Bacillus Calmette-Guérin (BCG) is the only intravesical therapy shown to be associated with decreased risk of bladder cancer progression, according to a report by the Agency for Healthcare Research and Quality (AHRQ), but the researchers cautioned that the therapy was associated with a high rate of adverse events.
The Comparative Effectiveness Review, headed by Dr. Roger Chou and based on research by the Pacific Northwest Evidence-Based Practice Center (EPC) under contract to the AHRQ, was conducted as a systematic review of trials identified via electronic databases and conducted from 1990 to 2014.
BCG was associated with a higher rate of local and systemic adverse events (granulomatous cystitis or irritative symptoms in 27%-84% of patients, macroscopic hematuria in 21%-72%, and fever in 27%-44%) when compared with no intravesical therapy, the researchers wrote. BCG was associated with decreased risk of bladder cancer progression, but no intravesical agent was associated with decreased risk of all-cause or bladder cancer mortality.
In addition, fluorescent cystoscopy was associated with decreased risk of subsequent bladder recurrence, compared with white light cystoscopy, but results were inconsistent through many of the trials identified.
Read the full report here.