Iranian
Biomedical Journal
Volume 26, Issue 5 (9-2022)
IBJ 2022, 26(5): 340-349 |
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Doroud D, Hozouri H. Role of Intravesical BCG as a Therapeutic Vaccine for Treatment of Bladder Carcinoma. IBJ 2022; 26 (5) :340-349
URL: http://ibj.pasteur.ac.ir/article-1-3676-en.html
URL: http://ibj.pasteur.ac.ir/article-1-3676-en.html
Abstract:
Bacterial products have attracted much attention as potential antitumor agents, with the ability to provide direct tumoricidal effects, leading to the inhibition of tumor growth. Treatment of superficial bladder cancer with intravesical Bacillus Calmette-Guérin (BCG) has a more reduction potential than surgery in tumor recurrence rate. BCG, the gold standard for nonmuscle invasive bladder cancer, is manufactured from different strains and produced commercially with varied strengths. There are a few countries known as the manufacturer of this strategic biopharmaceutical product, and Iran as a member of the Eastern Mediterranean Region plays a vital role in supplying this vaccine. Studies have failed to uncover the exact mechanism of action of the intravesical; however, evidence points toward an immunogenic mechanism that proficiently modifies a biologic response and provokes the immune cells in order to kill and suppress tumors. Among various underlying mechanisms, BCG bacillus attachment to fibronectin through its fibronectin attachment protein is a pivotal mechanism for BCG tumoricidal activity.
Type of Study: Review Article |
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References
1. Hozouri H, Norouzian D, Nafissi-Varcheh N, Aboofazeli R. Challenges to improve the stability and efficacy of an intravesical BCG product. Iranian journal of pharmaceutical research 2014; 13(Suppl): 143.
2. Chabalgoity JA, Dugan G, Mastroeni P, Aspinall RJ. Live bacteria as the basis for immunotherapies against cancer. Expert review of vaccines 2002; 1(4): 495-505. [DOI:10.1586/14760584.1.4.495]
3. Coley WB. The treatment of malignant tumors by repeated inoculations of erysipelas. With a report of ten original cases. Clinical orthopaedics and related research 1991; 262: 3-11. [DOI:10.1097/00003086-199101000-00002]
4. Nagorsen D, Marincola FM, Kaiser HE. Bacteria-related spontaneous and therapeutic remission of human malignancies. In-vivo 2002; 16(6): 551-556.
5. Chakrabarty A M. Microorganisms and Cancer: Quest for a therapy. Journal of bacteriology 2003; 185(9): 2683-2686. [DOI:10.1128/JB.185.9.2683-2686.2003]
6. Holmgren I. Employment of B.C.G., especially in intravenous injection. Acta medica scandinavica 1936; 90: 350-361. [DOI:10.1111/j.0954-6820.1936.tb15958.x]
7. Old LJ, Clarke DA, Benacerraf B. Effect of bacillus Calmette-Guerin infection on transplanted tumours in the mouse. Nature 1959; 184: 291. [DOI:10.1038/184291a0]
8. Coe JE., Feldman JD. Extracutaneous delayed hypersensitivity, particularly in guinea pig bladder. Immunology 1966; 10(2): 127-136.
9. Mathe G, Amiel JL, Schwarzenburg L. Active immunotherapy for acute lymphoblastic leukaemia. Lancet 1969; 293(7597): 697-699. [DOI:10.1016/S0140-6736(69)92648-8]
10. Heppner F, Mose JR. The liquefaction (oncolysis) of malignant gliomas by a non-pathogenic Clostridium. Acta neurochirurgica 1978; 42(1-2): 123-125. [DOI:10.1007/BF01406639]
11. Morales A, Eidinger D, Bruce AW. Intracavity BCG in the treatment of superficial bladder tumours. The journal of urology. 1976; 116(3): 180-183. [DOI:10.1016/S0022-5347(17)58737-6]
12. Lamm DL. Efficacy and Safety of Bacille Calmette-Guerin Immunotherapy in Superficial Bladder Cancer. Clinical infecttious disease 2000; 31: 86-90. [DOI:10.1086/314064]
13. Akaza H, Hinotsu S, Aso Y, Kakizoe T, Koiso K. Bacillus Calmette-Guérin treatment of existing papillary bladder cancer and carcinoma in situ of the bladder. Four-year results. The Bladder Cancer BCG Study Group. Cancer 1995; 75(2): 552-559.
