Levofloxacin safe and effective therapy for bladder cancer patients treated with BCG therapy: Study

Japan: The administration of prophylactic levofloxacin may reduce the severity of adverse outcomes in non-muscle-invasive bladder cancer (NMIBC) patients and contribute to better outcomes from bacillus Calmette-Guerin (BCG) intravesical therapy, says a recent study. The study was published online in European Urology Focus on 15 June 2022. 

BCG is a standard treatment for high-risk non–muscle-invasive bladder cancer but there is a difficulty with the high rate of adverse events with a variety of grades. Kazuyuki Numakura, Department of Urology, Akita University Graduate School of Medicine, Akita, Japan, and colleagues, therefore, aimed to examine whether levofloxacin, given after each intravesical instillation of BCG, could improve its tolerance in patients with intermediate- to high-risk urothelial carcinoma of the bladder without compromising its efficacy in a randomized, prospective, multicenter study. 

The study included 106 Japanese patients (85 men and 21 women; age: median, 69.5 yr) with primary or recurrent NMIBC. They were randomized after transurethral resection to induce treatment with intravesical BCG plus levofloxacin (group 1) or BCG alone (group 2). Patients who underwent intravesical instillation of BCG were randomized with or without levofloxacin administration.

The National Cancer Institute-Common Toxicity Criteria version 3.0 assessed adverse events. To estimate, survival outcomes, cumulative incidence functions and Kaplan-Meier methods were applied.