Tumor infiltrating immune cells to predict response to intravesical BCG in Patients with Non-muscle invasive Bladder Cancer: A Systematic Review and meta-analysis

Bladder Cancer

BJU Int. 2020 Oct 18. doi: 10.1111/bju.15276. Online ahead of print.


PURPOSE: To investigate the predictive value of tumor infiltrating immune cells (TIICs) on oncological outcomes and response to BCG treatment in patients with Non-muscle invasive bladder cancer (NMIBC).

MATERIALS AND METHODS: A systematic review and meta-analysis was performed using the PubMed, Scopus, and Cochrane Library on July 2020 to identify relevant studies according to the Preferred Reporting Items for Systematic Review (PRISMA) statement. The pooled recurrence-free survival (RFS) was calculated using a fixed effect model.

RESULTS: We retrieved 15 studies (including 791 patients) evaluating the effect of TIICs on oncologic outcomes in NMIBC patients treated with intravesical BCG. TIICs were reported as a significant predictor of oncological outcomes and response to BCG treatment in ten studies. Tumor-Associated Macrophages were associated with worse RFS (pooled HR 2.30, 95% CI 1.64-3.22).

CONCLUSIONS: Based on these data, TIICs are significant predictors of RFS and response to BCG treatment in NMIBC patients. Therefore, incorporating of TIICs into risk stratification models may help patients and physicians in clinical decision-making process achieving the maximum possible benefit from BCG treatment.