https://doi.org/10.1002/1097-0142(19950115)75:2<552::AID-CNCR2820750219>3.0.CO;2-H [DOI:10.1002/1097-0142(19950115)75:23.0.CO;2-H]
14. Kremenovic M, Schenk M, Lee DJ. Clinical and molecular insights into BCG immunotherapy for melanoma. Journal of internal medicine 2020; 288(6): 625-640. [DOI:10.1111/joim.13037]
15. Zhao W, Schorey JS, Bong-Mastek M, Ritchey J, Brown EJ. Ratliff TL. Role of a bacillus Calmette-Guerin fibronectin attachment protein in BCG-induced antitumor activity. International journal of cancer 2000; 86(1): 83-88.
https://doi.org/10.1002/(SICI)1097-0215(20000401)86:1<83::AID-IJC13>3.0.CO;2-R [DOI:10.1002/(SICI)1097-0215(20000401)86:13.0.CO;2-R]
16. Billerey C, Sibony C. Anatomie pathologique des tumeurs superficielles de la vessie. Progrès en urologie 2001; 11(5): 817-825.
17. Czerniak B, Dinney C, McConkey D. Origins of bladder cancer. Annual Review of Pathology: Mechanisms of disease 2016 23; 11: 149-174. [DOI:10.1146/annurev-pathol-012513-104703]
18. Koss LG. Tumors of the urinary bladder. 1st ed. Armed Forces Institute of Pathology: USA; 1975.
19. Hendricksen K, Aziz A, Bes P, K-H Chun F, Dobruch J, Kluth LA, Gontero P, Necchi A, Noon AP, van Rhijn BWG, Rink M, Roghmann F, Rouprêt M, Seiler R, Shariat SF, Qvick B, Babjuk M, Xylinas E. Discrepancy between European association of urology guidelines and daily practice in the management of non-muscle-invasive bladder Cancer: results of a european survey. European urology focus 2017; 5(4): 681-688. [DOI:10.1016/j.euf.2017.09.002]
20. Wong VK, Ganeshan D, Jensen CT, Devine CE. Imaging and management of bladder cancer. Cancers 2021; 13(6): 1396. [DOI:10.3390/cancers13061396]
21. Jordan B, Meeks JJ. T1 bladder cancer: current considerations for diagnosis and management. Nature reviews urology 2019; 16(1): 23-34. [DOI:10.1038/s41585-018-0105-y]
22. Pow-Sang JM, Seigne JD. Contemporary management of superficial bladder cancer. Cancer control 2000, 7(4): 335-339. [DOI:10.1177/107327480000700402]
23. Pasin E, Josephson DY, Mitra AP, Cote RJ, Stein JP. Superficial bladder cancer: an update on etiology, molecular development, classification, and natural history. Reviews in urology 2008; 10(1): 31.
24. Elawdy MM, Taha DE, Osman Y, Abd El-Hamid M, El-Mekresh M. Non-transitional cell carcinoma of the upper urinary tract: A case series among 305 cases at a tertiary urology institute. Urology annals 2017; 9(1): 99. [DOI:10.4103/0974-7796.198894]
25. Isharwal S, Hu W, Sarungbam J, Chen YB, Gopalan A, Fine SW, Tickoo SK, Sirintrapun SJ, Jadallah S, Loo FL, Pietzak EJ. Genomic landscape of inverted urothelial papilloma and urothelial papilloma of the bladder. The Journal of pathology 2019; 248(3): 260-265. [DOI:10.1002/path.5261]
26. Limaiem F, Pandey J, Leslie SW. Inverted Urothelial Papilloma. StatPearls [Internet]. 2020 Oct 16.
27. Hozouri H, Norouzian D, Aboofazeli R. An Investigation into Improvement of Stability and Efficacy of Intravesical BCG Formulations Using Freeze-Drying Technique. Trends in peptide and protein sciences 2020; 5: 1-9.
