This study aimed to evaluate the time toxicity of intravesical BCG compared to sequential intravesical gemcitabine and docetaxel (Gem/Doce) for non-muscle-invasive bladder cancer (NMIBC).
After IRB approval, we retrospectively reviewed patients with NMIBC treated with BCG or Gem/Doce between 2022 and 2025 at our institution. Medical records were used to calculate time for intravesical therapy, office visits, transurethral resection of bladder tumour (TURBT) and emergency department encounters. Continuous variables were compared using the Wilcoxon rank sum test with Hodges-Lehmann estimates.
Of 133 patients, 86 received BCG (65%) and 47 Gem/Doce (35%). Patients with BCG were more likely treatment naïve compared to those with Gem/Doce (77% vs 55%, p = 0.018). Median time per instillation was 179 min for BCG compared to 192 min for Gem/Doce (Hodges-Lehmann shift +27 min, 95% CI 4 to 57; p = 0.02). Median TURBT time, office visit time and emergency department visit time were similar between groups (all p > 0.05). Over the first six instillations, the cumulative difference was 306 min (+5.1 h, p < 0.001).
Gem/Doce requires a greater time investment than BCG. As effective NMIBC therapies expand, time toxicity should be considered alongside oncologic outcomes.
BJUI compass. 2026 May 14*** epublish ***
Jacob Hanna, Melinda Z Fu, Berk Inan, David Guevara, Lucille Lannan, Disha Patel, Mahdi Hemmati Ghavshough, David Golombos, Thomas Jang, Saum Ghodoussipour, Vignesh T Packiam
Rutgers Robert Wood Johnson Medical School New Brunswick New Jersey USA., Section of Urologic Oncology Rutgers Cancer Institute New Brunswick New Jersey USA.