Sequential intravesical gemcitabine and docetaxel for treatment-naïve and previously treated intermediate-risk nonmuscle invasive bladder cancer

Establishing an Intravesical Doublet Chemotherapy Clinic for Nonmuscle-Invasive Bladder Cancer Patients

“…Less than 1% of patients experienced grade 3 adverse events, which include severe UTIs. 7,10,14,15,31 The toxicity profile of Gem/MMC therapy is similar to that of Gem/Doce. 11,12,36 Less than 15% of patients experience adverse events that interfere with the course of their treatment, and < 5% of patients are unable to complete the recommended induction therapy.…”

“…13 Maintenance Gem/Doce for HR BCG failures reduced the 24-month risk of recurrence (hazard ratio of 0.42 [P < .01]). 14 Maintenance Gem/Doce in the IR population is supported by 2 studies 15,16 ; the role of maintenance Gem/Doce in HR BCG-naïve patients has not yet been adequately studied. 7 For Gem/MMC, the effect of maintenance therapy on oncological outcomes has not been assessed in clinical trials.…”

Ablative therapy with UGN-102 for low-grade intermediate risk non-muscle-invasive bladder cancer: ready for primetime?

“…A follow-up multi-institution series of 182 patients with LG IR NMIBC treated either with Gem/Doce or BCG demonstrated no difference in oncologic outcomes between groups. Importantly, Gem/Doce is consistently well-tolerated across studies, with 2.9–3.9% of patients unable to a complete induction course, and 2.6–4.0% of patients with Grade 3+ treatment-related adverse events ( 10 , 11 ).…”

“…The direct toxicity associated with adjuvant intravesical therapy for IR NMIBC seems to be decreasing over time. Sequential intravesical gemcitabine and docetaxel (Gem/Doce) has consistently shown clinical efficacy and an optimal safety profile amongst patients with various types of pathology and risk factors ( 10 - 12 ). With respect to IR NMIBC, a recent retrospective cohort of 77 patients with IR disease treated with Gem/Doce demonstrated 2-year RFS of 71% amongst the entire cohort and 79% amongst those that were treatment naïve, which compares similarly to BCG or single agent chemotherapy ( 10 ).…”

“…Sequential intravesical gemcitabine and docetaxel (Gem/Doce) has consistently shown clinical efficacy and an optimal safety profile amongst patients with various types of pathology and risk factors ( 10 - 12 ). With respect to IR NMIBC, a recent retrospective cohort of 77 patients with IR disease treated with Gem/Doce demonstrated 2-year RFS of 71% amongst the entire cohort and 79% amongst those that were treatment naïve, which compares similarly to BCG or single agent chemotherapy ( 10 ). A follow-up multi-institution series of 182 patients with LG IR NMIBC treated either with Gem/Doce or BCG demonstrated no difference in oncologic outcomes between groups.…”