[BCG-therapy for non-muscle-invasive bladder cancer: overview of the current trends].

Abstract

Introduction: Recurrence of non-muscle-invasive bladder cancer (NMIBC) occurs in 70% of cases, and the risk of progression to muscle-invasive bladder cancer is 20%. Intravesical BCG therapy is indicated in order to increase relapse-free survival in patients with intermediate and high-risk NMIBC. We carried out a survey of Russian urologists on the use of intravesical BCG therapy in the treatment of NMIBC, and also presented the regulatory framework for the use of BCG for the treatment of bladder cancer.

Aim: To evaluate the use of intravesical BCG therapy among urologists of the Russian Society of Urology.

Results: According to the results of a survey of 145 urologists, 46 (32%) do not prescribe BCG therapy to patients with NMIBC. Most of them (63%) have more than 10 years of experience. The main reasons why urologists do not recommend BCG therapy are the lack of conditions (74%), an absence of the drug (20%), fear of adverse reactions or development of tuberculosis infection of themselves and medical staff (2%), absence of recommendations for BCG therapy from an oncological dispensary (2%). The most commonly prescribed drugs for intravesical instillation areImuron-vac (69%), Uro-BCG-medac (29%), OncoTICE BCG (2%). Only 8% of doctors did not report difficulties during therapy. The most common reason for the refusing from BCG therapy was the lack of conditions in the medical facilities.

Conclusions: According to the survey, one third of doctors do not prescribe BCG therapy due to the lack of conditions or a shortage of the drug. An increase of relapse-free survival of patients with NMIBC is possible by providing conditions for intravesical immunotherapy.