Chemotherapy in the bladder an option when BCG fails in treatment of superficial bladder cancer
A course of BCG bacteria in the bladder over 6 weeks is the standard of care for treatment of intermediate or high-risk superficial bladder cancer (<T2). When this treatment fails, a recent study demonstrates that a combination of Gemcitabine and Docetaxel in the bladder may be an appropriate next step. One and 2-year recurrence-free survival rates with the chemotherapy regimen were 60% and 46%, respectively. Only 3.6%) had disease progression on transurethral resection, and 15.6% went on to cystectomy (median 11.3 months from induction), of whom 4.0% had progression to muscle invasion. More study is needed, but this regimen may become standard of care in the future.