Compliance With Intravesical Bacillus Calmette-Guérin Therapy for Nonmuscle-Invasive Bladder Cancer

Document Type

Article

Publication Date

12-24-2025

Publication Title

Urology Practice

Abstract

INTRODUCTION: This study aims to evaluate demographic and clinical factors associated with noncompliance with intravesical bacillus Calmette-Guérin (BCG) therapy in patients with nonmuscle-invasive bladder cancer (NMIBC). METHODS: A retrospective chart review was conducted of 239 patients with International Bladder Cancer Group intermediate- or high-risk NMIBC who received BCG therapy between 2012 and 2020 at a single academic/community practice. Compliance was assessed separately for receipt of adequate BCG, defined per FDA guidelines (≥5/6 induction doses and ≥2/3 maintenance doses), and for maintenance therapy adherence based on SWOG protocols (1 year for intermediate-risk disease, 3 years for high-risk disease). Compliance with maintenance instillations was defined as therapy administered within 1 month (intermediate risk) or 3 months (high risk) of the scheduled date. Associations between compliance and clinical or demographic factors, including clinical trial participation, were analyzed. RESULTS: After exclusions, 209 patients were included. Adequate BCG was received by 189 (90.4%) patients. Male patients demonstrated higher maintenance compliance than female patients (82% vs 68%, P = .048). Clinical trial participation was strongly associated with maintenance compliance (97.8% vs 63.3%, P < .0001), as was high-risk disease status compared with intermediate-risk disease (P = .036). Race, age, insurance type, and distance to clinic were not significantly associated with compliance. Recurrence rates were low (13.3%) in this highly compliant cohort. CONCLUSIONS: High rates of BCG compliance and low recurrence rates are achievable in an academic/community setting. Clinical trial participation, high-risk disease status, and male sex were associated with improved compliance. These findings may inform strategies to optimize BCG delivery and improve outcomes in NMIBC.

First Page

1

Last Page

8

PubMed ID

41440827

Rights

© 2025 American Urological Association Education and Research, Inc.

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