The Impact of Age on the Response of Patients With Superficial Bladder Cancer to Intravesical Immunotherapy
- 1 May 2006
- journal article
- Published by Ovid Technologies (Wolters Kluwer Health) in Journal of Urology
- Vol. 175 (5), 1634-1640
- https://doi.org/10.1016/s0022-5347(05)00973-0
Abstract
We determined the influence of age on response to intravesical immunotherapy in patients with superficial bladder cancer. Data from a national phase II multicenter trial for BCG plus IFN-alpha intravesical therapy for superficial bladder cancer were analyzed. Recurrence-free survival 2 years after the initiation of therapy was examined in patients by incremental age decade. BCG-N patients received 81 mg BCG and 50 MU IFN-alpha, while patients who had previously been treated with BCG received a third of the BCG dose with 50 MU IFN-alpha and those who were BCG intolerant received a tenth of the BCG dose with 100 MU IFN-alpha. Kaplan-Meier survival curves were obtained. In all patients the largest difference in response was between the 289 who were 61 to 70 years old and the 123 who were older than 80 years with a 22% difference in cancer-free survival at a median followup of 24 months (61% vs 39%, p = 0.0002). When we assessed BCG-N and BCG treated patients separately in the 2 age groups, patients older than 80 years had a persistently lower response rate than younger patients 61 to 70 years old. Of BCG-N patients those older than 80 and younger than 50 years had the lowest cancer-free survival at a median followup of 24 months (47% and 45%, respectively). On multivariate analysis age was an independent risk factor for response. Aging appears to be associated with a decreased response to intravesical immunotherapy and is particularly apparent in patients older than 80 years. A potential explanation could be their depressed baseline immune status and consequent inability to mount an immune reaction to BCG or IFN-alpha.Keywords
This publication has 16 references indexed in Scilit:
- Cancer Statistics, 2005CA: A Cancer Journal for Clinicians, 2005
- INTERIM RESULTS FROM A NATIONAL MULTICENTER PHASE II TRIAL OF COMBINATION BACILLUS CALMETTE-GUERIN PLUS INTERFERON ALFA-2B FOR SUPERFICIAL BLADDER CANCERJournal of Urology, 2004
- Aging biology and cancerSeminars in Oncology, 2004
- Bacillus calmete-guérin plus interferon-α2B intravesical therapy maintains an extended treatment plan for superficial bladder cancer with minimal toxicityUrologic Oncology, 2003
- Urinary IL‐2 assay for monitoring intravesical bacillus Calmette‐Guérin response of superficial bladder cancer during induction course and maintenance therapyInternational Journal of Cancer, 2003
- Urinary Cytokines During Intravesical Bacillus Calmetteguerin Therapy for Superficial Bladder Cancer: Processing, Stability and Prognostic ValueJournal of Urology, 1996
- Prognostic factors in pTa‐pT1 superficial bladder tumours treated with intravesical instillationsBritish Journal of Urology, 1994
- The Capacity of Lymphokine Production by Peripheral Blood Lymphocytes from Aged HumansImmunological Investigations, 1986
- Interleukin 2: Biology and biochemistryJournal of Clinical Immunology, 1983
- Immunological studies of aging. Decreased production of and response to T cell growth factor by lymphocytes from aged humans.JCI Insight, 1981