Clinical Results of Prophylactic Intravesical Chemotherapy on Superficial Bladder Cancer Using the Dye Exclusion Assay

Abstract

A chemosensitivity test was carried out on superficial bladder cancer using the dye exclusion assay for the purpose of screening chemosensitive drugs for prophylactic intravesical chemotherapy. Bladder cancer cells of each patients were incubated, in vitro, in the presence of adriamycin, (2"R)-4'-0-tetrahydropyranyladriamycin, mitomycin C, pepleomycin and 4'-epi-adriamycin (500 micrograms/ml) at 5%, CO2, 37 degrees C for 2 hours. The cytotoxic effect of the drugs was evaluated by the ratio of stained cells by trypan-blue. The most effective drug was instilled postoperatively into the bladder 3 times for the first week, and every 2 weeks during the following 14 weeks. In 18 patients followed more than 4 months the prophylactic effect was evaluated. Fifteen of the 18 patients completed the protocol, but the remaining 3 patients failed to complete to the instillation because of severe irritability of the bladder. Tumor recurrence was demonstrated in two patients. Non-recurrence rates of tumors at 12 and 24 months were 93.8% and 82.0%, respectively. These results suggested that this rapid and handy assay was useful for the purpose of screening chemosensitive drugs for the intravesical chemotherapy.

Mecanismos del ciclo celular y la apoptosis implicados en las resistencias a los fármacos de uso intravesical en el cáncer superficial de vejiga

“…Es lógico pensar que los resultados en términos de disminución de recurrencias o de retraso en su aparición pueden mejorar si la elección de la droga se hace en base a un test de quimiosensibilidad. En el caso de los tumores transicionales superficiales existen diversos tests en la literatura para las drogas utilizadas intravesicalmente 54,[83][84][85][86] . Su limitación más importante es que están basados en cultivos primarios en monocapa o en suspensión celular, por lo que sólo son capaces de reproducir in vitro los mecanismos de resistencia unicelulares.…”