AUA 2023: Does Prior Radiation Therapy Impact BCG Outcomes in High-Risk, Bladder Cancer?

By: Julia Fiederlein Cipriano
Posted: Monday, May 8, 2023

Adri Durant, MD, of the Mayo Clinic, Phoenix, and colleagues sought to examine the impact of previous pelvic radiation therapy on 5-year disease progression in patients with non–muscle-invasive bladder cancer who underwent Bacillus Calmette-Guérin (BCG) therapy. The results of this analysis, which were presented during the 2023 American Urological Association (AUA) Annual Meeting (Abstract MP08-06) and simultaneously published in The Journal of Urology, revealed that prior exposure may not be associated with worse outcomes in this clinical context.

“There is evidence that patients with bladder cancer who have previously received radiation therapy are at increased risk for poorer oncologic [outcomes] compared with [their] nonirradiated counterparts,” the investigators remarked. “Little is known about the impact of prior radiation therapy on the efficacy of BCG in patients with non–muscle-invasive bladder cancer.”

Using data from the Surveillance, Epidemiology, and End Results (SEER)-Medicare database, the investigators identified 3,442 male patients with a history of high-risk, non–muscle-invasive bladder cancer who underwent adequate BCG therapy (defined as at least five induction and two maintenance installations). The population was stratified into two cohorts: 136 individuals with a history of radiation therapy for prostate cancer and 3,306 without any prior exposure.

The risks of disease progression to chemotherapy (P = .6469), checkpoint inhibitor therapy (P = .1096), radical cystectomy (P = .2023), partial cystectomy (P = .5613), and cancer-specific death (P = .0667), as well as the combined risk of 5-year total disease progression, were not found to significantly differ between the cohorts. Based on a multivariate analysis, patients who underwent prior radiation therapy did not seem to have a higher risk of 5-year total disease progression (hazard ratio = 1.37; P = .08).

Disclosure: No disclosure information was provided.

The Journal of Urology