Systematic Review and Meta-Analysis of Response Rates in BCG-unresponsive Non–Muscle-Invasive Bladder Cancer: a Consensus Statement From the International Bladder Cancer Group

There is a critical need to establish reference response rates following bladder-sparing therapies administered in the setting of bacillus Calmete-Guerin (BCG)-unresponsive non–muscle-invasive bladder cancer (NMIBC). We sought determine efficacy different interventions recent trials accruing patients fulfilling strict BCGunresponsive definition established by US Food and Drug Administration. performed systematic review meta-analysis for clinical BCG-unresponsive disease space include published presented results. The primary endpoints were complete rate CIS±Ta/T1 tumors, recurrence-free with papillary-only disease, disease-free studies enrolling both papillary CIS tumors (Ta/T1/CIS). I2 was used assessing heterogeneity. Eleven using 9 therapeutic agents total 909 NMIBC identified. resulting outcomes at 3, 6, 12 months 44%, 38%, 25% tumors; 73%, 58%, 48% papillary-only; 48%, 22%, 43% combined Ta/T1/CIS, respectively. Relatively low levels heterogeneity observed amongst restricted or tumors. Future randomized controlled are needed will likely require stratification between Introduction