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Thomas Flaig, MD


Alternative to Bacillus Calmette-Guérin Under Study in Non-Muscle–Invasive Bladder Cancer

By: Kayci Reyer
Posted: Tuesday, September 6, 2022

According to research presented in The Journal of Urology, a combination treatment of gemcitabine plus docetaxel, two intravesical chemotherapies, may be effective and well tolerated in some patients with high-risk non-muscle–invasive bladder cancer. Gemcitabine plus docetaxel may prove to be an alternative treatment that is particularly important in the context of the ongoing shortage of the standard bacillus Calmette-Guérin (BCG) therapy.

“Compared to BCG, this treatment is readily available, cheap, and not subject to supply constraints,” noted Vignesh T. Packiam, MD, of the University of Iowa, and colleagues.

The retrospective study included 107 patients who received the combination of gemcitabine and docetaxel between May 2013 and April 2021. Eligible patients were BCG-naive. Following complete transurethral bladder tumor resection, patients underwent six weekly intravesical treatments of 1 g of gemcitabine and 37.5 mg of docetaxel. If no signs of disease were shown at initial follow-up, patients began 2 years of monthly maintenance therapy.

At follow-ups of 6, 12, and 24 months, the rate of recurrence-free survival was 89%, 85%, and 82%, respectively. Whether a patient had carcinoma in situ (n = 47) did not appear to have a significant impact on recurrence rates, according to the study authors. At a follow-up of 24 months, the rate of overall survival was 84%. A total of 92 adverse events occurred, with one being grade 3 or higher. Overall, four patients did not complete the full induction course. No patients experienced disease progression or disease-related death.

“These findings may serve as a benchmark for future prospective trial design assessing [gemcitabine/docetaxel] as a first-line treatment for [non-muscle–invasive bladder cancer],” concluded the authors.

Disclosure: For full disclosures of the study authors, visit

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