Sequential gemcitabine–docetaxel in BCG-naïve and BCG-failure non–muscle-invasive bladder cancer: a systematic review and meta-analysis - Summary - MDSpire
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Sequential gemcitabine–docetaxel in BCG-naïve and BCG-failure non–muscle-invasive bladder cancer: a systematic review and meta-analysis
To assess the efficacy and safety of intravesical gemcitabine and docetaxel (GEM/DOCE) in the treatment of naïve and BCG-failure high-risk and very high-risk NMIBC.
Approach:
Systematic Review and Meta-Analysis: Conducted in accordance with PRISMA 2020 guidelines, searching databases from January 2014 to March 2025 for studies on intravesical GEM/DOCE.
Key Findings:
Pooled recurrence-free survival (RFS) at 12 months was 73.75%; high-grade RFS (HG-RFS) was 75.78%.
BCG-naïve patients had significantly higher 12-month RFS (82.50% vs. 60.00%, p < 0.001) and HG-RFS (84.09% vs. 63.79%, p < 0.001) compared to BCG-failure patients.
Progression-free survival was 95.57%, cancer-specific survival was 99.18%, overall survival was 97.32%, and cystectomy-free survival was 94.41% at 12 months.
The pooled proportion of patients experiencing treatment-related adverse events was 52.59%, with an overall treatment intolerance rate of 3.55%.
Interpretation:
Intravesical GEM/DOCE is an effective and well-tolerated option for high- and very high-risk NMIBC, particularly in BCG-naïve patients.
Limitations:
Evidence is limited by heterogeneity across studies and predominance of retrospective designs.
Further prospective, adequately powered studies are required to better define its role and optimize treatment protocols.
Conclusion:
Intravesical GEM/DOCE shows favorable recurrence outcomes with preserved survival in NMIBC patients.
