Witjes - Figure 20

Dose/schedule reduction

FIG. 20:  This Figure shows the results of a large study from the European Organization for Research and Treatment of Cancer (EORTC) Genito-Urinary Group in around 1300 patients randomized to 4 different BCG treatment schedules and doses.[9]  One group was treated with 1/3 dosage over 1 year, a second group had full-dose treatment over 1 year, a third group had a 1/3 dose over 3 years, and the fourth group had full dose over 3 years.  As can be seen in the Figure, there was no significant difference in recurrence rate or disease-free survival between the 4 groups: progression rates, cancer-specific mortality, and toxicity were the same.

This significant “no difference” means that we can quite safely save some BCG without much risk of bladder cancer progression.

References

[9]

Oddens J, Brausi M, Sylvester R, et al. Final results of an EORTC-GU Cancers Group randomized study of maintenance bacillus Calmette-Guérin in intermediate- and high-risk Ta, T1 papillary carcinoma of the urinary bladder: one-third dose versus full dose and 1 year versus 3 years of maintenance. Eur Urol. 2013;63:462−72  http://dx.doi.org/10.1016/j.eururo.2012.10.039