Intravesical BCG+interferon-α-2b in prevention of recurrence in transitional cell carcinoma of urinary bladder

• Main Authors: Nayan K Mohanty, M N Mandal, A N Sinha, Alok K Jha
• Format: Article
• Language: English
• Published: Wolters Kluwer Medknow Publications 2000-01-01
• Series: Indian Journal of Urology
• Subjects: Immunotherapy; BCG; Interferon; Combined low Dose
• Online Access: http://www.indianjurol.com/article.asp?issn=0970-1591;year=2000;volume=16;issue=2;spage=129;epage=133;aulast=Mohanty
• ISSN: 0970-1591; 1998-3824

Bladder malignancy is the 11th most common cancer in the world with more than 2,00,000 new cases diagnosed every year 90% of these are TCC, of which 75-80% are superficial in nature. Our aim in this study was to find the efficacy, safety and cost effectiveness of a low dose intravesical imnumo-therapy with BCG (70 mg) + Interferon-α-2b in preven-tion of its recurrence and prolonging disease progression interval. Between Jan. ′94 to Dec. ′98, 100 patients with super-ficial TCC (Ta, TI) of urinary bladder with or without Tis after transurethral resection of tumor underwent intra-vesical instillation of BCG (70 ing) + Interferon-α-2b (5-million IU) weekly for 8 weeks, fortnightly for 8 weeks, monthly . for 8 weeks . followed by maintenance dose at the end of 9th, 12th, 18th & 24th months with follow-up for 60 months. Results: At the end of 60 months of follow-up 36 pa-tients (36%) showed complete response, 44 patients (44%) showed partial response, resulting in a total response rate of 80% while 20% progressed to higher stage & grade. Patients′ tolerance was good and adverse reaction was low 19%. Conclusion: This study has shown that a low dose com-bined therapy with BCG and Interferon is not only safe, well tolerated, cost effective but also highly efficient in preventing recurrences in 36%, maintaining superficial nature of the disease in another 44% with a disease pro-gression free interval of 5 years in 80% of cases.