Kamat - Figure 12
BCG reduces progression only when maintenance is used
FIG. 12: The first key fact about BCG immunotherapy is that the maintenance schedule is very important. This has undergone an evolution of understanding over the last decade, and today it is well accepted but bears repeating.
This is the classic study by Sylvester and colleagues[11] from 2002 showing that BCG reduces progression only when maintenance therapy is used. This was a meta-analysis of 24 randomized control trials of almost 5000 patients who had received BCG therapy. As seen in this Figure, the patients who did not receive maintenance therapy did not derive the optimal benefit seen in the patients who did receive maintenance therapy.
References
Sylvester RJ, van der Meijden AP, Lamm DL.Intravesical bacillus Calmette-Guérin reduces the risk of progression in patients with superficial bladder cancer: a meta-analysis of the published results of randomized clinical trials. J Urol. 2002;168:1964−70 https://doi.org/10.1097/01.ju.0000034450.80198.1c
