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I am thrilled to offer you this new and unique four-part Tx Reporter series that reflects my years of practice treating patients with bladder cancer. I have answered virtually hundreds of letters, e-mails, and phone calls fom physicians like you and their patients who have had questions on bladder cancer treatment. Many of these questions have probed for answers to controversial issues or have touched on areas of care for which there are no simple and straightforward answers or guidelines. After reviewing some of the these correspondences with Projects In Knowledge, we thought that offering an anthology of the most interesting, provocative, and clinically relevant questions with my answers could help you in your clinical practice.
The series focuses on my recent experience investigating bacillus Calmette-Guérin (BCG) and interferon combination therapy. Immunotherapy with intravesical BCGthe gold standard for treatment of superficial bladder canceris limited by its toxicity and by subsequent disease recurrence or progression in the vast majority of patients. Improvements in treatment options that result in less toxicity, prevent or delay of recurrence/progression, and avoid cystectomy are needed. Recent evidence suggests that the combination of low-dose BCG plus interferon alfa-2b may be synergistic without increasing toxicity over BCG alone. Phase III trials are currently under way, but positive preliminary data regarding this combination have led to considerable interest in this regimen, as well as a number of questions regarding the interpretation of available data and the practical aspects of using BCG/interferon combination therapy.
In this series of newsletters, I will address actual questions regarding BCG/interferon that I have received from colleagues like yourself. I hope you find this series helpful and informative.
Michael A. O'Donnell, MD
Associate Professor and Director of Urologic Oncology
Department of Urology
University of Iowa
Iowa City, IA
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