(UroToday.com) The 2025 EAU annual meeting featured a rapid-fire debate session on common problems and controversies in bladder cancer and a presentation by Dr. Gianluca Giannarini contending that for high risk non muscle invasive bladder cancer, BCG is still the best option in 2025. Dr. Giannarini started his presentation by discussing BCG is still the best option by using BCG as an acronym to make his 3 main points:
- B – enefit
- C – ost (and accessibility)
- G – rounded
With regards to benefit, the complete response rate of any CIS is up to 85%. Duration of response for only CIS is a 1 year high grade recurrence free survival rate of 77% and 5 year rate of 66%. For CIS + papillary Ta/T1, the duration of response is a 1 year high grade recurrence free survival rate of 77% and 5 year rate of 67%. For progression free survival, BCG offers a reduced risk for intermediate-, high-, and very high-risk tumors (with adequate maintenance BCG), with a 1 year progression risk of 1.6% for high risk and 4.0% for very high risk tumors, and 5 year progression risk of 5.3% for high risk and 14.9% for very high risk tumors.
With regards to cost, Dr. Giannarini notes that BCG is cheap, with an average price per vial in Europe of 162.29 Euros:
Recently, Scilipoti and colleagues1 assessed the financial burden of localized and metastatic bladder cancer, noting that 1 year of BCG only costs $1,800, which is significantly cheaper than many other available treatment options:
Particularly in Europe, BCG is widely accessible and affordable for multiple health care systems. Finally, BCG is grounded, with a straightforward administration protocol and schedule. There is no need for extra infrastructure or complicated logistics, and no need for specialized training. Moreover, serious BCG-related side effects (<5% of patients) can be managed effectively in almost all cases.
Dr. Giannarini concluded his presentation by emphasizing that BCG is still the best option in 2025 for high risk non muscle invasive bladder cancer.
Presented by: Gianluca Giannarini, MD, S. Maria della Misericordia University Hospital, Udine, ItalyWritten by: Zachary Klaassen, MD, MSc – Urologic Oncologist, Associate Professor of Urology, Georgia Cancer Center, Wellstar MCG Health, @zklaassen_md on Twitter during the European Association of Urology (EAU) 2025 Annual Meeting, Madrid, Spain, Fri, Mar 21 – Mon, Mar 24, 2025.
References: