Journal article
Multi-Institution Evaluation of Sequential Gemcitabine and Docetaxel as Rescue Therapy for Nonmuscle Invasive Bladder Cancer
The Journal of urology, Vol.203(5), pp.902-909
05/2020
DOI: 10.1097/JU.0000000000000688
PMID: 31821066
Abstract
Rescue intravesical therapies for patients with bacillus Calmette-Guérin failure nonmuscle invasive bladder cancer remain a critical focus of ongoing research. Sequential intravesical gemcitabine and docetaxel therapy has shown safety and efficacy in 2 retrospective, single institution cohorts. This doublet has since been adopted as an intravesical salvage option at multiple institutions. We report the results of a multi-institutional evaluation of gemcitabine and docetaxel.
Each institution retrospectively reviewed all records of patients treated with intravesical gemcitabine and docetaxel for nonmuscle invasive bladder cancer between June 2009 and May 2018. Only patients with recurrent nonmuscle invasive bladder cancer and a history of bacillus Calmette-Guérin treatment were included in the analysis. If patients were disease-free after induction, maintenance was instituted at the treating physician's discretion. Posttreatment surveillance followed American Urological Association guidelines. Survival analysis was performed using the Kaplan-Meier method and risk factors for treatment failure were assessed with Cox regression models.
Overall 276 patients (median age 73 years, median followup 22.9 months) received treatment. Nine patients were unable to tolerate a full induction course. One and 2-year recurrence-free survival rates were 60% and 46%, and high grade recurrence-free survival rates were 65% and 52%, respectively. Ten patients (3.6%) had disease progression on transurethral resection. Forty-three patients (15.6%) went on to cystectomy (median 11.3 months from induction), of whom 11 (4.0%) had progression to muscle invasion. Analysis identified no patient, disease or prior treatment related factors associated with gemcitabine and docetaxel failure.
Intravesical gemcitabine and docetaxel therapy is well tolerated and effective, providing a durable response in patients with recurrent nonmuscle invasive bladder cancer after bacillus Calmette-Guérin therapy. Further prospective study is warranted.
Details
- Title: Subtitle
- Multi-Institution Evaluation of Sequential Gemcitabine and Docetaxel as Rescue Therapy for Nonmuscle Invasive Bladder Cancer
- Creators
- Ryan L Steinberg - The University of Texas Southwestern Medical CenterLewis J Thomas - Cleveland ClinicNathan Brooks - The University of Texas MD Anderson Cancer CenterSarah L Mott - University of IowaAndrew Vitale - University of IowaTrafford Crump - University of CalgaryMounica Y Rao - University of ArizonaMarcus J Daniels - Johns Hopkins UniversityJonathan Wang - Beth Israel Deaconess Medical CenterSupriya Nagaraju - The University of Texas MD Anderson Cancer CenterWilliam C DeWolf - Beth Israel Deaconess Medical CenterDonald L Lamm - University of ArizonaMax Kates - Johns Hopkins UniversityM Eric Hyndman - University of CalgaryAshish M Kamat - The University of Texas MD Anderson Cancer CenterTrinity J Bivalacqua - Johns Hopkins UniversityKenneth G Nepple - University of IowaMichael A O'Donnell - University of Iowa
- Resource Type
- Journal article
- Publication Details
- The Journal of urology, Vol.203(5), pp.902-909
- DOI
- 10.1097/JU.0000000000000688
- PMID
- 31821066
- ISSN
- 1527-3792
- eISSN
- 1527-3792
- Language
- English
- Date published
- 05/2020
- Academic Unit
- Urology
- Record Identifier
- 9984319982502771
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