Shariat - Figure 54
Secondary Objectives: Safety analysis (N=184)
FIG. 54: In the trial of intravesical chemohyperthermia vs BCG described in the previous Figure, there was no difference in progression rates between the 2 cohorts, although the study was underpowered due to early closure. The safety analysis of 184 patients showed that the side effects were quite different, with systemic side effects more frequent in the BCG group and local side effects more frequent in the chemohyperthermia group. Nevertheless, most of these effects were Grade 2 or less.
New treatment approaches such as this will help us with management of bladder cancer in the future. Another approach being tested in clinical trials is immunotherapy with combination checkpoint inhibitors.[71] It has been suggested that this systemic therapy may help or even replace BCG in some patients, and the results of the trials are highly anticipated.
References
Arends TJ, Nativ O, Maffezzini M, et al. Results of a randomised controlled trial comparing intravesical chemohyperthermia with mitomycin C versus bacillus Calmette-Guérin for adjuvant treatment of patients with intermediate- and high-risk non-muscle-invasive bladder cancer. Eur Urol. 2016;69:1046-52 http://dx.doi.org/10.1016/j.eururo.2016.01.006
Popovic LS, Matovina-Brko G, Popovic M. Checkpoint inhibitors in the treatment of urological malignancies. ESMO Open. 2017;2:e000165 https://dx.doi.org/10.1136%2Fesmoopen-2017-000165
