ArticleOncology letters2025
Efficacy and safety of BCG and immune checkpoint inhibitors in non-muscle invasive bladder cancer: A meta-analysis with exploratory chemotherapy comparisons.
Article in Oncology letters, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
3 citing papers in PubMed.
- Beyond the BCG Paradox: Biological Rationale and Clinical Evidence for Combining Intravesical BCG with Immune Checkpoint Inhibitors in High-Risk Non-muscle-Invasive Bladder Cancer.Oncology and therapy · 2026Review
- Immune checkpoint inhibitors in bladder cancer: from mechanistic insights to emerging combination frontlines.Clinical and experimental medicine · 2026Review
- Immune checkpoint inhibitors in BCG-unresponsive non-muscle-invasive bladder cancer: a narrative review of evidence and future directions.Translational andrology and urology · 2026Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Bladder cancer (BC) is a significant global health concern and includes non-muscle-invasive BC (NMIBC), which poses challenges due to recurrence and progression. Immunotherapy, such as immune checkpoint inhibitors (ICIs) and Bacillus Calmette-Guérin (BCG), shows promise particularly in cases of BCG failure or BCG-unresponsive NMIBC, with ICIs emerging as a potential treatment option for these challenging cases. To the best of our knowledge, the present study is the first to systematically compare the efficacy and safety of BCG with ICIs in NMIBC. The present meta-analysis identifies response predictors and treatment outcomes, which can help in recognizing potential biomarkers such as tumor characteristics, hemoglobin levels and baseline performance status, associated with therapy response. These insights may guide future research in developing personalized treatment strategies for BCG non-responsive NMIBC cases. Following the Preferred Reporting Standards for Systematic Reviews and Meta-Analyses guidelines, a systematic literature search identified relevant studies published between January 2015 and April 2024. Randomized controlled trials and clinical trials involving patients with BCG-refractory NMIBC were included in the primary analysis. Data extraction and analysis were conducted using Review Manager version 5.4, employing a random effects model. The risk of bias assessment followed the Cochrane guidelines. The present study included 2,154 participants across 10 studies evaluating treatments for NMIBC. Primary comparisons focused on BCG vs. ICIs: Pembrolizumab significantly improved tumor control (OR, 4.67; 95% CI, 1.43-15.25; P=0.01), progression-free survival (PFS; OR, 4.85; CI, 1.58-14.85; P=0.006), and overall survival (OS; OR, 3.61; CI, 1.28-10.19; P=0.02). Atezolizumab similarly outperformed BCG in metastatic disease (OR, 0.19; CI, 0.06-0.59; P=0.004) and lymph node involvement (OR, 0.43; CI, 0.20-0.93; P=0.03). ICIs exhibited a favorable safety profile vs. BCG, with fewer incidents of anemia (OR, 2.87; P=0.001) and diarrhea (OR, 1.79; P=0.03), despite higher rates of asthenia (OR, 7.33; P<0.00001) and pyrexia (OR, 3.26; P<0.00001). Exploratory comparisons with chemotherapy revealed pembrolizumab's advantages in terms of PFS (OR, 1.36; P=0.02) and OS (OR, 1.31; P=0.005), while atezolizumab improved metastatic control (OR, 0.54; P=0.0008). Heterogeneity was low for BCG comparisons (I
Indexed as
Identifiers
What Socratic holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.