Gemcitabine and docetaxel show similar recurrence-free survival to BCG for bladder cancer

This systematic review and meta-analysis examined 1634 patients with non-muscle-invasive bladder cancer. The researchers compared intravesical gemcitabine and docetaxel against Bacillus Calmette-Guérin (BCG) therapy. The study followed patients for an average of 24 months. Results showed that recurrence-free survival at 24 months was 78% for high-risk patients who had not received BCG before. For those previously treated with BCG, the rate was 41%. Progression-free survival was 97% and 85% respectively in these groups. When comparing the two treatments directly in patients who had not received prior BCG, there was no significant difference in recurrence-free survival. The risk of adverse events also showed no significant difference between the groups. However, the study noted that maintenance effects were derived from between-study comparisons. These comparisons should be interpreted cautiously due to differences in maintenance protocols and adherence across the included studies. The overall safety profile was considered acceptable, though Grade 3 or higher adverse events occurred in 3.6% of the gemcitabine and docetaxel cohorts. Readers should understand that while the treatments appear similar in effectiveness for this condition, the data regarding long-term maintenance comes from indirect comparisons.