Intravesical Treatment with Electro-Mediated Administration of Mytomicin C as Prophylaxis for Intermediate and High-Risk Nonmuscle-Invasive Bladder Cancer: A Retrospective Multicenter Study

Abstract

<b><i>Background:</i></b> Topical therapy of nonmuscle-invasive bladder cancer (NMIBC) is based on immunotherapy with Bacillus Calmette-Guerin and chemotherapy administered by passive instillation, but an active drug administration achieves a better concentration of the drugs in the bladder. <b><i>Aim:</i></b> This study aimed to investigate the effectiveness of electromotive drug administration (EMDA) of mitomycin C (EMDA/MMC) in intermediate- and high-risk NMIBC patients 6 months after the end of induction treatment. <b><i>Materials and Methods:</i></b> Sixty-five patients diagnosed with histologically confirmed NMIBC, with a complete transurethral resection of all visible tumors underwent EMDA/MMC. Primary endpoint was the proportion of responders at 3 or 6 months. <b><i>Results:</i></b> Data on follow-up were available for 62 subjects at 3 months and 45 at 6 months. EMDA was effective in intermediate- and high-risk patients: because of the small number of cases no conclusions can be drawn on the efficacy in the low-risk group. No difference in the response to treatment between intermediate- (83.3%) and high-risk (84%) patients could be seen. <b><i>Conclusions:</i></b> EMDA/MMC is a useful technique for an effective and safe treatment of primary and recurrent NMIBC, and a valuable therapeutic option in intermediate- and high-risk NMIBC patients.

Electro-mediated drug administration of mitomycin C in preventing non-muscle-invasive bladder cancer recurrence and progression after transurethral resection of the bladder tumour in intermediate- and high-risk patients

“…In the present study, EMDA/MMC proved to be a safe and effective treatment against the recurrence and progression of NMIBC after TURBT in a sample of intermediate-and high-risk patients [24]. Our present results confirm previous studies assessing the efficacy of EMDA/MMC for NMIBC treatment [18,[26][27][28][29][30]. Several investigations have shown the efficacy of chemohyperthermia for the treatment of intermediateand high-risk patients with NMIBC [31][32][33].…”

Electromotive Drug Administration of Mitomycin C (EMDA/MMC) versus Intravesical Immunotherapy with Bacillus Calmette-Guérin (BCG) in Intermediate and High Risk Non Muscle Invasive Bladder Cancer

“…The largest reported study to date evaluated 124 EMDA/MMC treatments [11][12][13][14][15][16]. Thus, this research adds to the current literature by describing patient characteristics, efficacy, and recurrence as well as progression outcomes after EMDA/MMC treatments in the largest study reported to date, as shown in Table 4.…”

“…At the end of followup, recurrence-free rates were 75, 71.4, 50, and 25% in TaG3, T1G3, CIS, and TaT1G3 + CIS patients, respectively; progression-free rate was 61%. Carando et al [15,16] reported the data of 65 patients and 112 patients affected by NMIBC that performed a complete TURBT followed by EMDA/MMC. At the end of follow-up, recurrence-free rates were 84 and 75% in 65 and 112 patients, respectively.…”

“…Carando et al [15, 16] reported the data of 65 patients and 112 patients affected by NMIBC that performed a complete TURBT followed by EMDA/MMC. At the end of follow-up, recurrence-free rates were 84 and 75% in 65 and 112 patients, respectively.…”

Electromotive Enhanced Drug Administration in Oncology: Principles, Evidence, Current and Emerging Applications

“…EMDA protocols adopted by the various centers show slight variations, with earlier studies using a lower current amplitude of 15 mA over shorter time periods of 20 min, while most subsequent studies utilize a maximum of 20 to 23 mA of pulsed DC applied over a duration of 30 min [ 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 ]. No differences in tolerability and adverse side effects were observed with the higher amplitude and longer durations.…”