PMID- 23181987
OWN - NLM
STAT- MEDLINE
DCOM- 20130305
LR  - 20220330
IS  - 1349-7006 (Electronic)
IS  - 1347-9032 (Print)
IS  - 1347-9032 (Linking)
VI  - 104
IP  - 1
DP  - 2013 Jan
TI  - Bacillus Calmette-Guerin (BCG) immunotherapy for bladder cancer: current 
      understanding and perspectives on engineered BCG vaccine.
PG  - 22-7
LID - 10.1111/cas.12075 [doi]
AB  - Since the first report in 1976, accumulated clinical evidence has supported 
      intravesical Bacillus Calmette-Guerin (BCG) therapy as one of the standard 
      methods of management of intermediate- and high-risk non-muscle invasive bladder 
      cancer. Despite its efficacy, intravesical BCG therapy is associated with a 
      variety of adverse events (AEs), most of which are tolerable or controllable with 
      supportive care. However, some patients receiving intravesical BCG therapy may 
      experience uncommon but severe AEs, leading to cessation of BCG therapy. Not all, 
      but most severe AEs result from either local or systemic infection with live BCG. 
      Intravesical instillation of BCG elicits multiple immune reactions, although the 
      precise immunological mechanism of BCG therapy is not clear. It is convenient to 
      separate the complex reactions into the following three categories: infection of 
      urothelial cells or bladder cancer cells, induction of immune reactions, and 
      induction of antitumor effects. Recently, our knowledge about each category has 
      increased. Based on this understanding, predictors of the efficacy of 
      intravesical BCG therapy, such as urinary cytokine measurement and cytokine gene 
      polymorphism, have been investigated. Recently, preclinical studies using a novel 
      engineered mycobacterium vaccine have been conducted to overcome the limitations 
      of BCG therapy. One approach is Th1 cytokine-expressing recombinant forms of BCG; 
      another approach is development of non-live bacterial agents to avoid AEs due to 
      live BCG infection. We also briefly describe our approach using an 
      octaarginine-modified liposome-incorporating BCG cell wall component to develop 
      future substitutes for live BCG.
CI  - (c) 2012 Japanese Cancer Association.
FAU - Kawai, Koji
AU  - Kawai K
AD  - Department of Urology, Faculty of Medicine, University of Tsukuba, Tokyo, Japan. 
      rkawa@md.tsukuba.ac.jp
FAU - Miyazaki, Jun
AU  - Miyazaki J
FAU - Joraku, Akira
AU  - Joraku A
FAU - Nishiyama, Hiroyuki
AU  - Nishiyama H
FAU - Akaza, Hideyuki
AU  - Akaza H
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PT  - Review
DEP - 20130103
PL  - England
TA  - Cancer Sci
JT  - Cancer science
JID - 101168776
RN  - 0 (BCG Vaccine)
RN  - 0 (Liposomes)
RN  - 0 (Vaccines, Synthetic)
SB  - IM
MH  - Administration, Intravesical
MH  - BCG Vaccine/adverse effects/immunology/*therapeutic use
MH  - Humans
MH  - *Immunotherapy/adverse effects
MH  - Liposomes
MH  - Mycobacterium bovis/immunology
MH  - Urinary Bladder Neoplasms/immunology/*therapy
MH  - Urothelium/microbiology/pathology
MH  - Vaccines, Synthetic/adverse effects/immunology/therapeutic use
PMC - PMC7657210
EDAT- 2012/11/28 06:00
MHDA- 2013/03/06 06:00
PMCR- 2013/01/01
CRDT- 2012/11/28 06:00
PHST- 2012/10/28 00:00 [received]
PHST- 2012/11/18 00:00 [accepted]
PHST- 2012/11/28 06:00 [entrez]
PHST- 2012/11/28 06:00 [pubmed]
PHST- 2013/03/06 06:00 [medline]
PHST- 2013/01/01 00:00 [pmc-release]
AID - CAS12075 [pii]
AID - 10.1111/cas.12075 [doi]
PST - ppublish
SO  - Cancer Sci. 2013 Jan;104(1):22-7. doi: 10.1111/cas.12075. Epub 2013 Jan 3.