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BCG for the Treatment of Non-muscle Invasive Bladder Cancer

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The Role of Bacteria in Urology

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Abstract

Bacillus Calmette Guérin (BCG) was developed primarily as a vaccine against tuberculosis, but was found early on to demonstrate an antineoplastic effect in different cancers. Today the administration of BCG in oncology is limited to intravesical instillation in non-muscle invasive bladder cancer (NMIBC). Although BCG is one of the most studied medical treatments of any urologic cancer, its mechanisms of action are still not fully understood. After instillation into the bladder and internalization of BCG in bladder cancer cells and macrophages, BCG triggers apoptosis of neoplastic cells and promotes activation of T-cells that are responsible for the long-term antitumor defence. BCG is indicated as adjuvant treatment of patients with intermediate and high risk NMIBC, and subsequent maintenance treatment for 1–3 years can reduce recurrence and progression. Ongoing clinical trials are investigating different agents for combination therapy with BCG or modulation of BCG, in order to increase the efficacy of BCG and improve patient outcomes.

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Author information

Authors and Affiliations

  1. Department of Urology, University Hospital Bern, Bern, Switzerland

    Roland Seiler

  2. Department of Urologic Sciences, University of British Columbia, Vancouver Prostate Centre, Vancouver, BC, Canada

    Peter C. Black

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  1. Roland Seiler
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  2. Peter C. Black
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Correspondence to Peter C. Black .

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Editors and Affiliations

  1. University of British Columbia, The Stone Centre at Vancouver General Hospital, Jack Bell Research Centre, Vancouver, BC, Canada

    Dirk Lange

  2. University of British Columbia, The Stone Centre at Vancouver General Hospital, Jack Bell Research Centre, Vancouver, BC, Canada

    Kymora B. Scotland

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Seiler, R., Black, P.C. (2019). BCG for the Treatment of Non-muscle Invasive Bladder Cancer. In: Lange, D., Scotland, K. (eds) The Role of Bacteria in Urology. Springer, Cham. https://doi.org/10.1007/978-3-030-17542-9_10

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  • DOI: https://doi.org/10.1007/978-3-030-17542-9_10

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