Experience with Sequential Intravesical Gemcitabine and Docetaxel as Salvage Therapy for Non-Muscle Invasive Bladder Cancer

Velaer, Kyla N.; Steinberg, Ryan L.; Thomas, Lewis J.; O’Donnell, Michael A.; Nepple, Kenneth G.

doi:10.1007/s11934-016-0594-2

Cited by 26 publications

(14 citation statements)

References 27 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In one series involving 45 patients with NMIBC recurrence after BCG therapy, the intravesical combination of gemcitabine with docetaxel showed disease-free rates of 54% at 1 year and 34% at 2 years. [31] Similarly, a multi-institutional retrospective study of high-risk NMIBC patients treated with sequential intravesical gemcitabine followed by MMC demonstrated recurrence-free survival rates of 50% at 12 months. [32] Given the encouraging outcomes, a phase I trial is underway to evaluate the safety of various combinations of chemotherapeutic agents, such as cabazitaxel, gemcitabine, and cisplatin when given intravesically in patients with BCG-unresponsive NMIBC.…”

Section: Bcg-unresponsivementioning

confidence: 99%

Current clinical trials in non–muscle invasive bladder cancer

Siddiqui

Grant

Sanford

et al. 2017

Urologic Oncology: Seminars and Original Investigations

View full text Add to dashboard Cite

Background The treatment options for non-muscle invasive bladder cancer (NMIBC) remain limited. BCG was the last major breakthrough in bladder cancer therapy almost 4 decades ago. There have been improvements in the understanding of immune therapies and cancer biology, leading to the development of novel agents. This has led to many clinical trials that are currently underway to find the next generation of therapies for NMIBC. Method We reviewed clinicaltrials.org and pubmed.gov to find the recently completed and ongoing clinical trials in NIMBC. Included in this review are clinical trials that are currently active and trials that were completed in and after 2014. Result Many trials with BCG naïve and BCG unresponsive/recurrent/refractory/failure NMIBC patients are either currently underway or have been recently completed. A wide variety of novel therapeutic agents are being investigated that range from cytotoxic agents to immunomodulatory agents to targeted molecular therapies. Other approaches include cancer vaccines, gene therapies, and chemoradiation potentiation agents. Novel drug delivery methods are also being tested. Conclusion This comprehensive update of current trials provides researchers an overview of the current clinical trial landscape for patients with NMIBC.

show abstract

Section: Bcg-unresponsivementioning

confidence: 99%

Current clinical trials in non–muscle invasive bladder cancer

Siddiqui

Grant

Sanford

et al. 2017

Urologic Oncology: Seminars and Original Investigations

View full text Add to dashboard Cite

show abstract

“…Another possibility in the absence of BCG could be a combination of gemcitabine and either MMC or docetaxel. This has been tried in a few small trials, with few patients, usually as salvage therapy after failure of BCG [14]. Little is known about the long-term efficacy of these combinations; about a third of the patients seem to be responding after 3 yr, and the toxicity seems acceptable.…”

Section: Evidencementioning

confidence: 99%

How to Treat Multifocal Ta High-grade Disease if Bacillus Calmette-Guérin Is Unavailable

Witjes

Brausi

Malmström

2020

European Urology Oncology

View full text Add to dashboard Cite

The patient was a 71-yr-old man with a primary presentation of microhematuria. He was a retired pulmonologist but a current smoker, with a history of 50 pack-years. His cytology was normal, but cystoscopy revealed multiple lesions. At the original hospital, a transurethral resection of the bladder (TURB) without a photodynamic diagnosis (PDD) revealed pTa low-grade tumors; because there were multiple lesions, this was a case of intermediate-risk category.He was given one instillation of mitomycin C (MMC), followed with 6 mo of MMC maintenance. However, this regimen caused urgency, with voiding every 20-30 min, up to Abstract A 71-yr-old man was transferred to our institution with multiple and recurrent high-grade pTa bladder cancer 26 mo after an initial presentation of multiple and large pTa low-grade tumors and concomitant carcinoma in situ, treated with transurethral resection plus 6-mo postoperative mitomycin C. This case discusses several treatment options in the absence of bacillus Calmette-Guérin (BCG). Immediate radical cystectomy is an option with excellent survival, since there is a substantial risk of understaging and disease progression; however, this results in overtreatment in 50% of these patients. Therefore, a conservative approach could be intravesical combination therapy such as gemcitabine/docetaxel or epirubicin/ interferon. In addition, device-assisted intravesical therapy is becoming an option to consider. Finally, patients could be included in trials such as immunotherapy trials. Patient summary: This 71-yr-old patient was diagnosed with recurrent, moderately severe noninvasive bladder tumors, which were removed. The recommended additional therapy, intravesical bacillus Calmette-Guérin (BCG) instillations, was not available. Both the pros and the cons of radical surgery (bladder removal) and a more conservative approach (other intravesical treatments) are discussed.

show abstract

“…Docetaxel has a minimal role as an intravesical agent, although some BCG failure protocols have shown moderate success when sequentially using this agent with gemcitabine. 66 Intravesical paclitaxel is limited by high lipophilicity and penetration of the urothelium, which can result in systemic toxicity. Novel delivery platforms have conjugated paclitaxel to overcome these issues; this has increased tumor cell selectivity.…”

Section: Salvage Chemotherapies and Novel Delivery Platformsmentioning

confidence: 99%

Non–muscle‐invasive bladder cancer: Intravesical treatments beyond Bacille Calmette‐Guérin

Packiam

Johnson

Steinberg

2016

Cancer

View full text Add to dashboard Cite

An unmet need exists for patients with high-risk non-muscle-invasive bladder cancer for whom bacille Calmette-Guérin (BCG) has failed and who seek further bladder-sparing approaches. This shortcoming poses difficult management dilemmas. This review explores previously investigated first-line intravesical therapies and discusses emerging second-line treatments for the heterogeneous group of patients for whom BCG has failed. The myriad of recently published and ongoing trials assessing novel salvage intravesical treatments offer promise to patients who both seek an effective cure and want to avoid radical surgery. However, these trials must carefully be contextualized by specific patient, tumor, and recurrence characteristics. As data continue to accumulate, there will potentially be a role for these agents as second-line or even first-line intravesical therapies. Cancer 2017;123:390-400. © 2016 American Cancer Society.

show abstract

Experience with Sequential Intravesical Gemcitabine and Docetaxel as Salvage Therapy for Non-Muscle Invasive Bladder Cancer

Cited by 26 publications

References 27 publications

Current clinical trials in non–muscle invasive bladder cancer

Current clinical trials in non–muscle invasive bladder cancer

How to Treat Multifocal Ta High-grade Disease if Bacillus Calmette-Guérin Is Unavailable

Non–muscle‐invasive bladder cancer: Intravesical treatments beyond Bacille Calmette‐Guérin

Contact Info

Product

Resources

About