The Effect of Mitomycin C on Superficial Bladder Cancer

Soloway, Mark S.; Murphy, William M.; DeFuria, M. D.; Crooke, Stanley T.; Finebaum, Pamela J.

doi:10.1016/s0022-5347(17)55149-6

Cited by 74 publications

(17 citation statements)

References 7 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In our opinion, contact exanthema is ow ing to inhygienic handling, while general exanthema can be seen as a result of allergic reactions. Complications observed after intravesical MMC, as described pre viously by Bracken et al [1980] and Soloway et al [1981], cannot be explained by resorption of unchanged MMC which might take place during completion of ther apy. It cannot be excluded that MMC metabolites and/or degradation products are responsible for rare severe tox icity, such as bone marrow suppression.…”

Section: Discussionmentioning

confidence: 92%

“…The use of intravesical chemotherapy with MMC either for treatment of superficial bladder cancer or for prophylaxis following transurethral resection has been gaining popularity in the last decade, after favourable reports from Mishina et al [1975Mishina et al [ , 1982, Mishina and Watanabe [ 1979], Soloway [ 1980], Soloway et al [ 1981 ], Prior et al [ 1982], Harrison et al [1983] and Somerville et al [1985]. Systemic toxic side-effects from intravesi cal MMC are generally low, and life-threatening sideeffects were not observed.…”

Section: Discussionmentioning

confidence: 99%

“…The antitumor antibiotic mitomycin C (MMC) is one of the drugs of choice in the treatment of superficial bladder cancer today [Mishina et al, 1975;Mishina and Watanabe, 1979;Bracken et al, 1980;De Furia et al, 1980;Soloway et al, 1981], Intravesical instillations with MMC even resulted in approximately 80% re sponse rate, regardless of the number of tumours, pro vided individual tumour diameters were below 1 cm [Somerville et al, 1985], The overall results by local application of MMC in the bladder for prophylactic rea son vary from 7 until 48% [Otto ct al., 1984], General side-effects from the topical bladder instillation have been reported Soloway et al, 1981], but have been judged minimal. No severe myelo toxicity has been observed, which is thought to be related with low resorption.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Mitomycin C Resorption following Repeated Intravesical Instillations Using Different Instillation Times

Helsdingen¹,

Rikken²,

Sleeboom³

et al. 1988

Urol Int

View full text Add to dashboard Cite

In a prospective and randomized trial, 31 patients with superficial and/or CIS transitional cell carcinoma were treated by complete transurethral resection of all visible tumours, followed by instillation of 40 mg mitomycin C (MMC). The instillation time was 0.5 and 1.0 h. The resorption of MMC by the bladder wall was not influenced by the instillation time. There was no cumulative effect on MMC resorption observed in consecutive instillations. Less than 1 % of the instilled dose of MMC was resorbed. The maximum plasma concentration of MMC never exceeded 31 ng/ml. After instillation, mean percentages of MMC found in urine were 40.3 (0.5 h group) and 46.4 (1.0 h group), respectively. The only side-effects observed were chemical cystitis, contact and general exanthema. The instillation time had no influence on these side-effects. Bone marrow toxicity has not been observed.

show abstract

Section: Discussionmentioning

confidence: 92%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Mitomycin C Resorption following Repeated Intravesical Instillations Using Different Instillation Times

Helsdingen¹,

Rikken²,

Sleeboom³

et al. 1988

Urol Int

View full text Add to dashboard Cite

show abstract

“…It is due to many factors, including continuous exposure of the bladder epithelium to carcinogens, multifocal growth of tumors, implantation of tumor cells during TUR and incomplete tumor resection [1,9,10]. For these reasons, intravesical chemotherapy and immunotherapy have been advocated for patients at high risk of recurrence and progression [3][4][5][6]11]. The agents which have been most commonly used for bladder instil- lation are thiotepa, mitomycin C, doxorubicin and BCG [6].…”

Section: Discussionmentioning

confidence: 99%

Intravesical Combined Chemoimmunotherapy with Epirubicin and Bacillus Calmette-Guérin Is Not Indicated for Superficial Bladder Cancer

