INTRAVESICAL IMMUNOPROPHYLAXIS IN RECURRENT SUPERFICIAL BLADDER-CANCER (STAGE T1) - MULTICENTER TRIAL COMPARING BACILLE CALMETTE-GUERIN ANDINTERFERON-ALPHA

Objectives. To estimate and compare recurrence rates, index of recurre nce, and disease-free interval in patients with superficial recurrent bladder cancer receiving bacille Calmette-Guerin (BCG) or interferon ( IFN) for immunoprophylaxis. Methods. One hundred twenty-two patients w ith recurrent superficial Stage pT1, grade 1 to 3 tumors were enrolled in a randomized, prospective, multicenter trial with two treatment ar ms of endovesical immunoprophylaxis: 150 mg of BCG versus 54 MU of rec ombinant IFN-alpha-2a. Administration was weekly during the first mont h, biweekly for 2 months, and monthly for 9 months. Both groups were s imilar with regard to tumor stage, grade, size, and number. Results. S ixty-one patients were evaluable in the BCG group and 49 in the IFN gr oup. Tumors recurred in 34 (69.4%) of 49 patients in the IFN group (89 0 months of follow-up) and in 24 (39.3%) of 61 in the BCG group (1272 months of follow-up). The total number of recurrences (28 for BCG, 47 for IFN), disease-free interval (mean 19.3 months for BCG, 15.3 months for IFN), and index of recurrence (2.2 for BCG, 5.5 for IFN) were sta tistically significant (P = 0.001) in favor of BCG. Progression to inv asive carcinoma was similar in both study arms. Neither systemic nor l ocal side effects were seen in the IFN group. However, the previously reported toxicity of BCG was confirmed. Conclusions. According to our trial, BCG remains the most efficacious agent for immunoprophylaxis of recurrent superficial bladder tumors. (C) 1997, Elsevier Science Inc. All rights reserved.