Journal article
Sequential intravesical gemcitabine and docetaxel for treatment-naïve and previously treated intermediate-risk nonmuscle invasive bladder cancer
Urologic oncology, Vol.41(12), pp.485.e1-485.e7
12/2023
DOI: 10.1016/j.urolonc.2023.06.017
Abstract
Introduction
Adjuvant intravesical therapy is recommended for patients with intermediate-risk NMIBC. While intravesical gemcitabine-docetaxel (Gem/Doce) has demonstrated favorable outcomes for high-risk NMIBC, its utility in the intermediate-risk setting is not well described. We report outcomes of Gem/Doce as an adjuvant treatment for intermediate-risk NMIBC.
Methods
We retrospectively identified patients with intermediate-risk NMIBC by AUA criteria treated with Gem/Doce following TURBT between 2012 and 2022. Patients received weekly sequential intravesical instillations of 1 g gemcitabine and 37.5 mg docetaxel for 6 weeks. Monthly maintenance of 2 years was initiated if disease-free at first surveillance. The primary outcome was recurrence-free survival (RFS), assessed using the Kaplan-Meier method.
Results
The cohort included 77 patients with median follow-up of 26 (IQR 14–50) months. Prior to induction, 67 (87%) patients presented with Ta low-grade (LG) lesions, 3 (3.9%) with Ta high-grade (HG), 5 (6.5%) with TaLG plus focal TaHG, and 2 (2.6%) with T1LG. Thirty-three (43%) patients received previous intravesical therapy including BCG (23), mitomycin (13), and docetaxel monotherapy (12). The 2-year RFS was 71% among all patients. Treatment-naïve patients had superior RFS compared to previously treated patients (P = 0.04); 2-year estimates were 79% and 64%, respectively. Twenty-nine (38%) patients experienced adverse events; all were Grade 1 to 2 except 1 (1.3%) Grade 3 (acute oxygen desaturation). Three (3.9%) patients did not tolerate a full induction course.
Conclusions
In this retrospective review of a heterogenous population of patients with intermediate-risk NMIBC, Gem/Doce was an effective and well-tolerated adjuvant therapy. Further prospective evaluation in this setting is needed.
Details
- Title: Subtitle
- Sequential intravesical gemcitabine and docetaxel for treatment-naïve and previously treated intermediate-risk nonmuscle invasive bladder cancer
- Creators
- Ian M. McElree - University of IowaJoanna Orzel - University of IowaReid Stubbee - University of IowaRyan L. Steinberg - University of IowaSarah L. Mott - University of IowaMichael A. O'Donnell - University of IowaVignesh T. Packiam - University of Iowa
- Resource Type
- Journal article
- Publication Details
- Urologic oncology, Vol.41(12), pp.485.e1-485.e7
- DOI
- 10.1016/j.urolonc.2023.06.017
- ISSN
- 1078-1439
- eISSN
- 1873-2496
- Language
- English
- Electronic publication date
- 07/2023
- Date published
- 12/2023
- Academic Unit
- Urology
- Record Identifier
- 9984444867902771
Metrics
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