The use of recombinant mycobacterium bovis Bacillus Calmette-Guérin in the treatment of non-muscle-invasive bladder cancer.

Abstract

In the treatment of bladder cancer, Bacillus Calmette-Guérin (BCG) instillation is superior to chemotherapy. However, improving the effect of the therapy remains necessary since even frequent BCG instillation is not fully effective. Currently there are several recombinant BCG vaccines in development to prevent mycobacterium tuberculosis (TB) infections. The question arises, whether these vaccines could also play a role in bladder cancer treatment. The most promising vaccine, VPM1002, results in increased Th1 cytokine production and induces a higher cellular response. This review describes the immune response to bladder cancer and BCG instillation and attempts to answer the question whether the responses of VPM1002 would be safe and beneficial for bladder cancer patients. In addition the response to several of the vaccines in development are described and compared to native BCG.