Intravesical mitoxantrone in superficial bladder tumours (Ta-T1)

Serretta, Vincenzo; Corselli, G.; Pavone, Carlo; Pavone‐Macaluso, M.

doi:10.1016/0959-8049(93)90546-r

Cited by 7 publications

(3 citation statements)

References 2 publications

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“…Intravesical mitoxantrone appears to hold promise as an effective chemoprophylactic compound. Four weekly instillations of 20 mg each plus once every month for 1 year have decreased the tumor recurrence rate from 1.65 to 0.58 per year in a group of patients with recurrent superficial Ta-T 1 , G1-2 neoplasms, despite the 25.7% and 5.7% incidences of chemical cystitis and subsequent treatment interruption, respectively [37]. The use of mitoxantrone in tumor chemoresection has succeeded in producing CR in half of patients with recurrent cancer the most of whom had failed previous chemo-or immunotherapy [38].…”

Section: Mitoxantronementioning

confidence: 95%

Intravesical Therapy of Superficial Bladder Cancer

Moutzouris

2000

CPD

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Transurethral resection (TUR) of the superficial transitional cell carcinoma (TCC) of the bladder is known to be insufficient in controlling the disease because of the unacceptable rates of recurrence, progression and ultimate cystectomy. Adjuvant intravesical chemo-and/or immunotherapy is administered in an effort to enhance the efficacy of surgery alone. The initial tumor stage and grade, the multifocality of this cancer and the history of previous recurrences remain the determinant factors in survival. It is important to decide exactly which patients are at risk, and, therefore, do need treatment. Knowledge of the natural history of the disease will facilitate this decision making, although the natural history of TCC is largely unpredictable owing to tumor heterogeneity. Several cytotoxic and immune modifying agents have been used intravesically in different treatment schedules. However, despite their effectiveness, no consensus exists about the optimal antineoplastic regimen. The selection of the latter is a subject of continuous investigation. Intravesical treatment with cytotoxic drugs has been demonstrated to achieve an acceptable reduction in short- and intermediate-term recurrence rates, but has no proven ability in preventing disease progression to muscle-invasive cancer or prolonging survival. On the other hand, bacillus Calmette-Guerin (BCG) currently appears to be the most effective agent for intravesical use, especially in patients with high grade and stage neoplasms but the optimum strain, dosage and duration schedule have not been determined. Clinical trials have shown that BCG provides long-term protection from tumor recurrence, while there is evidence that it may favorably alter the progression rate of the disease with prolongation of survival. Toxicity of intravesical chemo- and immunotherapy still remains a major problem and attempts at reducing the dosage, and, thus, toxicity without affecting efficacy are underway. This review endeavors to present updated information on intravesical chemotherapy in treating superficial bladder cancer, the expanding role of intravesical immunotherapy, the recent work comparing various immunotherapeutic regimens with chemotherapeutic intravesical therapies, and the progress made towards achieving optimal treatment regimens.

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Section: Mitoxantronementioning

confidence: 95%

Intravesical Therapy of Superficial Bladder Cancer

Moutzouris

2000

CPD

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“…Stewart et al [16] noted that nearly 75% of the instilled mitoxantrone was recovered in urine after treatment, implying that the remainder of the drug was absorbed. It has been documented that the side effects of mitoxantrone are in proportion with the dose, the bladder retention time, and the dosage intervals [13,15,16,19]. On the contrary, it has been documented that IFN·-2b toxicity is minor, regardless of the instilled dose [11,12].…”

Section: Discussionmentioning

confidence: 97%

Adjuvant Intravesical Mitoxantrone versus Recombinant Interferon-α after Transurethral Resection of Superficial Bladder Cancer: A Randomized Prospective Study

et al. 2004

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Objective: To determine the efficacy and safety of two different doses of intravesical mitoxantrone and of recombinant interferon-α (IFNα-2b), instilled after transurethral resection (TUR) of superficial transitional cell carcinoma (TCC) of the bladder. Material and Methods: 208 patients (mean age 62.05 years) with primary or recurrent superficial (TaG1, T1G1, T1G2) bladder cancer were randomly allocated into four groups, after TUR of all visible tumors. Group A (45 patients) received no further therapy; group B (56 patients) received 10 mg of mitoxantrone (6 weekly and 20 fortnightly instillations), group C (54 patients) 20 mg of mitoxantrone (3 fortnightly and 10 monthly instillations) and group D (53 patients) received 100 MU of IFNα-2b (8 weekly, 8 fortnightly and 6 monthly instillations). Results: During the follow-up (mean 21.09 months), 29 (64.44%) patients in group A had recurrence, compared with 19 (33.92%) in group B, 17 (31.48%) in group C and 15 (28.3%) patients in group D (p < 0.005). Furthermore, the differences in simple recurrence rates were statistically more significant (p < 0.05), when group A was compared with the three other groups in the terms of T1G2, recurrent and multiple neoplasms. Twenty-nine patients (10, 7, 8, and 4 in groups A–D) experienced tumor progression, and the differences between the four groups were not statistically significant (p > 0.05). The mean recurrence time was 9.03 months in group A, 13.74 in group B, 14.24 in group C and 17.4 months in group D (p < 0.001), and the recurrence rate per 100 patient-months was 4.39, 1.57, 1.48 and 1.06, respectively (p < 0.05). Toxicity (grade 1–3) was recorded in 23.21% in group B, in 31.48% in group C and in 9.43% in group D (p < 0.01). Conclusion: The two doses of mitoxantrone resulted in similar efficacy for the prevention of superficial bladder cancer recurrences, with the dose of 10 mg of mitoxantrone being related to fewer side effects. In comparison with mitoxantrone, the adjuvant intravesical immunotherapy with 100 MU of IFNα-2b showed a better combination of efficacy and safety.

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“…Mitozantrone has been studied as an intravesical agent in superficial bladder carcinoma. In early studies there is a 50% response rate with a dose of 20 mg in 50 mls of N saline instilled intravesically for one hour every four weeks 37 . A randomised study comparing such treatment with regular cystoscopy and diathermy is required to evaluate the role of intravesical mitozantrone.…”

Section: Bladder Carcinomamentioning

confidence: 99%

An Overview of Mitozantrone

Birchall

Bailey

Blackledge

1991

Int J Clinical Practice

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INTRODUCTION Mitozantrone is a member of the anthraquinone group of chemicals. Anthraquinones were used as blue dyes in the fabric industry in the early 20th century, and subsequently in ballpoint pen ink as ametantrone.1 Since the discovery of doxorubicin in 1968 searches have continued for anthracycline‐related compounds with improved efficacy and/or a different spectrum of activity with less toxicity.

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Intravesical mitoxantrone in superficial bladder tumours (Ta-T1)

Cited by 7 publications

References 2 publications

Intravesical Therapy of Superficial Bladder Cancer

Intravesical Therapy of Superficial Bladder Cancer

Adjuvant Intravesical Mitoxantrone versus Recombinant Interferon-α after Transurethral Resection of Superficial Bladder Cancer: A Randomized Prospective Study

An Overview of Mitozantrone

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