1. Intravesical immunoprophylaxis in recurrent superficial bladder cancer (stage T1): Multicenter trial comparing bacille calmette-guérin and interferon-alpha
- Author
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M. Martinez-Lasierra, O. Leiva, N. Flores, C.D. Vera-Donoso, M. Unda, J.F. Jimenez-Cruz, M. Pamplona, and L.A. Rioja-Sanz
- Subjects
Adult ,Male ,medicine.medical_specialty ,Urology ,medicine.medical_treatment ,Alpha interferon ,Antineoplastic Agents ,Interferon alpha-2 ,Gastroenterology ,Drug Administration Schedule ,law.invention ,Adjuvants, Immunologic ,Randomized controlled trial ,law ,Multicenter trial ,Internal medicine ,medicine ,Humans ,Prospective Studies ,Stage (cooking) ,Prospective cohort study ,Neoplasm Staging ,Urinary bladder ,business.industry ,Interferon-alpha ,Immunotherapy ,Middle Aged ,Recombinant Proteins ,Surgery ,Clinical trial ,Administration, Intravesical ,medicine.anatomical_structure ,Urinary Bladder Neoplasms ,BCG Vaccine ,Female ,Neoplasm Recurrence, Local ,business - Abstract
Objectives To estimate and compare recurrence rates, index of recurrence and disease-free interval in patients with superficial recurrent bladder cancer receiving bacille Calmette-Guerin (BCG) or interferon (IFN) for immunoprophylaxis. Methods One hundred twenty-two patients with recurrent superficial Stage pT1, grade 1 to 3 tumors were enrolled in a randomized, prospective, multicenter trial with two treatment arms of endovesical immunoprophylaxis: 150 mg of BCG versus 54 MU of recombinant IFN-alpha-2a. Administration was weekly during the first month, biweekly for 2 months and monthly for 9 months. Both groups were similar with regard to tumor stage, grade, size and number. Results Sixty-one patients were evaluable in the BCG group and 49 in the IFN group. Tumors recurred in 34 (69.4%) of 49 patients in the IFN group (890 months of follow-up) and in 24 (39.3%) of 61 in the BCG group (1272 months of follow-up). The total number of recurrences (28 for BCG, 47 for IFN), disease-free interval (mean 19.3 months for BCG, 15.3 months for IFN) and index of recurrence (2.2 for BCG, 5.5 for IFN) were statistically significant (P = 0.001) in favor of BCG. Progression to invasive carcinoma was similar in both study arms. Neither systemic nor local side effects were seen in the IFN group. However, the previously reported toxicity of BCG was confirmed. Conclusions According to our trial, BCG remains the most efficacious agent for immunoprophylaxis of recurrent superficial bladder tumors.
- Published
- 1997
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