Multi-institutional analysis of sequential intravesical gemcitabine and mitomycin C chemotherapy for non-muscle invasive bladder cancer

Andrew J Lightfoot; Benjamin N Breyer; Henry M Rosevear; Bradley A Erickson; Badrinath R Konety; Michael A O'Donnell

doi:10.1016/j.urolonc.2013.01.009

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Multi-institutional analysis of sequential intravesical gemcitabine and mitomycin C chemotherapy for non-muscle invasive bladder cancer

Journal article

Open access

Peer reviewed

Multi-institutional analysis of sequential intravesical gemcitabine and mitomycin C chemotherapy for non-muscle invasive bladder cancer

Andrew J Lightfoot, Benjamin N Breyer, Henry M Rosevear, Bradley A Erickson, Badrinath R Konety and Michael A O'Donnell

Urologic oncology, Vol.32(1), pp.35.e15-35.e19

01/2014

DOI: 10.1016/j.urolonc.2013.01.009

PMCID: PMC4113080

PMID: 23510863

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Abstract

Apart from cystectomy, few treatment options exist for the management of bacillus Calmette-Guerin refractory non-muscle invasive bladder cancer (NMIBC). We report a multi-institutional experience with sequential intravesical combination chemotherapy using gemcitabine and mitomycin C (MMC) for NMIBC in the treatment of high-risk patients. We performed a retrospective review of patients who received 6 weekly treatments with sequential intravesical gemcitabine (1g) and MMC (40 mg) chemotherapy for NMIBC. Gemcitabine was administered first and retained for 90 minutes and then drained. MMC was then administered directly after and retained for an additional 90 minutes. Forty-seven patients received treatment from 3 academic tertiary referral centers between 2000 and 2010. Forty-seven patients (median age 70, range 32-85; 36 males, 11 females) who previously failed a median of 2 intravesical treatments were reviewed. Complete response, 1-year, and 2-year recurrence-free survival rates for all patients were 68%, 48%, and 38%, respectively. Median recurrence-free survival for all patients was 9 months (range 1-80). Fourteen of 47 patients (30%) remained free of recurrence with a median time to follow-up of 26 months (range 6-80 mo). Ten patients required cystectomy. Sequential intravesical combination chemotherapy using gemcitabine and MMC appears to be a useful treatment for patients with high-grade NMIBC as well as those with prior bacillus Calmette-Guerin failure. Further prospective studies are warranted.

Recurrence

Drug Administration Schedule

Deoxycytidine - administration & dosage

Humans

Middle Aged

Male

Treatment Outcome

Urinary Bladder Neoplasms - drug therapy

Academic Medical Centers

Disease-Free Survival

Antineoplastic Combined Chemotherapy Protocols - therapeutic use

Aged, 80 and over

Adult

Female

Aged

Retrospective Studies

Mitomycin - administration & dosage

Cystectomy - methods

Deoxycytidine - analogs & derivatives

Details

Title: Subtitle: Multi-institutional analysis of sequential intravesical gemcitabine and mitomycin C chemotherapy for non-muscle invasive bladder cancer
Creators: Andrew J Lightfoot - Department of Urology, University of Iowa, Iowa City, IA
Benjamin N Breyer - University of California, San Francisco, CA
Henry M Rosevear - Department of Urology, University of Iowa, Iowa City, IA
Bradley A Erickson - Department of Urology, University of Iowa, Iowa City, IA
Badrinath R Konety - University of Minnesota, Minneapolis, MN
Michael A O'Donnell - Department of Urology, University of Iowa, Iowa City, IA. Electronic address: michael-odonnell@uiowa.edu
Resource Type: Journal article
Publication Details: Urologic oncology, Vol.32(1), pp.35.e15-35.e19
DOI: 10.1016/j.urolonc.2013.01.009
PMID: 23510863
PMCID: PMC4113080
NLM abbreviation: Urol Oncol
ISSN: 1078-1439
eISSN: 1873-2496
Publisher: United States
Grant note: K12 DK083021 / NIDDK NIH HHS P30 CA086862 / NCI NIH HHS
Language: English
Date published: 01/2014
Academic Unit: Urology
Record Identifier: 9984051771102771

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