A comparison between intravesical gemcitabine plus docetaxel and intravesical BCG in the treatment of non-muscle invasive naive urinary bladder cancer: A systematic review and meta-analysis of oncological outcomes

Rachana Tripathy; Lalit Kumar; Sakshi Agarwal; Anuja Thakur; Mahesh Khairnar; Sameer Trivedi; S N Sankhwar

doi:10.1016/j.urology.2025.01.004

A comparison between intravesical gemcitabine plus docetaxel and intravesical BCG in the treatment of non-muscle invasive naive urinary bladder cancer: A systematic review and meta-analysis of oncological outcomes

Urology. 2025 Jan 9:S0090-4295(25)00006-8. doi: 10.1016/j.urology.2025.01.004. Online ahead of print.

Authors

Rachana Tripathy¹, Lalit Kumar², Sakshi Agarwal¹, Anuja Thakur³, Mahesh Khairnar⁴, Sameer Trivedi³, S N Sankhwar³

Affiliations

¹ Department of Obstetrics & Gynaecology, Institute of Medical Sciences, Banaras Hindu University, Varanasi, India.
² Department of Urology, Institute of Medical Sciences, Banaras Hindu University, Varanasi, India. Electronic address: lalitkumarims@bhu.ac.in.
³ Department of Urology, Institute of Medical Sciences, Banaras Hindu University, Varanasi, India.
⁴ Faculty of Dental Science, Institute of Medical Sciences, Banaras Hindu University, Varanasi, India.

PMID: 39798618
DOI: 10.1016/j.urology.2025.01.004

Abstract

Objective: To evaluate the efficacy, recurrence rates, and safety profile of intravesical gemcitabine plus docetaxel versus standard Bacillus Calmette-Guérin (BCG) therapy for treating naïve non-muscle-invasive bladder cancer (NMIBC), focusing on reducing recurrence and progression concerns associated with transurethral resection (TURBT).

Methods: Relevant articles were identified and appraised through a structured assessment of the literature. Databases searched included PubMed, Medline, Scopus, and Science Direct.

Results: The meta-analysis incorporated a quantitative assessment of 3 original articles. The meta-analysis studies evaluated parameters, including the recurrence rate and safety profile. The I² statistics indicated no heterogeneity in recurrence rates between the gemcitabine plus docetaxel (experimental) group and the BCG (control) treatment group. According to the results, the cumulative Odds Ratio for the recurrence rate was 0.72 (95% CI: 0.36-1.47), favoring a slightly lower recurrence rate clinically in the experimental group. The overall effect test yielded a Z-value of 0.89 with a P-value of 0.37, indicating no statistically significant difference in outcome odds between the experimental and control groups.

Conclusions: The meta-analysis showed a slightly lower clinical recurrence rate in the intravesical gemcitabine plus docetaxel group than in the intravesical BCG treatment group. The intravesical gemcitabine plus docetaxel group experienced fewer severe side effects. There are limited number of studies available at present. This meta-analysis suggests need of further randomized studies to establish role of intravesical gemcitabine plus docetaxel in NMIBC.

Publication types

Review