Abstract
Transitional cell carcinoma of the bladder is an ideal tumor for the evaluation of cancer immunotherapy. Unlike most tumors, patients with transitional cell carcinoma of the bladder typically present with localized superficial disease which can be readily resected. After tumor resection patients are generally immunologically competent and adequately nourished, but have an approximately 70% risk of tumor recurrence. Such recurrences may be due to the implantation of tumor cells released during transurethral resection. Animal models suggest that traumatized urothelium is particularly susceptible to tumor implantation. Alternatively, tumor recurrence may be due to incomplete resection of the primary tumor, growth of microscopic tumors not visible to the endoscopist, or the generation of new tumors. New tumors may result from continued physical, chemical, or biological carcinogen exposure in a susceptible host or, more likely, from the progression of malignantly transformed cells from occult to overt malignancy. Multifocal atypia, loss of blood group antigens in normal appearing urothelium, and multifocal recurrences in patients with transitional cell carcinoma suggest that malignant transformation is widespread. Such microscopic or submicroscopic disease is accessible for topical therapy. It is presumably the combination of an immunocompetent host with an accessible, antigenic, microscopic or submicroscopic malignancy which has resulted in the successful immunotherapy of bladder cancer.
Supported in part by NCI 5 ROI CA 42327.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Preview
Unable to display preview. Download preview PDF.
References
Kelly DR, Catalona WJ: BCG therapy for superficial bladder cancer. Urol Oncol, Ratliff TL, Catalona WJ (eds). Baton Rouge House Publishers, p 169, 1984
Gregg ERN: The archana of tuberculosis with a brief epidemiological history of the disease in the USA. Parts I and II. Am Rev Tuberculosis 78: 151, 1958
Gros P, Skamene M, Forget A: Cellular mechanisms of genetically controlled host resistance to mycobacterium bovis(BCG). J Immunol 131: 1966, 1983
Crispen RG: BCG vaccine in perspective. Sem oncol 1: 311, 1974
Lotte A, Wafz-Hockert O, Poisson N, Jimmy-Dumitoescu N, Verron M and Couvet E: BCG complication: estimated risks among vaccinated subjects and statisticam analysis of the main characteristics. Adv Tuberc Res 21: 107, 1984
Freund J: The mode of action of immunologic adjuvants. Adv Tuberc Res 7: 130, 1956
Biozzi G, Benacerraf B, Grumback F, et al: Etude de activité: Granulopexique du système réticulo-endothélial au cours de l’infection tuberculeuse expérimentale de la souris. Ann instit pasteur 87: 291, 1954
Bradner WT, Clarke DA, Stock CC: Stimulation of host mice defense against experimental cancer. I. Zymosan and sarcoman 180 in mice. Cane Res 18: 347, 1958
Bast Jr RC, Zbar D, Borsos T, Rapp HJ: BCG and cancer. NEJM 290: 1413, 1974
Bast Jr RC, Zbar B, Borsos T, Rapp HJ: BCG and cancer. NEJM 290: 1458, 1974
Terry WD, Rosenberg FA: Immunotherapy of human cancer. Excerpta Medica New York Proufaca, Elsevier North-Holland Inc, New York, 1982
Lamm DL, Harris SC, Gittes RF: Bacillus Calmette-Guerin and dinitrochlorobenzene immunotherapy of chmically induced bladder tumors. Invest Urol 14: 369, 1977
Dernion JB, Rammin KP, Fraser K: A bladder tumor model: response to immunotherapy. Nat Cane Inst Monograph 49: 333, 1978
Adolphs HD, Fiele J, Kiel H: Effective intralesional and systemic BCG application of a combined cyclophosphamide BCG treatment on experimental bladder cancer. Urol Res 7: 71, 1979
Soloway MS: Effectiveness of Long Term Chemotherapy and/or BCG on murine bladder cancer. Nat Cane Inst Monograph 49: 327, 1978
Morales A, Djeu J, Herberman RB: Immunization by irradiated whole cells or cell extracts against experimental bladder tumor. Invest Urol 17: 310, 1980
