(UroToday.com) The American Urological Association (AUA) 2025 Annual Meeting, held in Las Vegas, NV, was host to a non-invasive bladder cancer interactive poster session. Dr. Kaushik Kolanukuduru presented the results of a study comparing the efficacy of Bacillus Calmette Guérin (BCG) induction with maintenance to gemcitabine + docetaxel (Gem/Doce) maintenance.
In the current BCG shortage era, intravesical Gem/Doce has emerged as a potential alternative for the adjuvant intravesical treatment of NMIBC patients. The study investigators sought to compare the outcomes of patients who received BCG induction + BCG maintenance to those who received BCG induction + Gem/Doce maintenance for NMIBC.
This study included patients with NMIBC who received BCG induction between 2018 and 2024. Patients with no evidence of recurrence after induction were offered either maintenance BCG or Gem/Doce. A 1:1 propensity-matched analysis was performed using age, sex, smoking status, tumor size, tumor pathology, and multifocality as matching variables. Any-grade recurrence-free (RFS), high-grade RFS (HG-RFS), and progression free survivals were assessed using the Kaplan-Meier method.
Of 140 patients who received maintenance therapy after BCG induction, 109 received BCG maintenance and 31 received Gem/Doce maintenance. Following 1:1 propensity matching, 29 matched patients were identified in each group. The baseline characteristics are summarized below:
Illustrated below are the propensity score-matched Kaplan-Meier curves for any-grade RFS and HG-RFS for patients receiving induction + maintenance BCG versus induction BCG + Gem/Doce maintenance:
There were no differences in any-grade or high-grade recurrence free survival between the two groups. Only one patient in the BCG induction + Gem/Doce maintenance group experienced disease progression after maintenance therapy.
Dr. Kolanukuduru concluded as follows:
- In patients receiving BCG induction for NMIBC, Gem/Doce maintenance can be used with similar efficacy to BCG maintenance
- Centers with BCG shortage may consider prioritizing BCG for induction therapy alone and using Gem/Doce for maintenance.
Presented by: Kaushik Kolanukuduru, MBBS, Research Fellow, Department of Urology, Icahn School of Medicine at Mount Sinai, New York, NY
Written by: Rashid K. Sayyid, MD, MSc – Robotic Urologic Oncology Fellow at The University of Southern California, @rksayyid on Twitter during the 2025 American Urological Association (AUA) annual meeting held in Las Vegas, NV, Saturday, April 26 - Tuesday, April 29, 2025