Low-dose or -number of BCG in non-muscle invasive bladder cancer: updated systematic review and meta-analysis

We aimed to review the evidence of reducing the dose or number of BCG instillations in non-muscle invasive bladder cancer (NMIBC) patients. A literature search was done according to Preferred Reporting Items for Meta-Analyses statement. Overall, 15 and 13 studies were eligible for qualitative and quantitative synthesis, respectively. In patients with NMIBC, lowering either the dose or number of BCG instillations increases the risk of recurrence, but not the risk of progression. Lowering the dose of BCG decreases the risk of adverse events compared with standard-dose BCG. Standard-dose and -number of BCG is preferred for NMIBC patients based on oncologic efficacy; however, low-dose BCG could be considered in selected patients who suffer from significant adverse events. Doctors use a medicine called BCG to treat a kind of bladder cancer that hasn't spread to other parts of the body. But because there isn't enough of this medicine, scientists are looking at giving smaller amounts. They found that smaller amounts of the medicine have fewer side effects, but they also found that they might not work as well to stop the cancer from coming back. So, the regular amount of BCG is still the best option for most patients, but smaller amounts might be okay for some people who are worried about side effects. However, more research is needed to make sure it's safe and effective.