Pang AS, Morales A: Immunoprophylaxis of a murine bladder cancer with high dose BCG immunization. J Urol 127: 1006, 1982
Drago JR, Sipio J: Characterization of Nb Rat Bladder Cancer Model. Surg Forum 36: 654, 1985
Lamm DL, Reichert DF, Harris SC, Lucio RM: Immunotherapy of murine transitional cell carcinoma. J Urol 128: 1104, 1982
Pimm MV, Baldwin RW: Tumor models for screening immunomodulators: Suppression of tumor growth by delayed hypersensitivity reactions. Behring Inst Mitt 74: 214, 1984
Reichert DF, Lamm DL: Long term protection in bladder cancer following intralesional immunotherapy. J Urol 132: 570, 1984
Minder P: Shared antigens between animal and human tumors and micro-organisms. In BCG in cancer immunotherapy: Jamoureux G, Turcotte R, Portelance V (eds). New York: Grune and Stratton, 73–81, 1976
Winters WD, Lamm DL: Antibody responses to bacillus Calmette-Guerin immunotherapy in bladder cancer patients. Cane Res 41: 2672, 1981
Winters WD, Lamm DL: BCG-induced circulating interferon, antibody, and immune complexes in bladder cancer patients during immunotherapy. 13th Int Cancer Congress 13: 313 (1775), 1982
Lamm DL: BCG immunotherapy in bladder cancer. J Urol 134: 40, 1985
Kelley DR, Lage J, Bauer WC, Catalona WJ, Ratliff TL: Prognostic value of PPD skin test and granuloma formation in patients treated with intravesical BCG. J Urol (In press)
Netto Jr NR, Lemos CG: A comparison of treatment methods for prophylaxus of recurrent superficial bladder tumors. J Urol 129: 33, 1983
Thatcher N, Crowther D: Changes in non-specific lymphoid (NK, K, T cell) cytotoxicity following BCG immunizations of healthy subjets. Cane Immunol Immunother 5: 105, 1978
Antonaci S, Ticcinno A, Lucivero G, Miglietta A, Ticcininno A, Bonoma L: The effect of BCG immunotherapy on cell media and cytotoxicity in bladder cancer patients following surgical treatment. Tumori 67: 177, 1981
Davies M: Bacillus Calmette-Guerin as an antitumor agent. The interaction with cells of the mammalian immune system. Biochem Biophys Acta 651: 143, 1982
Davies M, Sabbadini E: Mechanisms of BCG Action. Cancer Immunol Immunother 14: 46, 1982
Morales A, Eidinger D, Bruce AW: Intracavitary bacillus Calmette-Guerin in the treatment of superficial bladder tumors. J Urol 116: 180, 1976
Lamm DL, Thor DE, Harris SC, Reyna JA, Stogdill VD, Radwin HM: Bacillus Calmette-Guerin immunotherapy of superficial bladder cancer. J Urol 124: 38, 1980
Camacho F, Pinsky CM, Kerr D, Braun Jr DW, Whitmore Jr WF, and Oettgen HF: Treatment of superficial bladder cancer with intravesical BCG in immunotherapy of human cancer. Terry WT, Rosenber SA. (eds). Elsevier, North Holland, New York, p 309, 1982
Herr HW, Pinsky CM, Whitmore Jr WF, Oettgen HF, Melamed MR: Intravesical bacillus Calmette-Guerin (BCG) therapy of superficial bladder tumors. Abstract 307, Am Urol Assoc 78: 1983
Martinez-Peneiro JA: BCG Vaccine in the treatment of non-infiltrating papillary tumors of the bladder. In: Bladder Tumors and Other Topics in Urologie Oncology, Pavone-Macabew M, Smith PH, Edsmyr F (eds). Plenum Press, New York, p 173, 1980
Brosman SA: Experience with bacillus Calmette-Guerin in patients with superficial bladder cancer. J Urol 128: 27, 1982
Adolphs HD, Bastian HP: Chemoimmune prophylaxis of superficial bladder tumors. J Urol 129: 29, 1983
Babayan RK, Krane RS: Intravesical BCG for superficial bladder cancer. Abstract 393. Am Urol Assoc, 80th Ann Mthn., Atlanta, Ga, May 1985
DeKernion JB, Huang MY, Lindner A, Smith RB, Kaufman J J: The Management of superficial bladder tumors and carcinoma in situ with intravesical bacillus Calmette-Guerin. J Urol 133: 598, 1985
Haaff EO, Kelley DR, Dresner SM, Ratliff TL, Catalona WJ: Results of retreatment with intravesical BCG therapy for patients failing the initial BCG course. Abstract 289. Am Urik Assoc 80th Ann Mtng, Atlanta, Ga, May 1985
