Could Hyaluronic acid (HA) reduce Bacillus Calmette-Guérin (BCG) local side effects? Results of a pilot study

Topazio, Luca; Miano, Roberto; Maurelli, Valentina; Gaziev, Gabriele; Gacci, Mauro; Iacovelli, Valerio; Finazzi‐Agrò, Enrico

doi:10.1186/1471-2490-14-64

Cited by 23 publications

(14 citation statements)

References 27 publications

(36 reference statements)

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“…Alternatively, glycosaminoglycan drug carriers have been shown to be taken up into GAG layers, increasing penetration of drug into tumour interstitium [12,13]. GAG has also been considered a barrier to effective therapy with the immunotherapeutic drug BCG [14]. Although these methods have resulted in improvements in antitumour effects of drugs in pre-clinical models, none have been approved for use in conjunction with intravesical chemotherapy.…”

Section: Glycosaminoglycans Present a Barrier To Drug Penetrationmentioning

confidence: 99%

Effects of hyperthermia in neutralising mechanisms of drug resistance in non-muscle-invasive bladder cancer

Heijden

Dewhirst

2016

International Journal of Hyperthermia

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Non-muscle-invasive bladder cancer is a challenging disease, even given its superficial nature. It is prone to multiple recurrences and progression to muscle-invasive cancer. These features of this disease contribute significantly to reduced quality of life as well as creating significant morbidity and even mortality. Randomised trials demonstrate that when hyperthermia is added to conventional mitomycin-C treatment that local control rates and progression-free survival are substantially improved. In this review we consider how hyperthermia can exert such beneficial effects. Some of the mechanisms presented are theoretical, while others are facts. It is hoped that this review will contribute rationale for further examination of mechanisms, because an understanding of such mechanisms may lead to even better chemotherapeutic approaches, as well as potential biomarkers for predicting and monitoring treatment success.ARTICLE HISTORY

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Section: Glycosaminoglycans Present a Barrier To Drug Penetrationmentioning

confidence: 99%

Effects of hyperthermia in neutralising mechanisms of drug resistance in non-muscle-invasive bladder cancer

Heijden

Dewhirst

2016

International Journal of Hyperthermia

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“…Finally Topazio and colleagues investigated if sequential administration of HA could reduce the side effects related to BCG [Topazio et al 2014] A total of 30 consecutive subjects undergoing BCG intravesical administration for high risk NMIBC were randomized to receive either BCG alone or BCG and HA. The mean VAS for pain was significantly lower in the group receiving the combination of BCG and HA.…”

Section: Chemotherapy and Radiotherapy Induced Cystitismentioning

confidence: 99%

Managing chronic bladder diseases with the administration of exogenous glycosaminoglycans: an update on the evidence

Lazzeri

Hurle

Casale

et al. 2015

Therapeutic Advances in Urology

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Although the pathophysiology of acute chronic cystitis and other ‘sensory’ disorders, i.e. painful bladder syndrome (PBS) or interstitial cystitis (IC), often remains multifactorial, there is a wide consensus that such clinical conditions may arise from a primary defective urothelium lining or from damaged glycosaminoglycans (GAGs). A ‘cascade’ of events starting from GAG injury, which fails to heal, may lead to chronic bladder epithelial damage and neurogenic inflammation. To restore the GAG layer is becoming the main aim of new therapies for the treatment of chronic cystitis and PBS/IC. Preliminary experiences with GAG replenishment for different pathological conditions involving the lower urinary tract have been reported. There is a range of commercially available intravesical formulations of these components, alone or in combination. Literature evidence shows that exogenous intravesical hyaluronic acid markedly reduces recurrences of urinary tract infections (UTIs). Patients treated with exogenous GAGs have fewer UTI recurrences, a longer time to recurrence and a greater improvement in quality of life. Exogenous intravesical GAGs have been used for the treatment of PBS/IC. Despite the limitations of most of the studies, findings confirmed the role of combination therapy with hyaluronic acid and chondroitin sulfate as a safe and effective option for the treatment of PBS/IC. To prevent and/or treat radiotherapy and chemotherapy induced cystitis, GAG replenishment therapy has been used showing preliminary encouraging results. The safety profile of exogenous GAGs has been reported to be very favourable, without adverse events of particular significance.

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“…Thirty subjects were enrolled in this pilot study and randomized 1:1 to receive intravesical BCG alone or combined with hyaluronic acid. 107 BCG therapy had a lower impact on quality of life in patients concomitantly receiving hyaluronic acid, but similar therapeutic effects. 107 These data suggest a possible role for hyaluronic acid in limiting the local side effects of BCG-based immunotherapy.…”

Section: Recently Initiated Clinical Trialsmentioning

confidence: 82%

Trial Watch: Immunostimulation with Toll-like receptor agonists in cancer therapy

et al. 2015

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Accumulating preclinical evidence indicates that Toll-like receptor (TLR) agonists efficiently boost tumor-targeting immune responses (re)initiated by most, if not all, paradigms of anticancer immunotherapy. Moreover, TLR agonists have been successfully employed to ameliorate the efficacy of various chemotherapeutics and targeted anticancer agents, at least in rodent tumor models. So far, only three TLR agonists have been approved by regulatory agencies for use in cancer patients. Moreover, over the past decade, the interest of scientists and clinicians in these immunostimulatory agents has been fluctuating. Here, we summarize recent advances in the preclinical and clinical development of TLR agonists for cancer therapy.

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Could Hyaluronic acid (HA) reduce Bacillus Calmette-Guérin (BCG) local side effects? Results of a pilot study

Cited by 23 publications

References 27 publications

Effects of hyperthermia in neutralising mechanisms of drug resistance in non-muscle-invasive bladder cancer

Effects of hyperthermia in neutralising mechanisms of drug resistance in non-muscle-invasive bladder cancer

Managing chronic bladder diseases with the administration of exogenous glycosaminoglycans: an update on the evidence

Trial Watch: Immunostimulation with Toll-like receptor agonists in cancer therapy

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