Prior radiation treatment for prostate cancer does not increase the risk for bladder cancer recurrence following bacillus Calmette-Guérin (BCG) induction for high-risk nonmuscle-invasive bladder cancer (NMIBC), investigators reported at the ASCO Genitourinary Cancers Symposium 2022.
“Despite known associations with history of radiation and worse oncologic outcomes in bladder cancer, our study provides preliminary evidence that BCG intravesical therapy in high-grade NMIBC remains effective in patients with prior prostate radiotherapy,” said Adri M. Durant, MD, of Mayo Clinic Arizona in Phoenix, who presented the findings. “With high BCG failure rates and current BCG shortages, this data provides reassurance that BCG therapy is being appropriately allocated to this population.”
The retrospective study included 199 patients who received at least 1 induction course of BCG for NMIBC. Of these, 23 patients had a history of prostate radiotherapy, 17 had a prior radical prostatectomy, and 159 had no prostate cancer history. The 1-year bladder cancer recurrence rates in these patients were 39.1% , 29.4%, and 42.8%, respectively. The rates of progression to MIBC were 8.7%, 0%, and 6.9%, respectively; the rates of progression to metastatic disease were 4.3%, 5.9%, and 6.9%, respectively. None of the differences in these rates among the groups were statistically significant.
Study limitations included the retrospective design, the small number of patients treated with radiation, and the lack of full radiation histories, such as dose and length of treatment. In addition, the investigators used a patient population from a single academic institution, thus limiting generalizability of the findings.
Durant AM, Chang YH, Faraj K, Tyson M. BCG administration after prior radiation treatment for prostate cancer. Presented at ASCO GU 2022; February 17-19, 2022. Abstract 482.