intravesical bcg+interferon-α-2b in prevention of recurrence in transitional cell carcinoma of urinary bladder

Bladder malignancy is the 11th most common cancer in the world with more than 2,00,000 new cases diagnosed every year 90% of these are TCC, of which 75-80% are superficial in nature. Our aim in this study was to find the efficacy, safety and cost effectiveness of a low dose intravesical imnumo-therapy with BCG (70 mg) + Interferon-α-2b in preven-tion of its recurrence and prolonging disease progression interval. Between Jan. ′94 to Dec. ′98, 100 patients with super-ficial TCC (Ta, TI) of urinary bladder with or without Tis after transurethral resection of tumor underwent intra-vesical instillation of BCG (70 ing) + Interferon-α-2b (5-million IU) weekly for 8 weeks, fortnightly for 8 weeks, monthly . for 8 weeks . followed by maintenance dose at the end of 9th, 12th, 18th & 24th months with follow-up for 60 months. Results: At the end of 60 months of follow-up 36 pa-tients (36%) showed complete response, 44 patients (44%) showed partial response, resulting in a total response rate of 80% while 20% progressed to higher stage & grade. Patients′ tolerance was good and adverse reaction was low 19%. Conclusion: This study has shown that a low dose com-bined therapy with BCG and Interferon is not only safe, well tolerated, cost effective but also highly efficient in preventing recurrences in 36%, maintaining superficial nature of the disease in another 44% with a disease pro-gression free interval of 5 years in 80% of cases.