Radiofrequency-induced Thermo-chemotherapy Effect Versus a Second Course of Bacillus Calmette-Guérin or Institutional Standard in Patients with Recurrence of Non–muscle-invasive Bladder Cancer Following Induction or Maintenance Bacillus Calmette-Guérin Therapy (HYMN): A Phase III, Open-label, Randomised Controlled Trial

Tan, Wei Shen; Panchal, Anesh; Buckley, Laura; Devall, Adam J.; Loubière, Laurence; Pope, Ann; Feneley, Mark; Cresswell, Jo; Issa, Rami; Mostafid, Hugh; Madaan, Sanjeev; Bhatt, Rupesh I.; McGrath, John; Sangar, Vijay; Griffiths, T.R. Leyshon; Page, Toby; Hodgson, Damian; Datta, SN; Billingham, Lucinda; Kelly, John D.

doi:10.1016/j.eururo.2018.09.005

Cited by 108 publications

(59 citation statements)

References 26 publications

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“…The authors reported that maintenance BCG was superior to maintenance MMC; however, non‐maintenance BCG had significantly poor efficacy of prophylaxis based on recurrence than MMC 32 . Notably, we did not include chemohyperthermia of MMC because it is still under investigation 33,34 …”

Section: Discussionmentioning

confidence: 99%

Efficacy of intravesical therapies on the prevention of recurrence and progression of non‐muscle‐invasive bladder cancer: A systematic review and network meta‐analysis

Xia

et al. 2020

Cancer Medicine

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Intravesical instillation therapy is the mainstay of prophylaxis of tumor recurrence and progression in non‐muscle‐invasive bladder cancer. However, there is no study evaluating the superiority of monotherapy. The aim of this study is to compare the efficacy of preventing recurrence and progression of intravesical monotherapies via network meta‐analysis (NMA) of randomized controlled trials. Database searches were conducted on Embase, Ovid Medline, Web of Science, ScienceDirect, Cochrane Library, and ClinicalTrials.com from the time of establishment to February 6, 2020. The monotherapies included Bacille Calmette‐Guérin (BCG), mitomycin C (MMC), interferon (IFN), adriamycin, epirubicin, gemcitabine (GEM), and thiotepa (THP). A Bayesian consistency network model was generated under a random‐effects model. The superiority of therapy was identified based on the surface under the cumulative ranking curve (SUCRA). Fifty‐seven studies with 12462 patients are included. NMA shows that GEM (SUCRA = 0.92), BCG (SUCRA = 0.82), and IFN (SUCRA = 0.78) are the top three effective drugs to reduce recurrence. GEM (SUCRA = 0.87) is the most effective therapy to prevent progress, followed by BCG, MMC, THP, and IFN with similar efficacy. Subgroup analysis of pairwise meta‐analysis and NMA was performed on publication year, trial initiation year, study origin, center involvement, sample size, drug schedule, tumor characteristics, and trial quality to address confounding factors, which suggests the robustness of the results with stable effect sizes. Network meta‐regression also indicates consistent rank by analyzing year, sample size, and quality. Compared with BCG, GEM is also a promising therapy with favorable efficacy to reduce tumor recurrence and progression. IFN and MMC could be alternative therapies for BCG with slightly inferior efficacy in recurrence prevention and similar efficacy in progression prevention. However, the results of this study should be treated with caution since most of the included studies are of moderate to high risk of bias.

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Section: Discussionmentioning

confidence: 99%

Efficacy of intravesical therapies on the prevention of recurrence and progression of non‐muscle‐invasive bladder cancer: A systematic review and network meta‐analysis

Xia

et al. 2020

Cancer Medicine

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“…Patients unresponsive to BCG represent a particular population with a high recurrence risk, for whom radical cystectomy remains the standard and most effective treatment [34][35][36][37]. Several treatment options for the management of these patients are under investigation, and preliminary results of studies using EMDA [38] and CHT [17,39,40] to prevent radical cystectomy have provided promising results. However, one of these studies also highlighted the lack of efficacy of chemotherapy for carcinoma in situ (CIS) [39].…”

Section: Discussionmentioning

confidence: 99%

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

Carando

Soldini

Cotrufo

et al. 2020

Arab Journal of Urology

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“…The 10-year disease-free survival rate was increased from 15% in the Mitomycin C arm to 53% in the Mitomycin C plus hyperthermia arm [72]. Two randomized trials demonstrated that Mitomycin C þ Synergo based hyperthermia provides similar or possibly better results compared to standard Bacillus Calmette-Gu erin (BCG) treatment for NMIBC patients [73,74]. Disadvantages of this intracavitary heating approach are an uneven SAR distribution over the bladder wall, and that treatment of more deeply penetrating muscle invasive bladder cancer will require the use of a locoregional hyperthermia device [299,302].…”

Section: Clinical Applications Of Intraluminal Hyperthermia and Hivecmentioning

confidence: 99%

“…Overview of clinical applications of local, locoregional and whole-body heating techniques [55,[71][72][73][74]81,96,97,132,139,166,[199][200][201][202]. BO: Bone (metastases, osteoid osteoma)…”

mentioning

confidence: 99%

Heating technology for malignant tumors: a review

Kok

Cressman

Ceelen

et al. 2020

International Journal of Hyperthermia

257

188

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The therapeutic application of heat is very effective in cancer treatment. Both hyperthermia, i.e., heating to 39-45 C to induce sensitization to radiotherapy and chemotherapy, and thermal ablation, where temperatures beyond 50 C destroy tumor cells directly are frequently applied in the clinic. Achievement of an effective treatment requires high quality heating equipment, precise thermal dosimetry, and adequate quality assurance. Several types of devices, antennas and heating or power delivery systems have been proposed and developed in recent decades. These vary considerably in technique, heating depth, ability to focus, and in the size of the heating focus. Clinically used heating techniques involve electromagnetic and ultrasonic heating, hyperthermic perfusion and conductive heating. Depending on clinical objectives and available technology, thermal therapies can be subdivided into three broad categories: local, locoregional, or whole body heating. Clinically used local heating techniques include interstitial hyperthermia and ablation, high intensity focused ultrasound (HIFU), scanned focused ultrasound (SFUS), electroporation, nanoparticle heating, intraluminal heating and superficial heating. Locoregional heating techniques include phased array systems, capacitive systems and isolated perfusion. Whole body techniques focus on prevention of heat loss supplemented with energy deposition in the body, e.g., by infrared radiation. This review presents an overview of clinical hyperthermia and ablation devices used for local, locoregional, and whole body therapy. Proven and experimental clinical applications of thermal ablation and hyperthermia are listed. Methods for temperature measurement and the role of treatment planning to control treatments are discussed briefly, as well as future perspectives for heating technology for the treatment of tumors.

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Cited by 108 publications

References 26 publications

Efficacy of intravesical therapies on the prevention of recurrence and progression of non‐muscle‐invasive bladder cancer: A systematic review and network meta‐analysis

Efficacy of intravesical therapies on the prevention of recurrence and progression of non‐muscle‐invasive bladder cancer: A systematic review and network meta‐analysis

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

Heating technology for malignant tumors: a review

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