Schellhammer PF, Ladaga LE: Bacillus Calmette-Guerin for therapy of superficial transitional cell carcinoma of the bladder. J Urol 135: 261, 1986
Flamm J, Grof F: Adjuvant local immunotherapy with bacillus Calmette-Guerin (BCG) in treatment of urothelial carcinoma of the urinary bladder. Wien Med Wochenschr 131: 501, 1981
Stober U, Peters HH: BCG-immunotherapie zur rezidiuphylaxe bein harnblasenkarzinom. Therapiewoche 30: 6067, 1980
Douville Y, Pelouze G, Roy R, Charrois R, Kibrite A, Martin M, Dionne L, Coulonval L, Robinson J: Recurrent bladder papillomata treated with bacillus Calmette-Guerin: a preliminary report (Phase I Trial). Cancer Treat Rep 62: 551, 1978
Morales A, Ottenhof P, Emerson L: Treatment of residual, non-infiltrating bladder cancer with bacillus Calmette-Guerin. J Urol 125: 649, 1981
Lamm DL, Thor DE, Stogdill VD, Radwin HM: Bladder cancer immunotherapy. J Urol 128: 931, 1982
Kojima H, Ishida Y, Mori C: Eradication of superficial transitional cell carcinoma of the bladder by intravesical instillation of bacillus Calmette-Guerin (BCG). Am Urol Assoc 80th Ann Mtng, Atlante, Ga, p 212, abstract 295, May 1985
Morales A: Treatment of carcinoma in situ of the bladder with BCG. A Phase II Trial. Cancer Immunol Immunother 9: 69, 1980
Brosman S: The Use of Bacillus Calmette-Guerin in the therapy of bladder carcinoma in situ. J Urol 134: 36, 1985
Lamm DL, Crawford ED: BCG Versus adriamycin in bladder cancer: a southwest oncology group study. Proc ASCO 4: 109-(c424), March 1985
Herr HW, Pinsky CM, Whitman Jr WF, Oettgen HF, Melamed MR: Effect of intravesical bacillus Calmette-Guerrin (BCG) on Cancinoma in situ of the bladder. Cancer 51: 1323, 1983
Green DF, Robindon MRG, Glashan R, Newling D, Dalesio O, Smith PH: Does intravesical chemotherapy prevent invasive bladder cancer? J Urol 131: 33, 1984
Huland H, Otto U, Droese M, Klöppel G: Long term mitomycin C instillation after transurethral resection of superficial.bladder carcinoma: influence of recurrence, progression and survival. J Urol 132: 27, 1984
Reynolds RH, Stogdill VD, Lamm DL: Disease progression in BCG-treated patients with transitional cell carcinoma of the bladder. AUA Proc 133: 390 (392) April 1985
Heney NM, Ahmed S, Flanagan MJ, Frable W, Corder MP, Haferman MD, Hawkins IL: Superficial bladder cancer: progression and recurrence. J Urol 130, 1983
Whitmore Jr WF: The management of invasive bladder cancer. Sem Oncol 1: 1983
Robinson MR, Richards B, Adib R, Abdas A, Rigby CC, Push RC: Intravesical BCG (Bacillus Calmette-Guerin) in the management of TlNxMx transitional cell tumors of the bladder: a toxicity study. In: Bladder Tumours and Other Topics in Urological Oncology, Pavone-Macaluso M, Smith PH, Edsmyr F (eds). Plenum Press, New York, Vol 1, 528 p, 1980
Kierum Jr CA, Reichert DF, Mori K, Lamm DL: Differential stimulation of human natural cell mediated cytotoxicity (NCMC) by Gloxo and Pasteur Bacillus Calmette-Guerin (BCG) in vitro. AUA 86the Ann Mtng, Atlanta, Ga, abstract 840, May 1985
Kelley DR, Ratliff TL, Catalona WJ, Shapiro A, Lage JM, Baur WC, Haaff EO, Dresner SM: Intravesical bacillus Calmette-Guerin therapy for superficial bladder cancer: effect of Bacillus Calmette-Guerin viability on treatment results. J Urol 134: 48, 1985
Lamm DL, Crispen RG, Stogdill BJ, Stogdill VD: Complications of BCG immunotherapy in 1278 patients with bladder cancer. J Urol 135: 212, 1986
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 1987 Martinus Nijhoff Publishers, Boston
About this chapter
Cite this chapter
Lamm, D.L. (1987). BCG immunotherapy for superficial bladder cancer. In: Ratliff, T.L., Catalona, W.J. (eds) Genitourinary Cancer. Cancer Treatment and Research, vol 34. Springer, Boston, MA. https://doi.org/10.1007/978-1-4613-2033-3_17
Download citation
DOI: https://doi.org/10.1007/978-1-4613-2033-3_17
Publisher Name: Springer, Boston, MA
Print ISBN: 978-1-4612-9210-4
Online ISBN: 978-1-4613-2033-3
eBook Packages: Springer Book Archive