28. Miyazaki J, Nishiyama H. Epidemiology of urothelial carcinoma. International journal of urology 2017; 24(10): 730-734. [DOI:10.1111/iju.13376]
29. Khayamzadeh M, Aliakbari F, Zolghadr Z, Emadeddin M, Ahadi M, Akbari M, Abedi AR, Nematollahi S, Hosseini J. Five-year Survival Rate of Bladder Cancer in Iran during 2001-2007. Iranian journal of pathology 2021; 16(1): 69. [DOI:10.30699/ijp.2020.118375.2287]
30. Redelman-Sidi G, Glickman MS, Bochner BH. The mechanism of action of BCG therapy for bladder cancer-a current perspective. Nature reviews urology 2014; 11(3): 153. [DOI:10.1038/nrurol.2014.15]
31. Al-Husseini MJ, Kunbaz A, Saad AM, Santos JV, Salahia S, Iqbal M, Alahdab F. Trends in the incidence and mortality of transitional cell carcinoma of the bladder for the last four decades in the USA: a SEER-based analysis. BMC cancer 2019; 19(1): 1-2. [DOI:10.1186/s12885-019-5267-3]
32. Merz VW, Marth D, Kraft R, Ackermann DK, Zingg EJ, Studer UE. Analysis of early failures after intravesical instillation therapy with bacille Calmette-Guérin for carcinoma in situ of the bladder. British journal of urology 1995; 75(2): 180-184. [DOI:10.1111/j.1464-410X.1995.tb07307.x]
33. Lamm DL. Long term results of intravesical therapy for superficial bladder cancer. The urologic clinics of north America 1992; 19(3): 573-580. [DOI:10.1016/S0094-0143(21)00424-9]
34. Unda-Urzaiz M, Cozar-Olmos JM, Miñana-Lopez B, Camarero-Jimenez J, Brugarolas-Rossello X, Zubiaur-Libano C, Ribal-Caparros MJ, Suarez-Charneco AJ, Rodriguez-Tesedo V, Chantada-Abal V, Gonzalez-Ruiz-de-Leon C. Safety and efficacy of various strains of Bacille Calmette-Guérin in the treatment of bladder tumors in standard clinical practice. Actas urológicas españolas 2018 1; 42(4): 238-248. [DOI:10.1016/j.acuroe.2018.03.004]
35. Farah NB, Ghanem R, Amr M. Treatment efficacy and tolerability of intravesical Bacillus Calmette-Guerin (BCG)-RIVM strain: induction and maintenance protocol in high grade and recurrent low grade non-muscle invasive bladder cancer (NMIBC). BMC urology 2014; 14(1): 11. [DOI:10.1186/1471-2490-14-11]
36. Sood R, Sharma H, Sharma B, Parekh S, Pujari P, Shewale S. A prospective comparative study to assess the efficacy and tolerability of 2 different doses of intravesical bacillus Calmette-Guerin (BCG) in patients with non-muscle-invasive bladder cancer. Urologic oncology 2020; 38( 5): 433-439. [DOI:10.1016/j.urolonc.2020.01.002]
37. Hinotsu S, Akaza H, Naito S, Ozono S, Sumiyoshi Y, Noguchi S, Yamaguchi A, Nagamori S, Terai A, Nasu Y, Kume H. Maintenance therapy with bacillus Calmette‐Guérin Connaught strain clearly prolongs recurrence-free survival following transurethral resection of bladder tumour for non-muscle-invasive bladder cancer. BJU international. 2011; 108(2): 187-195. [DOI:10.1111/j.1464-410X.2010.09891.x]
38. D'Andrea D, Gontero P, Shariat SF, Soria F. Intravesical bacillus Calmette-Guérin for bladder cancer: are all the strains equal? Translational andrology and urology 2019; 8(1): 85. [DOI:10.21037/tau.2018.08.19]
39. Guallar-Garrido S, Julián E. Bacillus Calmette-Guérin (BCG) therapy for bladder cancer: an update. Immuno targets and therapy 2020; 9: 1. [DOI:10.2147/ITT.S202006]
40. Lundholm C, Norlén BJ, Ekman P, Jahnson S, Lagerkvist M., Lindeborg T, Olsson JL, Tveter K, Wijkstrom H, Westberg R, Malmström PU. A randomized prospective study comparing long-term intravesical instillations of mitomycin C and bacillus Calmette-Guerin in patients with superficial bladder carcinoma. The journal of urology 1996; 156 (2 Pt 1): 372-376. [DOI:10.1016/S0022-5347(01)65853-1]
41. Herr HW, Laudone VP, Badalament RA, Oettgen HF, Sogani PC, Freedman BD, Melamed MR, Whitmore WF Jr. Bacillus Calmette-Guérin therapy alters the progression of superficial bladder cancer. Journal of clinical oncology 1988; 6(9): 1450-1455. [DOI:10.1200/JCO.1988.6.9.1450]
