Display options
Cite
Porten SP, Leapman MS, Greene KL. Intravesical chemotherapy in non-muscle-invasive bladder cancer. Indian J Urol. 2015;31(4):297-303doi: 10.4103/0970-1591.166446.
Porten, S. P., Leapman, M. S., & Greene, K. L. (2015). Intravesical chemotherapy in non-muscle-invasive bladder cancer. Indian journal of urology : IJU : journal of the Urological Society of India, 31(4), 297-303. https://doi.org/10.4103/0970-1591.166446
Porten, Sima P, et al. "Intravesical chemotherapy in non-muscle-invasive bladder cancer." Indian journal of urology : IJU : journal of the Urological Society of India vol. 31,4 (2015): 297-303. doi: https://doi.org/10.4103/0970-1591.166446
Porten SP, Leapman MS, Greene KL. Intravesical chemotherapy in non-muscle-invasive bladder cancer. Indian J Urol. 2015 Oct-Dec;31(4):297-303. doi: 10.4103/0970-1591.166446. PMID: 26604440; PMCID: PMC4626913.
Copy Download .nbib Format: NLM
Share it on

Indian J Urol. 2015 Oct-Dec;31(4):297-303. doi: 10.4103/0970-1591.166446.

Intravesical chemotherapy in non-muscle-invasive bladder cancer.

Indian journal of urology : IJU : journal of the Urological Society of India

Sima P Porten, Michael S Leapman, Kirsten L Greene

Affiliations

  1. Department of Urology, University of California, San Francisco, California, USA.

PMID: 26604440 PMCID: PMC4626913 DOI: 10.4103/0970-1591.166446

Abstract

Non-muscle-invasive bladder cancer (NMIBC) is characterized by a tendency for recurrence and capacity for progression. Intravesical instillation therapy has been employed in various clinical settings, which are summarized within this review. Several chemotherapeutic agents have shown clinical efficacy in reducing recurrence rates in the post-transurethral resection of bladder tumor (TURBT) setting, including mitomycin C (MMC), doxorubicin, and epirubicin. Mounting evidence also supports the use of intravesical MMC following nephroureterectomy to reduce later urothelial bladder recurrence. In the adjuvant setting, bacillus Calmette-Guérin (BCG) immunotherapy is an established first-line agent in the management of carcinoma in situ (CIS) and high-grade non muscle invasive urothelial carcinoma (UC). Among high and intermediate-risk patients (based on tumor grade, size, and focality) improvements in disease-free intervals have been seen with adjunctive administration of MMC prior to scheduled BCG dosing. Following failure of first-line intravesical therapy, gemcitabine and valrubicin have demonstrated modest activity, though valrubicin remains the only agent currently Food and Drug Administration (FDA)-approved for the treatment of BCG-refractory CIS. Techniques to optimize intravesical chemotherapy delivery have also been explored including pharmacokinetic methods such as urinary alkalization and voluntary dehydration. Chemohyperthermia and electromotive instillation have been associated with improved freedom from recurrence intervals but may be associated with increased urinary toxicity. Improvements in therapeutic selection may be heralded by novel opportunities for genomic profiling and refinements in clinical risk stratification.

Keywords: Intermediate risk; intravesical chemotherapy; non-muscle-invasive bladder cancer

References

  1. Eur Urol. 2009 Aug;56(2):260-5 - PubMed
  2. Pharm Res. 1991 Feb;8(2):168-73 - PubMed
  3. BJU Int. 2013 May;111(6):977-83 - PubMed
  4. Urol Oncol. 2015 Jan;33(1):20.e1-7 - PubMed
  5. Eur Urol. 2009 Sep;56(3):495-503 - PubMed
  6. BJU Int. 2011 Mar;107(6):912-8 - PubMed
  7. J Urol. 2013 Nov;190(5):1686-91 - PubMed
  8. Eur Urol. 2008 Apr;53(4):709-19 - PubMed
  9. J Urol. 2014 Dec;192(6):1633-8 - PubMed
  10. J Urol. 1999 Apr;161(4):1124-7 - PubMed
  11. J Natl Cancer Inst. 2001 Apr 18;93(8):597-604 - PubMed
  12. Clin Infect Dis. 2000 Sep;31 Suppl 3:S86-90 - PubMed
  13. J Urol. 2013 Mar;189(3):834-9 - PubMed
  14. Eur Urol. 2009 Aug;56(2):247-56 - PubMed
  15. Anticancer Res. 2001 Jan-Feb;21(1B):765-9 - PubMed
  16. Urol Oncol. 2013 Nov;31(8):1635-42 - PubMed
  17. Eur Urol. 2013 Oct;64(4):639-53 - PubMed
  18. Eur Urol. 2004 Sep;46(3):336-8 - PubMed
  19. J Urol. 2004 Jun;171(6 Pt 1):2186-90, quiz 2435 - PubMed
  20. J Urol. 2005 Apr;173(4):1375-80 - PubMed
  21. Cancer. 2010 Apr 15;116(8):1893-900 - PubMed
  22. J Urol. 2000 Apr;163(4):1124-9 - PubMed
  23. J Urol. 2003 Sep;170(3):777-82 - PubMed
  24. Eur Urol. 2006 Mar;49(3):466-5; discussion 475-7 - PubMed
  25. BJU Int. 2009 Mar;103(6):726-9 - PubMed
  26. Eur Urol. 2015 Mar;67(3):508-16 - PubMed
  27. Lancet Oncol. 2011 Sep;12(9):871-9 - PubMed
  28. BMC Cancer. 2013 Jul 05;13:332 - PubMed
  29. Eur Urol. 2011 Jun;59(6):997-1008 - PubMed
  30. Eur Urol. 2010 May;57(5):766-73 - PubMed
  31. BJU Int. 2014 Aug;114(2):193-201 - PubMed
  32. ScientificWorldJournal. 2006 Mar 27;6:2617-25 - PubMed
  33. J Urol. 1993 Apr;149(4):749-52 - PubMed
  34. J Urol. 2014 Aug;192(2):305-15 - PubMed
  35. Eur Urol. 2010 Jan;57(1):25-31 - PubMed
  36. Urol Oncol. 2014 Jan;32(1):35.e15-9 - PubMed
  37. Eur Urol. 2009 Apr;55(4):773-80 - PubMed
  38. Cancer Chemother Pharmacol. 1993;32(4):255-62 - PubMed
  39. J Cancer Res Clin Oncol. 2015 Jan;141(1):161-8 - PubMed
  40. Lancet Oncol. 2006 Jan;7(1):43-51 - PubMed
  41. Cancer. 2009 Dec 1;115(23):5450-9 - PubMed

Publication Types