Comparisons of placebo, pyridoxine, and topical thiotepa in preventing recurrence of stage I bladder cancer

Byar, David P.; Blackard, Clyde E.

doi:10.1016/0090-4295(77)90101-7

Cited by 180 publications

(69 citation statements)

References 13 publications

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“…The Veterans Administration Study by Byar and group showed that Pyridoxine provided the best benefit (P=0.03) in a 3-ARM trial of intravesical thiotepa, Pyridoxine and placebo in 121 patients with history of recurrent NMIUBC (Byar and Blackard 1977). The authors also showed that the efficacy of Pyridoxine was equivalent to that of thiotepa.…”

Section: Vitamin B6 (Pyridoxine)mentioning

confidence: 75%

“…However, dietary supplement, multivitamins and phytochemicals/botanical agents are being evaluated in the prevention of many human cancers (Byar and Blackard 1977;Shibata, Paganini-Hill et al 1992;Lamm, Riggs et al 1994;Newling, Robinson et al 1995;Studer, Jenzer et al 1995;Castelao, Yuan et al 2000;Decensi, Torrisi et al 2000;Michaud, Spiegelman et al 2000;Kamat and Lamm 2002;Castelao, Yuan et al 2004;Miller, Pastor-Barriuso et al 2005;Messing, Kim et al 2006;Sabichi, Lerner et al 2008). Investigators have reported on results of screening strategies for synthetic pharmaceuticals in an experimental bladder cancer prevention model using the chemically-induced rat bladder tumor model (Sindhwani, Hampton et al 2001;Lubet, You et al 2006;Park, Kim et al 2006;Tian, Wang et al 2008;Parada, Reis et al 2011).…”

Section: Future Research and Experimental Cancer Chemopreventionmentioning

confidence: 99%

“…Individual vitamins including Vitamin A, and its analogues, Vitamin B6 (pyridoxine), Vitamin C, Vitamin E have been studied individually, reported and proposed as dietary supplements to prevent bladder cancer.as discussed above (Byar and Blackard 1977;Shibata, Paganini-Hill et al 1992;Newling, Robinson et al 1995;Studer, Jenzer et al 1995;Decensi, Torrisi et al 2000;Kamat and Lamm 2002;Castelao, Yuan et al 2004;Miller, Pastor-Barriuso et al 2005;Sabichi, Lerner et al 2008). However, Lamm et al combined mega doses of Vitamins A(40,000U), B6(100mg), C(2000 mg), E(400U) and Zinc (90mg) in a randomized 2x2 factorial design study in which 65 patients were randomized to receive intraderrmal BCG (Lamm, Riggs et al 1994).…”

Section: Mega Dose Vitaminsmentioning

confidence: 99%

See 2 more Smart Citations

The Potential Role of Chemoprevention in the Management of Non-Muscle Invasive Bladder Urothelial Carcinoma

Nseyo¹,

Corbyons²,

Tunuguntla³

2012

Bladder Cancer - From Basic Science to Robotic Surgery

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Section: Vitamin B6 (Pyridoxine)mentioning

confidence: 75%

Section: Future Research and Experimental Cancer Chemopreventionmentioning

confidence: 99%

Section: Mega Dose Vitaminsmentioning

confidence: 99%

See 1 more Smart Citation

The Potential Role of Chemoprevention in the Management of Non-Muscle Invasive Bladder Urothelial Carcinoma

Nseyo¹,

Corbyons²,

Tunuguntla³

2012

Bladder Cancer - From Basic Science to Robotic Surgery

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“…When patients followed for less than 10 months were excluded, pyridoxine provided better activity than placebo and was as efficacious as thiotepa in reducing recurrence (p = 0.03). 25 These initial positive results were not reproduced by an EORTC, randomized, phase 3 trial of 291 patients, which showed no difference between vitamin B6 and placebo in terms of time to first recurrence or recurrence rate. 26 Vitamin B6 cannot therefore be recommended as a stand-alone chemoprevention strategy in BC.…”

Section: Vitamin B6 (Pyridoxine)mentioning

confidence: 99%

Chemoprevention in bladder cancer: What’s new?

