Intravesical chemotherapy and immunotherapy for superficial bladder cancer

Abstract

Both intravesical chemotherapy using anti-cancer drug and immunotherapy are standard treatment for superficial bladder tumor. The latter, intravesical immunotherapy using bacillus Calmette-Guerin(BCG), is the most clinically used cancer immunotherapy with established efficacy. The most common indication of intravesical treatment is prevention of recurrence after transurethral resection(TUR) of superficial bladder tumor. The intravesical therapy is also known to be effective in eradicating carcinoma in situ. The goal of the treatment is to prevent progression to invasive bladder cancer. Single, early instillation of anti-cancer drug after TUR is indicated in low and intermediate risk superficial bladder tumors. The treatment has proven effective but the role of maintenance chemotherapy has been controversial. Intravesical BCG therapy generally have proven more efficacious than chemotherapy, but its side-effects are more pronounced. Several meta-analyses showed that intravesical BCG therapy significantly reduce the risk of disease progression. In this review, we discuss the current status and recent investigation including meta-analysis of the intravesical treatment for superficial bladder. © 2007, THE JAPAN SOCIETY OF DRUG DELIVERY SYSTEM. All rights reserved.