42. Lamm DL, Blumenstein BA, Crawford ED, Montie JE, Scardino P, Grossman HB, Stanisic TH, Smith JA Jr, Sullivan J, Sarosdy MF. A randomized trial of intravesical doxorubicin and immunotherapy with bacille Calmette-Guérin for transitional-cell carcinoma of the bladder. The New England journal of medicine 1991; 325(17): 1205-1209. [DOI:10.1056/NEJM199110243251703]
43. Meyer J, Persad R, Gillatt D. Use of bacille Calmette-Guerin in Superficial bladder cancer. Postgraduate medical journal 2002; 78(922): 449-454. [DOI:10.1136/pmj.78.922.449]
44. Martínez-Piñeiro JA, Jiménez León J, Martínez-Piñeiro LJ, Fiter L, Mosteiro JA, Navarro J, García Matres MJ, Cárcamo P. Bacillus Calmette-Guerin versus doxorubicin versus thiotepa: a randomized prospective study in 202 patients with superficial bladder cancer. The Journal of urology 1990; 143(3): 502-506. [DOI:10.1016/S0022-5347(17)40002-4]
45. Pettenati C, Ingersoll MA. Mechanisms of BCG immunotherapy and its outlook for bladder cancer. Nature reviews urology 2018; 15(10): 615-625. [DOI:10.1038/s41585-018-0055-4]
46. Kamat AM, Li R, O'Donnell MA, Black PC, Roupret M, Catto JW, Comperat E, Ingersoll MA, Witjes WP, McConkey DJ, Witjes JA. Predicting response to intravesical Bacillus Calmette-Guérin immunotherapy: are we there yet? A systematic review. European urology 2018; 73(5): 738-748. [DOI:10.1016/j.eururo.2017.10.003]
47. Ratliff TL, Gillen D, Catalona WJ. Requirement of a thymus dependent immune response for BCG mediated antitumour activity. The Journal of urology 1987; 137(1): 155-158. [DOI:10.1016/S0022-5347(17)43909-7]
48. Jackson AM, James K. Understanding the most successful immunotherapy for cancer. The mmunologist; 1994; 2: 208-215.
49. Alhunaidi O, Zlotta AR. The use of intravesical BCG in urothelial carcinoma of the bladder. Ecancermedical science 2019; 13: 905. [DOI:10.3332/ecancer.2019.905]
50. Patard JJ, Saint F, Velotti F, Abbou CC. Immune response following intravesical Bacille Calmette-Guerin instillations in superficial bladder cancer: a review. Urological research 1998; 26(3): 155-159. [DOI:10.1007/s002400050039]
51. Han J, Gu X, Li Y, Wu Q. Mechanisms of BCG in the treatment of bladder cancer-current understanding and the prospect. Biomedicine and pharmacotherapy 2020; 129: 110393. [DOI:10.1016/j.biopha.2020.110393]
52. Pichler R, Gruenbacher G, Culig Z, Brunner A, Fuchs D, Fritz J, Gander H, Rahm A, Thurnher M. Intratumoral Th2 predisposition combines with an increased Th1 functional phenotype in clinical response to intravesical BCG in bladder cancer. Cancer immunology, immunotherapy 2017; 66(4):427-440. [DOI:10.1007/s00262-016-1945-z]
53. Oddens J R, de Reijke T M. The current state of predicting response on Bacillus Calmette-Guérin treatment for nonmuscle invasive bladder Cancer is not yet useful for patients but attributes to understanding its mechanisms of action. European urology 2018; 73(5): 749. [DOI:10.1016/j.eururo.2017.11.021]
54. Thoma C. PD-L1 and BCG response prediction. Nature reviews urology 2020; 17(1): 8. [DOI:10.1038/s41585-019-0267-2]
55. Kates M, Matoso A, Choi W, Baras AS, Daniels MJ, Lombardo K, Brant A, Mikkilineni N, McConkey DJ, Kamat AM, Svatek RS. Adaptive immune resistance to intravesical BCG in non-muscle invasive bladder cancer: Implications for prospective BCG-unresponsive trials. Clinical cancer research 2020; 26(4): 882-891. [DOI:10.1158/1078-0432.CCR-19-1920]
56. Chen S, Crabill GA, Pritchard TS, McMiller TL, Wei P, Pardoll DM, Pan F, Topalian SL. Mechanisms regulating PD-L1 expression on tumor and immune cells. Journal for immunotherapy of cancer 2019; 7(1): 1-2. [DOI:10.1186/s40425-019-0770-2]
57. Pierconti F, Raspollini MR, Martini M, Larocca LM, Bassi PF, Bientinesi R, Baroni G, Minervini A, Petracco G, Pini GM, Patriarca C. PD-L1 expression in bladder primary in situ urothelial carcinoma: evaluation in BCG-unresponsive patients and BCG responders. Virchows archiv 2020; 477(2): 269-277. [DOI:10.1007/s00428-020-02755-2]
58. Srivastava N, McDermott D. Update on benefit of immunotherapy and targeted therapy in melanoma: the changing landscape. Cancer management and research 2014; 6: 279. [DOI:10.2147/CMAR.S64979]
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