title: Superficial bladder cancer: the role of interferon-alpha.
abstract: OBJECTIVE
  We evaluate the clinical experience with recombinant interferon-alpha in superficial transitional cell carcinoma and discuss the most rational use of recombinant interferon-alpha in the context of current treatment options.
  
  
  METHODS
  The available data were reviewed and discussed at a consensus conference in August 1996. The conclusions and recommendations are those of the authors based on the consensus reached at that meeting.
  
  
  RESULTS
  While bacillus Calmette-Guerin (BCG) is recognized as the most efficacious intravesical agent in the prophylaxis and treatment of superficial transitional cell carcinoma, it is associated with significant toxicities and a 20 to 40% relapse rate. Interferons, particularly recombinant interferon-alpha, have demonstrated efficacy against primary and recurrent papillary transitional cell carcinoma and carcinoma in situ with minimal toxicity, although the response and relapse rates are inferior to BCG. Intravesical recombinant interferon-alpha therapy has also produced responses in patients who failed to respond or were refractory to BCG or chemotherapy.
  
  
  CONCLUSIONS
  The clinical experience suggests that recombinant interferon-alpha has an important role in the treatment of superficial transitional cell carcinoma, particularly as second line therapy following failure of BCG or chemotherapy, and it may have synergistic effects when combined with chemotherapy or BCG. We propose a prospective randomized study comparing the efficacy of recombinant interferon-alpha, BCG and BCG plus recombinant interferon-alpha as maintenance following complete response to primary BCG therapy. The proposed study would also investigate the efficacy of BCG plus recombinant interferon-alpha as second line therapy following BCG failure. This study will be important to determine the most effective strategy to integrate recombinant interferon-alpha into current treatment options for superficial bladder cancer.
authors.affiliation: Division of Urologic Oncology, UCLA School of Medicine, Los Angeles, California, USA.
authors.forename: A S
authors.initials: AS
authors.lastname: Belldegrun
authors.forename: J R
authors.initials: JR
authors.lastname: Franklin
authors.forename: M A
authors.initials: MA
authors.lastname: O'Donnell
authors.forename: L G
authors.initials: LG
authors.lastname: Gomella
authors.forename: E
authors.initials: E
authors.lastname: Klein
authors.forename: R
authors.initials: R
authors.lastname: Neri
authors.forename: U O
authors.initials: UO
authors.lastname: Nseyo
authors.forename: T L
authors.initials: TL
authors.lastname: Ratliff
authors.forename: R D
authors.initials: RD
authors.lastname: Williams
mesh_terms: D000283:Administration, Intravesical; D002295:Carcinoma, Transitional Cell / Q000628:therapy*; D006801:Humans; D015552:Injections, Intralesional; D007273:Injections, Intramuscular; D007370:Interferon Type I / Q000627:therapeutic use*; D016032:Randomized Controlled Trials as Topic; D011994:Recombinant Proteins; D016896:Treatment Outcome; D001749:Urinary Bladder Neoplasms / Q000628:therapy*
chemical_list: D007370:Interferon Type I; D011994:Recombinant Proteins