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Reply from Author re: Maurizio Brausi, Salvatore Siracusano. Collateral Activity of Immunotherapy with Bacillus Calmette-Guérin for the Treatment of Non–muscle-invasive Transitional Cell Carcinoma of the Bladder: New Insights. Eur Urol 2013;63:836–7

By: Harry W. Herrlowast

European Urology, Volume 63 Issue 1, May 2013, Pages 837-838

Published online: 01 May 2013

Abstract Full Text Full Text PDF (491 KB)

Refers to article:

Intravesical Bacille Calmette-Guérin Eradicates Bacteriuria in Antibiotic-naïve Bladder Cancer Patients

Harry W. Herr

Accepted 12 August 2012

May 2013 (Vol. 63, Issue 5, pages 832 - 835)

Refers to article:

Collateral Activity of Immunotherapy with Bacillus Calmette-Guérin for the Treatment of Non–muscle-invasive Transitional Cell Carcinoma of the Bladder: New Insights

Maurizio Brausi and Salvatore Siracusano

May 2013 (Vol. 63, Issue 5, pages 836 - 837)

Intravesical bacillus Calmette-Guérin (BCG) induces a cascade of robust immunologic responses in the bladder that conspire to destroy urothelial carcinoma. Although unproven, the same augmented innate and activated immune reactions, as Brausi and Siracusano point out [1], may explain how BCG might also eradicate uropathogens entrenched within the mucosa.

BCG therapy has been shown to be safe and effective in antibiotic-naïve bacteriuric bladder cancer patients [2]. I agree that further studies are necessary to corroborate these findings, especially the collateral damage BCG may cause to chronic bacteriuria [3]. For that to happen, however, urologists must be willing to treat infected patients with BCG and monitor them closely without resorting to frequent use of antibiotics to sterilize the urine. Because of guidelines and traditional practices warning against outpatient urologic procedures in patients with positive urine cultures, that becomes difficult. So far and despite my best efforts, I have been unable to persuade co-investigators at other institutions to participate in such studies, although I am open and happy to share our data and protocols as well as to collaborate in multicenter trials.

Conflicts of interest

The author has nothing to disclose.

References

  • [1] M. Brausi, S. Siracusano. Collateral activity of immunotherapy with bacillus Calmette-Guérin for the treatment of non–muscle-invasive transitional cell carcinoma of the bladder: new insights. Eur Urol. 2013;63:836-837 Abstract, Full-text, PDF, Crossref.
  • [2] H.W. Herr. Intravesical BCG in bladder cancer patients with asymptomatic bacteriuria. JAMA. 2011;305:1413-1414 Crossref.
  • [3] H.W. Herr. Intravesical bacille Calmette-Guérin eradicates bacteriuria in antibiotic-naïve bladder cancer patients. Eur Urol. 2013;63:832-835 Abstract, Full-text, PDF, Crossref.

Footnotes

Department of Urology, Memorial Sloan-Kettering Cancer Center, New York, NY, USA

lowast MSKCC, 1275 York Avenue, New York, NY 10065, USA. Tel. +1 646 422 4411; Fax: +1 212 988 0768.

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