title: The Role of Interferon in the Management of BCG Refractory Nonmuscle Invasive Bladder Cancer.
abstract: Background. Thirty to forty percent of patients with high grade nonmuscle invasive bladder cancer (NMIBC) fail to respond to intravesical therapy with bacillus Calmette-Guerin (BCG). Interferon-α2B plus BCG has been shown to be effective in a subset of patients with NMIBC BCG refractory disease. Here we present a contemporary series on the effectiveness and safety of intravesical BCG plus interferon-α2B therapy in patients with BCG refractory NMIBC. Methods. From January of 2005 to April of 2014 we retrospectively found 44 patients who underwent induction with combination IFN/BCG for the management of BCG refractory NMIBC. A chart review was performed to assess initial pathological stage/grade, pathological stage/grade at the time of induction, time to IFN/BCG failure, pathological stage/grade at failure, postfailure therapy, and current disease state. Results. Of the 44 patients who met criteria for the analysis. High risk disease was found in 88.6% of patients at induction. The 12-month and 24-month recurrence-free survival were 38.6% and 18.2%, respectively. 25 (56.8%) ultimately had disease recurrence. Radical cystectomy was performed in 16 (36.4%) patients. Conclusion. Combination BCG plus interferon-α2B remains a reasonably safe alternative treatment for select patients with BCG refractory disease prior to proceeding to radical cystectomy.
authors.affiliation: Department of Urology, University of Pittsburgh Medical Center, 3471 5th Avenue, Suite 700 Kaufmann Building, Pittsburgh, PA 15213, USA.
authors.forename: Andres F
authors.initials: AF
authors.lastname: Correa
authors.affiliation: Department of Urology, University of Pittsburgh Medical Center, 3471 5th Avenue, Suite 700 Kaufmann Building, Pittsburgh, PA 15213, USA.
authors.forename: Katherine
authors.initials: K
authors.lastname: Theisen
authors.affiliation: Department of Urology, University of Pittsburgh Medical Center, 3471 5th Avenue, Suite 700 Kaufmann Building, Pittsburgh, PA 15213, USA.
authors.forename: Matthew
authors.initials: M
authors.lastname: Ferroni
authors.affiliation: Department of Urology, University of Pittsburgh Medical Center, 3471 5th Avenue, Suite 700 Kaufmann Building, Pittsburgh, PA 15213, USA.
authors.forename: Jodi K
authors.initials: JK
authors.lastname: Maranchie
authors.affiliation: Department of Urology, University of Pittsburgh Medical Center, 3471 5th Avenue, Suite 700 Kaufmann Building, Pittsburgh, PA 15213, USA.
authors.forename: Ronald
authors.initials: R
authors.lastname: Hrebinko
authors.affiliation: Department of Urology, University of Pittsburgh Medical Center, 3471 5th Avenue, Suite 700 Kaufmann Building, Pittsburgh, PA 15213, USA.
authors.forename: Benjamin J
authors.initials: BJ
authors.lastname: Davies
authors.affiliation: Department of Urology, University of Pittsburgh Medical Center, 3471 5th Avenue, Suite 700 Kaufmann Building, Pittsburgh, PA 15213, USA.
authors.forename: Jeffrey R
authors.initials: JR
authors.lastname: Gingrich