Mycobacterial cell wall therapy may be an alternative to BCG in the
treatment of carcinoma in situ (CIS) of the bladder, Dr. Alvaro Morales,
of Queen's University, Kingston, Ontario, reported at the AUA meeting.
The cell walls of Mycobacterium phlei (an organism similar to
M bovis) were instilled into the bladder of 68 patients at a dose of 4
mg once a week for six weeks, then monthly for one year.
At 12-week follow-up, 40 of 64 evaluable patients had responded to treatment:
33 with complete response and 7 with partial response. All 9 patients remaining
in the study at 78-week follow-up were complete responders, Dr. Morales
said. Of those who had failed previous BCG therapy, 48% responded to cell
Adverse events were "much less intense than with BCG, though of
a similar kind," he said, listing fever, chills, and malaise of "very
short duration." No sepsis occurred.
"At this low dose, mycobacterial cell wall was less effective than
BCG, but dose escalation studies are needed," Dr. Morales said, adding
that mycobacterial cell wall could potentially be used as a rescue agent
for BCG failures.