastatic-disease of them 1 died. RFS at 6, 12 and 18 months for the BCG induction + Gem/Doce maintenance was 100%,90% and 75% and for Gem/Doce induction + maintenance 97% and 95%; and 77% respectively. No difference in RFS was found between the treatment arms (Figure 1.). Baseline characteristics stratified according to treatment arm are presented in table 1. With the premise of alternative intravesical adjuvant therapies in patients with non-muscle invasive bladder cancer, our study results indicate the Gem/Doce maintenance ther