Global real-world patients characteristics, treatment patterns, and impact of BCG shortage in patients with high-risk non-muscle invasive bladder cancer.

• DOI: 10.1200/jco.2025.43.5_suppl.717
• Publication Date: 2025-02-18T14:38:27Z
• Authors: Jens Bedke; Anthony Eccleston; Julia Brinkmann; Jane Chang; Abin Koshy; Neil Milloy; Laure Manuel; Jacob Skilling; Emilia Biondi; Elliott Brown; Gary D. Steinberg; Oscar Rodriguez Faba; Yohann Loriot; Paolo Gontero; Yair Lotan
• Keywords: Economic shortage

717 Background: Global guidelines recommend that High Risk Non-Muscle Invasive Bladder Cancer (HR NMIBC) patients (pts) receive 1-3 years of Bacillus Calmette-Guérin (BCG) treatment (Tx). This global real-world study aimed to understand pt characteristics, Tx patterns and impact the BCG shortage in pts with HR NMIBC. Methods: Physicians across EU5 (n=244), US (n=55), Japan (n=44) Canada (n=21) were recruited Adelphi NMIBC Disease Specific Programme: a cross-sectional survey retrospective data collection extracted from medical record for their next eight consecutively consulting physician. characteristics analysed descriptively. Data was collected June December 2023. Results: 364 physicians (55% urologists; 45% oncologists) provided 1930 an initial diagnosis (IDx) At IDx 73% presented high grade T1 tumors, 21% had carcinoma in-situ, 37% multifocal tumors. The median time between 613 days. are described table. Of 1395 who received intravesical therapy after IDx, 462 (33%) induction only, 875 (63%) followed by maintenance Tx. most commonly used (28%), whilst 5% chemo, similarly 56% 7% chemo. those completed (n=269) (IQR) duration 336 (180-382) Physician reported affected 8% pts: 41% fewer instillations, lower dosages, 33% different strains. Among 29% ≥1 recurrence 1 st 426 (224-580) After recurrence, 57 partial or radical cystectomies. surveyed stated 20% overall caseload unresponsive 50% naïve. having been shortage, ranging 23% (Japan) 71% (Canada), 61% reserved 46% chemotherapy as alternative. Conclusions: remains frequently prescribed even though there have issues many do not maintenance. New options could safely reduce amount administered without compromising pts’ outcomes needed. n=1930, n (%) 1st n=551, 2nd n=130, TURBT + 1209 (63) 194 (35) 40 (31) Other surgery 14 (1) 11 (2) 0 (0) Intravesical only 172 (9) 31 (6) 10 (8) 327 (17) 162 (29) 43 (33) 13 9 3 Radical cystectomy 44 6 (4) drug ± 88 41 (7) No 107 (5) 59 (11) 19 (15)