Lattouf

2013

CUAJ

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Bladder cancer is the sixth most common tumour in Canada and ranks eighth in terms of cancer mortality. Up to now, management of this condition relied mostly on surgical and intravesical treatments once the disease is established. Chemoprevention is an attractive option to prevent the disease in high-risk populations and may well reduce the costs related to its treatment. This review examines the available data on chemoprevention strategies in bladder cancer, with special emphasis on randomized controlled trials when available.Can Urol Assoc J 2009;3(Suppl4):S184-7 IntroductionBladder cancer (BC) is one of the most expensive cancers to treat in North America due to its recurrent nature necessitating investigative follow-up and intravesical treatments, and due to comorbidities related to major surgery in cases of invasive cancer. In Canada, BC represents the sixth most common tumour type and ranks 8th with respect to cancer mortality. 1 Of the 3 main histological variants of BC (Table 1), transitional cell carcinoma is the most prevalent in North America, 2 and thus constitutes the object of this review.For a variety of reasons, BC is a disorder very well suited to chemoprevention. First, its natural history is characterized by frequent recurrences, which need to be minimized. Second, in addition to the role of genetic susceptibility, the pathogenesis of BC also correlates with environmental factors such as cigarette smoking, implying sustained contact of urinary carcinogens with the urothelium. The rationale behind chemoprevention lies, therefore, in reducing or preventing the intimate contact of these chemicals with bladder mucosa. Additionally, chemopreventive compounds administered systemically and excreted in urine have the favourable pharmacokinetic property of remaining in close prolonged contact with bladder epithelium. Finally, diagnostic methods in BC allow easy bladder access and tissue sampling for evaluation of the efficacy of prevention strategies.Three types of prevention have been defined: primary prevention, which focuses on avoiding development of cancer in healthy subjects; secondary prevention, which targets premalignant lesions with the intent of avoiding their progression to cancer; and tertiary prevention, which focuses on preventing cancer progression in patients diagnosed with and treated for the disease. Primary and tertiary prevention strategies apply well to BC. However, in the case of primary prevention, because it pertains to a nonafflicted population, this strategy implies that the trade-off between the risk/inconvenience of intervention and the anticipated benefit is substantial. It also implies that a population at risk, in which intervention is warranted, can be identified. These restrictions make primary intervention, albeit attractive conceptually, somewhat difficult to implement in practice. Tertiary intervention is already widely practiced in BC in the form of intravesical treatment, but other alternatives with less toxicity have yet to be explored. This review report...

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“…Review of these initial studies identified nine controlled trials including 1130 patients. Reviewing five of the trials that achieved statistical significance, 84,[88][89][90][91] the mean rate of recurrence in the control populations was 61% versus 49% in the treated groups, resulting in a modest 12% benefit with thiotepa therapy. 69 Currently, due to its marginal efficacy and risk of systemic toxicity, use of thiotepa is limited to patients who cannot tolerate BCG or selected BCG-refractory cases not medically fit for cystectomy.…”

Section: Thiotepamentioning

confidence: 99%

Emerging intravesical therapies for management of nonmuscle invasive bladder cancer

Smaldone¹,

Tomaszewski²

2010

OAJU

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Transitional cell carcinoma (TCC) is the second most common urologic malignancy, and 70% of patients present with superficial or nonmuscle invasive bladder cancer (NMIBC). Intravesical bacillus Calmette-Guerin (BCG) is the most effective agent for preventing disease recurrence, and the only therapy able to inhibit disease progression. However, recurrence rates as high as 30% and significant local and systemic toxicity have led to increased interest in alternative intravesical therapies. In patients refractory or intolerant to BCG, BCG-interferon α2b, gemcitabine, and anthracyclines (doxorubicin, epirubicin, valrubicin) have demonstrated durable clinical responses. Phase I trials investigating alternative cytotoxic agents, such as apaziquone, taxanes (docetaxel, paclitaxel), and suramin are reporting promising data. Novel immunomodulating agents have demonstrated promise as efficacious alternatives in patients refractory to BCG. Optimization of existing chemotherapeutic regimens using hyperthermia, photodynamic therapy, magnetically-targeted carriers, and liposomes remains an area of active investigation. Despite enthusiasm for new intravesical agents, radical cystectomy remains the treatment of choice for patients with NMIBC who have failed intravesical therapy and selected patients with naïve T1 tumors and aggressive features. This report provides a comprehensive review of contemporary intravesical therapy for NMIBC and refractory NMIBC, with an emphasis on emerging agents and novel treatment modalities.

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Comparisons of placebo, pyridoxine, and topical thiotepa in preventing recurrence of stage I bladder cancer

Cited by 180 publications

References 13 publications

The Potential Role of Chemoprevention in the Management of Non-Muscle Invasive Bladder Urothelial Carcinoma

The Potential Role of Chemoprevention in the Management of Non-Muscle Invasive Bladder Urothelial Carcinoma

Chemoprevention in bladder cancer: What’s new?

Emerging intravesical therapies for management of nonmuscle invasive bladder cancer

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