Evidence-based Assessment of Current and Emerging Bladder-sparing Therapies for Non-muscle-invasive Bladder Cancer After Bacillus Calmette-Guerin Therapy: A Systematic Review and Meta-analysis
European Urology Oncology, March 19, 2020
A study cowritten by Analysis Group consultants assesses the efficacy and safety evidence of current and emerging treatments for patients with non-muscle-invasive bladder cancer (NMIBC) whose cancer recurred following treatment with Bacillus Calmette-Guerin (BCG) therapy. The meta-analysis, published in European Urology Oncology, is the first to quantitatively assess and compare current and emerging treatments for NMIBC after BCG, and sheds light on the challenges of future NMIBC trials and the evolving treatment landscape of this disease.
There is no current standard of care for patients whose cancer recurs after BCG therapy. Radical cystectomy, which removes the bladder entirely, is typically recommended, yet many patients decline or are unable to receive this procedure. Multiple therapies are under investigation, but variability in efficacy and safety outcomes as well as differences in patient population definitions make evaluation difficult. This study, funded by FerGene and conducted by a team including Analysis Group Vice President Min Yang and Associate Mihaela Georgieva, was undertaken to provide a clear baseline for future clinical trials.
Dr. Yang and Dr. Georgieva supported a systematic literature review of MEDLINE, Embase, and the Cochrane Central Register of Controlled Trials (CENTRAL) from January 2007 through June 2019, and of abstracts and presentations from major conference proceedings. Data for single-arm trials were pooled using a random-effect meta-analysis with the proportions approach.
Kamat AM, Lerner SP, O’Donnell M, Georgieva MV, Yang M, Inman BA, Kassouf W, Boorjian SA, Tyson MD, Kulkarni GS, Chang SS, Konety BR, Svatek RS, Balar A, Witjes JA