Dr. Chun highlights findings on NMIBC treatment patterns during the BCG shortage

In this video, Brian Chun, MD, discusses findings from the recent Urology study, “Variation in Statewide Intravesical Treatment Rates for Non-Muscle Invasive Bladder Cancer During the BCG Drug Shortage,” for which he served as the lead author. Chun is a urology resident at the University of Pittsburgh Medical Center in Pennsylvania.

Video Transcript:

We did see that BCG use did decrease across the board nationally, about 5.9%. I think what was more striking is when we looked at the types of agents that were used, in the periods where BCG utilization dropped, we saw a concomitant increase in mitomycin C. It became very clear that mitomycin C was a prime alternative agent that was used in lieu of the BCG shortage. We also found that in addition to less patients being started on BCG, those patients that were started on and planned for an induction course of BCG were also less likely to follow through and complete at least 5 of the 6 courses needed to complete an induction course. Taken altogether, that represents a substantial number of patients who did not have access to a complete induction course of gold standard BCG treatment.

Additionally, when we looked at the state practice patterns in BCG use, we were quite taken aback about how variable it was. We weren't surprised to see that a lot of these states reported decrease in BCG use, but that decrease was highly variable—anywhere between 5% and 36%. We did not see a specific geographic pattern for these variations; it seemed evenly distributed across the country. So, that was not entirely clear to us, but it was very surprising to see the amount of variation in practice change.

This transcription has been edited for clarity.