Intravesical treatment with gemcitabine followed by docetaxel may offer an alternative first-line option to bacillus Calmette-Guérin (BCG) for treating patients with high-risk non-muscle invasive bladder cancer (NMIBC), according to study data presented at the ASCO Genitourinary Cancers Symposium 2022.1

“Our study provides evidence that using sequential intravesical gemcitabine and docetaxel is a safe and effective alternative to BCG during the now-chronic BCG shortage,” said lead investigator Vignesh T. Packiam, MD, clinical assistant professor of urology at the University of Iowa in Iowa City.

“This will provide a valuable option for patients with non-muscle invasive bladder cancer who do not have access to BCG,” Dr Packiam added. “These results will need prospective evaluation, which is underway with our group and others.”

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Dr Packiam and colleagues retrospectively studied 107 patients with BCG-naïve high-risk NMIBC treated with sequential intravesical gemcitabine and docetaxel. The median follow-up was 15 months.

Recurrence-free survival (RFS), the primary endpoint, was 85% and 82% at 12 and 24 months, respectively. No difference in RFS was observed in patients with and without carcinoma in situ disease.

For comparison, the investigators cited a contemporary study by Justin T. Matulay, MD, and colleagues showing a 12-month RFS rate of 79% with intravesical BCG used to treat high-risk NMIBC.2

Of the 107 patients in the current study, 4 (3.7%) were intolerant to the gemcitabine-docetaxel treatment. No patient progressed to metastatic disease.

Disclosures: Some study authors declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of authors’ disclosures.


1. McElree IM, Steinberg RL, Martin AC, et al. Gemcitabine and docetaxel for the treatment of BCG-naïve high-risk NMIBC. Presented at ASCO GU 2022; February 17-19. Abstract 497.

2. Matulay JT, Li R, Hensley PJ, et al. Contemporary outcomes of patients with nonmuscle-invasive bladder cancer treated with bacillus Calmette-Guérin: Implications for clinical trial design. J Urol. 205:1612-1621. doi:10.1997/JU.0000000000001633

This article originally appeared on Renal and Urology News