Evaluating the efficacy and safety of intravesical chemotherapies for non-muscle invasive bladder cancer: a network meta-analysis

• Published in: Oncotarget Vol. 7; no. 50; pp. 82567 - 82579
• Main Authors: Zhuo, Chuanjun, Li, Xubin, Zhuang, Hongqing, Tian, Shunli, Cui, Hailong, Jiang, Ronghuan, Liu, Chuanxin, Tao, Ran, Lin, Xiaodong
• Format: Journal Article
• Language: English
• Published: United States Impact Journals LLC 13.12.2016
• Subjects: Administration, Intravesical; Aged; Aged, 80 and over; Antineoplastic Combined Chemotherapy Protocols - administration & dosage; Antineoplastic Combined Chemotherapy Protocols - adverse effects; Bayes Theorem; BCG Vaccine - administration & dosage; Deoxycytidine - administration & dosage; Deoxycytidine - analogs & derivatives; Disease Progression; Epirubicin - administration & dosage; Female; Humans; Isoniazid - administration & dosage; Male; Middle Aged; Mitomycin - administration & dosage; Neoplasm Invasiveness; Neoplasm Recurrence, Local; Odds Ratio; Randomized Controlled Trials as Topic; Research Paper; Risk Factors; Time Factors; Treatment Outcome; Urinary Bladder Neoplasms - drug therapy; Urinary Bladder Neoplasms - mortality; Urinary Bladder Neoplasms - pathology; tumor recurrence; non-muscle invasive bladder cancer; tumor progression; intravesical therapy; efficacy and safety
• ISSN: 1949-2553; 1949-2553
• DOI: 10.18632/oncotarget.12856

Various intravesical therapies have been introduced into clinical practices for controlling non-muscle invasive bladder cancer (NMIBC). However, evidence with respect to the efficacy and safety of those intravesical therapies is very limited. Hence, we present a network meta-analysis in order to address this limitation in the current literature. The primary outcomes were the risk of tumor recurrence (TR), tumor progression (TP) and disease-specific mortality (DM). Secondary outcomes included the risk of fever, cystitis and haematuria. Conventional pair-wise and network meta-analysis were both performed for each endpoint. The surface under the cumulative ranking curve (SUCRA) was incorporated in our analysis for ranking the corresponding intravesical instillation interventions. In total, 23 randomized clinical trials (RCTs) were finally included in our study after irrelevant papers were screened out. Results of network meta-analysis suggested that Epirubicin (EPI) was less preferable than Bacille Calmette Guerin (BCG), BCG+EPI, BCG+ Isoniazid (INH), BCG+ Mytomicin C (MMC), Gemcitabine (GEM) and MMC with respect to TR. As suggested by the corresponding ranking probabilities and SUCRA, incorporating EPI or MMC into BCG may enhance the efficacy of BCG monotherapy.