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The following is a summary of “Factors predicting local or systemic side effects related to intravesical BCG (Bacillus Calmette-Guérin) therapy: a retrospective observational study,” published in the March 2025 issue of BMC Urology by Aksakalli et al. 

Intravesical Bacillus Calmette-Guérin (BCG) is a common adjuvant treatment for non-muscle invasive bladder tumors. However, systemic and local side effects may lead to treatment discontinuation. 

Researchers conducted a retrospective study to identify clinical factors predicting BCG-related side effects during intravesical therapy in patients with non-muscle invasive bladder cancer. 

They obtained demographic and clinical data from patient records of individuals who received intravesical adjuvant BCG therapy for non-muscle invasive bladder tumors. Data on side effects and clinical approaches were collected. Binary logistic regression analysis was performed to identify parameters and independent risk factors predicting BCG-related side effects and to evaluate data related to the clinical management of these side effects. 

The results showed that among 276 patients, 23 (8.3%) developed BCG-related side effects. Mean IPSS (13.5 ± 2.9 vs. 17.6 ± 1.7) and tumor size (2.5 ± 0.9 vs. 3.6 ± 1.0 cm) were significantly higher in the side effect group (P < 0.001). The rate of CIS was higher in the side effect group (21.7% vs. 3.9%, P = 0.004). Local side effects included cystitis in 18 (78.2%) patients and epididymo-orchitis in 2 (8.6%). Systemic side effects included patients with malaise and fever below 38.5 °C in 4 (17.3%) and fever above 38.5 °C lasting over 48 hours in 2 (8.6%). Logistic regression identified IPSS, tumor size, and CIS as independent risk factors. 

Investigators identified high IPSS, large tumor size, and the presence of CIS as significant predictors of side effects during intravesical BCG therapy. Clinicians could improve BCG use by preventing treatment discontinuation through approaches like quinolone use and dose reduction in patients with these factors. 

Source: bmcurol.biomedcentral.com/articles/10.1186/s12894-025-01734-6