Tozawa

Okamura²,

Sasaki³

et al. 2001

Urol Int

View full text Add to dashboard Cite

Purpose: The short-term effects of intravesical chemoimmunotherapy with epirubicin and bacillus Calmette-Guérin (BCG) administered repeatedly for prophylaxis of recurrence of superficial bladder cancer (pTa, pT1) were investigated in 24 patients aged a median of 70 years between March 1996 and February 1999, and were compared with those of BCG monotherapy in 50 patients from March 1990 to February 1999. Patients and Methods: The patients underwent intravesical instillation of the Tokyo strain BCG with or without epirubicin after transurethral resection (TUR) of bladder cancer. For the combined treatment, at 1–2 weeks after TUR, epirubicin (40 mg) and BCG (80 mg) were istilled into the bladder by turns once a week for 12 weeks. For the group receiving only BCG, 80-mg instillations were done with the same schedule. Thereafter, the patients were followed by cystoscopy and urinary cytology every 3 months for up to 3 years after intravesical therapy. Results and Conclusions: At 2 years after treatment, the simple recurrence rate was 26.1% (6/23) in patients with chemoimmunotherapy and 32.0% (16/50) in BCG-treated patients. Adverse reactions, including increased frequency of urination, urgency and miction pain, were observed in 18 patients (85.7%) undergoing chemoimmunotherapy and 58.0% undergoing BCG monotherapy. One patient receiving chemoimmunotherapy was withdrawn from treatment because of symptoms of severe bladder irritation due to the instillation. Intravesical chemoimmunotherapy using epirubicin and BCG was finally found to be inferior in comparison with BCG monotherapy for the prophylaxis of recurrence of superficial bladder cancer.

show abstract

“…As evidenced by several studies, the various agents in use can reduce the rate of tumour recurrence. Controlled clinical trials have shown that, following chemotherapy, the rate of tumour recurrence is reduced by 16-18%, immunotherapy achieved a complete response in about half of the patients with papillary tumours and over 70% in those with carcinoma in situ (Koontz et al, 1981;Schulman et al, 1982;Garnick et al, 1984;Soloway et al, 1981;Herr et al, 1989). Of more importance is the impact of intravesical therapy on tumour progression and patient survival in superficial bladder cancer.…”

Section: Discussionmentioning

confidence: 99%

Treatment of experimental mouse bladder tumour by LPS-induced epithelial cell shedding

Nativ

Medalia²,

Mor³

et al. 1996

Br J Cancer

View full text Add to dashboard Cite

Summary The purpose of the present study was to explore the therapeutic potential of serial administration of shedding-inducing endotoxin in a mouse tumour bladder model. The studies were conducted with two variants derived from the MBT-2 tumour namely, T5 and T50, the latter being far more aggressive than the former. It was found that T5 tumours responded to intravesical lipopolysaccharides (LPS) instillation by a considerable reduction in their pace of growth (P<0.0001) when treatment was initiated 3 days after tumour implantation, but not when started after 7 days. The T50 variant did not respond to LPS when treated 3 days after implantation, but a considerable reduction in rate of growth occurred when treatment was started after 1-2 days. Shedding induced by intravesically instilled LPS was found to retard considerably the progression rate of experimental bladder tumour.Keywords: bladder neoplasm; lipopolysaccharide; shedding; desquamation Carcinoma of the bladder is the second most common urological neoplasm, accounting for approximately 5% of all new malignancies and 1.9% of all cancer deaths in the United States (Silverberg et al., 1990). Papillary superficial transitional cell carcinoma is the most common type representing 75% of initial tumour events; of these, approximately 70% involve only the mucosa (Ta, Tis), while 30% invade the lamina propria (TI).If treated by endoscopic resection alone, about 50% to 70% of these tumours will recur locally and usually display the same grade and stage (Torti and Lum, 1984;Rubben et al., 1988); hence, many of the patients are candidates for intravesical therapy. Response to the available intravesical agents ranges between 30% and 70% (depending on the drug used), and all of them are associated with serious side-effects (Herr et al., 1987;Soloway, 1987;Huland et al., 1990).We have previously shown that specific Escherichia coli bacteria and lipopolysaccharides (LPS) are capable of inducing shedding of normal urothelial cells (Aronson et al., 1988). Shed cells originated from all the different mucosal layers: the majority of these cells was found to be viable. Desquamation starts about 1 h after LPS instillation, long before the appearance of polymorphonuclear cells. In addition, it was found that administration of aprotinin, an inhibitor of proteolytic enzymes, considerably abrogated the extent of shedding. These results suggest that the epithelial cells secrete proteolytic enzymes whose activity results in shedding, and that the cells are programmed to respond with shedding following proper stimuli. Our working hypothesis regards shedding as an antimicrobial defence mechanism, since bacteria which adhere to shed epithelial cells are washed out.We have recently made use of the phenomenon of LPSinduced shedding for early detection of experimentally induced bladder tumour and, indeed, the efficacy of this method is considerably higher than that obtainable by irrigation of the bladder with saline (Nativ et al., 1994). In the present study we investigated whether intrav...

show abstract

The Effect of Mitomycin C on Superficial Bladder Cancer

Cited by 74 publications

References 7 publications

Mitomycin C Resorption following Repeated Intravesical Instillations Using Different Instillation Times

Mitomycin C Resorption following Repeated Intravesical Instillations Using Different Instillation Times

Intravesical Combined Chemoimmunotherapy with Epirubicin and Bacillus Calmette-Guérin Is Not Indicated for Superficial Bladder Cancer

Treatment of experimental mouse bladder tumour by LPS-induced epithelial cell shedding

Contact Info

Product

Resources

About