PMID- 26834838
OWN - NLM
STAT- PubMed-not-MEDLINE
DCOM- 20160202
LR  - 20200930
IS  - 1756-2872 (Print)
IS  - 1756-2880 (Electronic)
IS  - 1756-2872 (Linking)
VI  - 8
IP  - 1
DP  - 2016 Feb
TI  - The role of mycobacterial cell wall nucleic acid complex in the treatment of 
      bacillus Calmette-Guerin failures for non-muscle-invasive bladder cancer.
PG  - 29-37
LID - 10.1177/1756287215607818 [doi]
AB  - INTRODUCTION: The treatment of high-risk non-muscle-invasive bladder cancer 
      (NMIBC) utilizes transurethral resection followed by adjuvant intravesical 
      immunotherapy or chemotherapy. Intravesical bacillus Calmette-Guerin (BCG) is the 
      mainstay of adjuvant immunotherapy, but there are limited nonsurgical options for 
      patients that fail this treatment. Mycobacterial cell wall nucleic acid complex 
      (MCNA) is an immunotherapeutic agent utilized primarily after failure of 
      intravesical BCG. The purpose of this paper is to provide a comprehensive review 
      of the published literature regarding MCNA. METHODS: A literature review was 
      performed and identified studies indexed in MEDLINE((R)) related to utilization of 
      MCNA for patients with NMIBC. RESULTS: Two trials assessed the efficacy of MCNA 
      in patients with NMIBC, comprising a total of 184 patients. Most patients had 
      carcinoma in situ (CIS) with (26%) or without (52%) concomitant papillary tumors. 
      A minority of patients had only papillary tumors (22%). Most patients (95%) 
      previously received BCG or other intravesical therapy prior to receiving MCNA. In 
      the largest available trial, 25% and 19% of patients had no evidence of residual 
      cancer in 1 and 2 years following initiation of MCNA. A total of 2.3% of patients 
      had adverse events (AEs) leading to delay or discontinuation of therapy and 66% 
      of patients had mild drug-related AEs. CONCLUSION: Based on analysis of available 
      published data, MCNA offers a durable response for a small proportion of patients 
      that have failed prior intravesical therapy. There still exists a large unmet 
      need for nonsurgical treatment options for patients with NMIBC who have failed 
      adjuvant intravesical therapies.
FAU - Packiam, Vignesh T
AU  - Packiam VT
AD  - Department of Surgery, Section of Urology, The University of Chicago, 5841 South 
      Maryland Ave. MC-6038, Chicago, IL 60637, USA.
FAU - Pearce, Shane M
AU  - Pearce SM
AD  - Department of Surgery, Section of Urology, University of Chicago Medical Center, 
      Chicago, IL, USA.
FAU - Steinberg, Gary D
AU  - Steinberg GD
AD  - Department of Surgery, Section of Urology, University of Chicago Medical Center, 
      Chicago, IL, USA.
LA  - eng
PT  - Journal Article
PT  - Review
PL  - England
TA  - Ther Adv Urol
JT  - Therapeutic advances in urology
JID - 101487328
PMC - PMC4707423
OTO - NOTNLM
OT  - BCG failure
OT  - MCNA
OT  - Mycobacterium
OT  - bladder cancer
COIS- Conflict of interest statement: Dr. Steinberg discloses that he is a consultant 
      for EndoPharmaceuticals, Genentech, Telesta, Cold Genesys, Heat Biologics, 
      Baxter, Photocure, Karl Storz, Taris Biomedical, Abbott Molecular.
EDAT- 2016/02/03 06:00
MHDA- 2016/02/03 06:01
PMCR- 2016/02/01
CRDT- 2016/02/03 06:00
PHST- 2016/02/03 06:00 [entrez]
PHST- 2016/02/03 06:00 [pubmed]
PHST- 2016/02/03 06:01 [medline]
PHST- 2016/02/01 00:00 [pmc-release]
AID - 10.1177_1756287215607818 [pii]
AID - 10.1177/1756287215607818 [doi]
PST - ppublish
SO  - Ther Adv Urol. 2016 Feb;8(1):29-37. doi: 10.1177/1756287215607818.