PD17-11 THE IMPACT OF DIFFERENT BCG STRAINS ON OUTCOME IN A LARGE COHORT OF T1G3 PATIENTS TREATED WITH BCG.

You have accessJournal of UrologyBladder Cancer: Non-invasive II1 Apr 2015PD17-11 THE IMPACT OF DIFFERENT BCG STRAINS ON OUTCOME IN A LARGE COHORT OF T1G3 PATIENTS TREATED WITH BCG. Paolo Gontero, Richard Sylvester, Francesca Pisano, Guido Dalbagni, Sharok Shariat, Jeffrey Karnes, Steven joniau, Vincenzo Serretta, Jouan Palou, Savino Di Stasi, Stephane Larrè, Renzo Colombo, Marek Babjuk, Per Uno Malmstrom, Jaques Irani, Nuria Malats, Jack Baniel, Tommaso Cai, Eugene Cha, Petere Ardelt, Jhon varkarakis, Riccardo Bartoletti, Marthin Sphan, and J Alfred Witjes Paolo GonteroPaolo Gontero More articles by this author , Richard SylvesterRichard Sylvester More articles by this author , Francesca PisanoFrancesca Pisano More articles by this author , Guido DalbagniGuido Dalbagni More articles by this author , Sharok ShariatSharok Shariat More articles by this author , Jeffrey KarnesJeffrey Karnes More articles by this author , Steven joniauSteven joniau More articles by this author , Vincenzo SerrettaVincenzo Serretta More articles by this author , Jouan PalouJouan Palou More articles by this author , Savino Di StasiSavino Di Stasi More articles by this author , Stephane LarrèStephane Larrè More articles by this author , Renzo ColomboRenzo Colombo More articles by this author , Marek BabjukMarek Babjuk More articles by this author , Per Uno MalmstromPer Uno Malmstrom More articles by this author , Jaques IraniJaques Irani More articles by this author , Nuria MalatsNuria Malats More articles by this author , Jack BanielJack Baniel More articles by this author , Tommaso CaiTommaso Cai More articles by this author , Eugene ChaEugene Cha More articles by this author , Petere ArdeltPetere Ardelt More articles by this author , Jhon varkarakisJhon varkarakis More articles by this author , Riccardo BartolettiRiccardo Bartoletti More articles by this author , Marthin SphanMarthin Sphan More articles by this author , and J Alfred WitjesJ Alfred Witjes More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2015.02.668AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES There are few RCT's comparing different BCG strains. As a consequence, there is limited information available on the difference in their efficacy in the treatment of patients with NMIBC. A trial from 1995 showed that an induction course BCG RIVM significantly reduced the number of recurrences compared to an induction course of BCG Tice [Vegt et al, J Urol 1995]. A recently published trial [Rentsch et al, Eur Urol 2014] also found an induction course of BCG Connaught to be significantly better in the reduction of recurrences than an induction course of BCG Tice. We retrospectively compared the outcomes after BCG Connaught and BCG Tice in a large study cohort of high risk NMIBC patients, and looked at recurrence, progression and cancer specific survival (CSS). METHODS In a large multicenter retrospective cohort of 2451 primary T1G3 patients, information on the BCG strain was available for 2099 patients: 1546 on Connaught and 553 on TICE. 765 patients received maintenance BCG, 560 (36%) on Connaught and 205 (37%) on TICE. 1334 patients (64%) did not receive maintenance. Since there are imbalances in the distribution of prognostic factors in this non randomized comparison, multivariate analyses were done to adjust for the most important variables. RESULTS When no maintenance was given, Connaught was more effective than TICE for the time to first recurrence (HR = 1.34, p=0.004) with a trend towards a longer time to death due to bladder cancer (HR = 1.46, p = 0.09). When maintenance was given, TICE was more effective than Connaught for the time to first recurrence (HR = 0.64, p=0.01) and the time to death due to bladder cancer (HR = 0.37, p = 0.04). Maintenance BCG reduced the risk of recurrence (p < 0.001) for both strains. For the time to progression, Connaught and TICE had a similar efficacy, however maintenance reduced the risk of progression compared to no maintenance only in the patients receiving TICE. CONCLUSIONS We can confirm that, when no maintenance is used, BCG Connaught results in a lower recurrence rate as compared to BCG Tice. However, the opposite is true when maintenance is given. Rentsch et al suggested that the superiority of BCG Connaught is due to a superior immunogenicity, as they demonstrated in mice. Additionally they found genetic differences that may explain the differential efficacy of the two BCG strains. This is in line with findings by Secanella et al [J Urol 2013], showing Russian and Connaught BCG strains (an evolutionary early and late substrain) to be most effective in cell proliferation inhibition and cytokine response as compared to 6 other BCG strains, amongst which Tice BCG. © 2015 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 193Issue 4SApril 2015Page: e385 Advertisement Copyright & Permissions© 2015 by American Urological Association Education and Research, Inc.MetricsAuthor Information Paolo Gontero More articles by this author Richard Sylvester More articles by this author Francesca Pisano More articles by this author Guido Dalbagni More articles by this author Sharok Shariat More articles by this author Jeffrey Karnes More articles by this author Steven joniau More articles by this author Vincenzo Serretta More articles by this author Jouan Palou More articles by this author Savino Di Stasi More articles by this author Stephane Larrè More articles by this author Renzo Colombo More articles by this author Marek Babjuk More articles by this author Per Uno Malmstrom More articles by this author Jaques Irani More articles by this author Nuria Malats More articles by this author Jack Baniel More articles by this author Tommaso Cai More articles by this author Eugene Cha More articles by this author Petere Ardelt More articles by this author Jhon varkarakis More articles by this author Riccardo Bartoletti More articles by this author Marthin Sphan More articles by this author J Alfred Witjes More articles by this author Expand All Advertisement Advertisement PDF DownloadLoading ...