BCG Quota for NMIBC in France: Real-Life Indications and Characteristics

What is it about?

This study investigates the clinico-pathological characteristics of non-muscle-invasive bladder cancer (NMIBC) treated in France over 1 year during a national BCG quota, and documents the real-life indications for adjuvant treatment. The study analyzed 25,878 BCG requests and found that 60.5% of patients were aged ≥70 years, with requests for induction and maintenance treatment accounting for 49.1% and 50.9%, respectively. High-risk NMIBC was more frequently treated with BCG maintenance therapy (91.7%) than NMIBC for which induction therapy was requested (90.2%). The number of cases of NMIBC leading to BCG adjuvant treatment was estimated at 12,704 cases/66,062,188 inhabitants over 1 year in metropolitan France. The study found that the incidence of NMIBC at high risk of recurrence and progression is underestimated in reference epidemiological studies, and the results should help to better define future care needs.

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Why is it important?

This research is important because it provides valuable insights into the real-life indications for adjuvant treatment with Bacillus Calmette-Guérin (BCG) in patients with non-muscle-invasive bladder cancer (NMIBC) in metropolitan France, particularly during a period of BCG shortage. The study examines the clinico-pathological characteristics of NMIBC treated during this time and offers a comprehensive analysis of the data collected, making it one of the largest cohorts reported on this subject. Key Takeaways: 1. The study analyzed data from 25,878 BCG requests made for 19,024 patients over a 1-year period in metropolitan France, with 60.5% of patients being aged ≥70 years. 2. BCG maintenance therapy was more frequently used for high-risk NMIBC (91.7%) compared to NMIBC for which induction therapy was requested (90.2%). 3. The incidence of NMIBC at high risk of recurrence and progression is underestimated in reference epidemiological studies, highlighting the need for better defining future care needs. 4. The study provides insights into the real-life indications for BCG treatment in the context of shortages, emphasizing the importance of preserving BCG for patients with high-risk NMIBC.