Intravesical cisplatin for superficial bladder tumors

Abstract

Cisplatin, 50–150 mg in a maximum concentration of 1 mg/ml, was administered intravesically each week to 24 patients with multiple, recurrent carcinoma in situ and/or bladder tumors confined to the mucosa and lamina propria. All patients had a history of multiple transurethral resections and four had received prior chemotherapy. Response was evaluated by urinary cytology, cystoscopy, and biopsy. In a total of 237 weekly doses, toxicities included mild dysuria, pruritus, rash and in one patient, acute anaphylaxis. Only three (13%) patients were classified as achieving complete remission. Cisplatin, in the dose and schedule employed, is ineffective in controlling superficial bladder cancer.

Intravesical chemotherapy of superficial bladder tumors in a controlled trial with cis‐platinum versus Cis‐platinum plus hyaluronidase

“…Although some discouraging results were pub-the nurses Amira Markovitz and Lina Spigel. lished in the literature with CDDP [5,17,18], we accept the statement by Blumenreich et a1 [17] that the failure of from Hadassah-Wizo, Canada.…”

Synthesis and Characterization of Carboxylic Acid Conjugated, Hydrophobically Derivatized, Hyperbranched Polyglycerols as Nanoparticulate Drug Carriers for Cisplatin

“…The drug is usually combined with methotrexate, vinblastine and doxorubicin (so-called M-VAC) and is effective at controlling tumor growth and metastatic progression of advanced bladder cancer. , However, systemic administration of cisplatin is associated with unpredictable and life threatening toxicities whereby comorbid conditions may actually prevent older patients from receiving the drug. , At the time of diagnosis, the majority of bladder cancer cases are nonmuscle invasive or superficial bladder cancer and are often treated by the intravesical administration of chemotherapeutic agents. Intravesical administration of cisplatin for the treatment of superficial bladder cancer (>70% of cancer cases) in humans was associated with mild but unpredictable toxicities including dysuria, bladder irritation, hematuria, and some nausea with only minor evidence of any chemotherapeutic benefit. , It was suggested that the limited efficacy associated with the intravesical route of administration might arise from the poor uptake of this hydrophilic drug into bladder tissues and binding of the drug to urine components . On the other hand, effective intravesical chemotherapy with cisplatin has been described whereby tailored dosing and combination therapy with immunomodulators prevented tumor recurrence with negligible toxicity except cystitis .…”

Chemotherapy-Induced Hypersensitivity Reactions

“…When platinum compounds were introduced as chemotherapy, they induced type I hypersensitivity reactions (Cleare et al). These drugs are associated with a high risk of hypersensitivity reactions (10%-27%), which have occurred with all routes of administration, including IV, intraperitoneal, and intravesicular (Blumenreich et al, 1982;Denis, 1983;Shukunami, Kurokawa, Kawakami, Kubo, & Kotsuji, 1999). Clinical studies have demonstrated that grades III and IV hypersensitivity reactions to oxaliplatin occur in less than 2% of cases (Sanofi -Synthelabo, Inc., 2003).…”