Approaches to Non-Muscle-Invasive Bladder Cancer

Slovacek, Hannah; Zhuo, Jerry; Taylor, Jennifer

doi:10.1007/s11912-021-01091-1

Cited by 26 publications

(14 citation statements)

References 62 publications

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“…In the present study, the majority of the 14 patients were male (13 cases), which is consistent with the incidence of both bladder cancer and HIV infection being more common in men [6,7]. In a study in the UK, the median age of muscularized invasive bladder cancer was 76 years old [8]; a study from the United States reported the median age of bladder cancer was 73 years old, and the median age of death was 79 years old [9]. Additionally, a meta-analysis of 1340 cases of metastatic bladder cancer determined the median age of males was 71 years, and 74 for females [10].…”

Section: Resultssupporting

confidence: 89%

Bladder cancer in patients with HIV infection: a retrospective study of 14 cases

Zhang

Xue

et al. 2022

Preprint

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Purpose: This study was intended to determine whether differences existed between bladder cancers in HIV-infected patients compared to those in the general population. Patients and methods: In this study, 14 patients with HIV infection were found also to have bladder cancer, treated in Beijing Ditan Hospital and Beijing You 'an Hospital from 2013 to 2021. The retrospective study parameters analyzed included HIV infection route, regular treatment, viral load and number of CD4+T lymphocytes prior to surgery, and preoperative laboratory examination. Details specific to bladder cancer included pathological stage and grade, treatment, recurrence at 3 months and longer-term follow-up. Results: The study comprised 13 males (93%) and 1 female (7%), with a median age of 50.5 years, of whom only 9 patients received regular antiretroviral therapy after HIV infection. The median value of CD4+T lymphocytes detected before surgery was 368 cells/μL (range: 147cells/μL-759cells /μL). Other preoperative laboratory results were as follows (median counts): WBC, 6.165×109 /L; erythrocytes, 4.16×1012 /L; hemoglobin, 214.5 g/L; platelets, 143×109 /L; creatinine, 70.85μmol/L; and serum albumin, 41.5 g/L. All patients were treated surgically, 11 of whom had non-muscle invading bladder cancer that underwent localized tumor resection (plus epirubicin bladder infusion) , and the remaining 3 patients had tumor invasion of the muscle that required radical resection (plus postoperative chemotherapy). The cancers were all urothelial, 5 high-grade and 9 low-grade histologically. At three months postoperatively, 3 cases had recurred and were re-excised, 7 had no evidence of recurrence, and 4 had not undergone reevaluation. On subsequent longer-term follow-up (median, 40 months), 2 patients had died[1] of unrelated causes, 10 were alive[2] including 1 with liver metastasis, and 2 were lost to follow-up.Conclusions: The clinical characteristics of HIV-positive patients with bladder cancer were similar to those of the general population with the exception of a significant earlier onset of disease. The type and stages of the bladder cancer, treatment, and outcomes of these patients were also similar to the general population. However, the cause of earlier onset of bladder cancer in HIV positive patients remains to be further elucidated.

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Section: Resultssupporting

confidence: 89%

Bladder cancer in patients with HIV infection: a retrospective study of 14 cases

Zhang

Xue

et al. 2022

Preprint

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“…Additionally, recent evidence suggests that maintenance BCG is not a cost-effective alternative for the entire population of patients with intermediate/high risk NMIBC [ 8 ]. To make matters worse, shortages in the BCG supply have compromised patient outcomes and left clinicians around the globe without clear effective and reliable alternatives [ 9 , 10 , 11 ].…”

Section: Introductionmentioning

confidence: 99%

Long-Term Experience with Hyperthermic Chemotherapy (HIVEC) Using Mitomycin-C in Patients with Non-Muscle Invasive Bladder Cancer in Spain

Plata

Guerrero-Ramos

Garcia

et al. 2021

JCM

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(1) Background: Intravesical mitomycin-C (MMC) combined with hyperthermia is increasingly used in non-muscle invasive bladder cancer (NMIBC), especially in the context of a relative BCG shortage. We aim to determine real-world data on the long-term treatment outcomes of adjunct hyperthermic intravesical chemotherapy (HIVEC) with MMC and a COMBAT® bladder recirculation system (BRS); (2) Methods: A prospective observational trial was performed on patients with NMIBC treated with HIVEC using BRS in nine academic institutions in Spain between 2012–2020 (HIVEC-E). Treatment effectiveness (recurrence, progression and overall mortality) was evaluated in patients treated with HIVEC MMC 40mg in the adjuvant setting, with baseline data and a clinical follow-up, that comprise the Full Analysis Set (FAS). Safety, according to the number and severity of adverse effects (AEs), was evaluated in the safety (SAF) population, composed by patients with at least one adjunct HIVEC MMC instillation; (3) Results: The FAS population (n = 502) received a median number of 8.78 ± 3.28 (range 1–20) HIVEC MMC instillations. The median follow-up duration was 24.5 ± 16.5 (range 1–81) months. Its distribution, based on EAU risk stratification, was 297 (59.2%) for intermediate and 205 (40.8%) for high-risk. The figures for five-year recurrence-free and progression-free survival were 50.37% (53.3% for intermediate and 47.14% for high-risk) and 89.83% (94.02% for intermediate and 84.23% for high-risk), respectively. A multivariate analysis identified recurrent tumors (HR 1.83), the duration of adjuvant HIVEC therapy <4 months (HR 1.72) and that high-risk group (HR 1.47) were at an increased risk of recurrence. Independent factors of progression were high-risk (HR 3.89), recurrent tumors (HR 3.32) and the induction of HIVEC therapy without maintenance (HR 2.37). The overall survival was determined by patient age at diagnosis (HR 3.36) and the treatment duration (HR 1.82). The SAF population (n = 592) revealed 406 (68.58%) patients without AEs and 186 (31.42%) with at least one AE: 170 (28.72%) of grade 1–2 and 16 (2.7%) of grade 3–4. The most frequent AEs were dysuria (10%), pain (7.1%), urgency (5.7%), skin rash (4.9%), spasms (3.7%) and hematuria (3.6%); (4) Conclusions: HIVEC using BRS is efficacious and well tolerated. A longer treatment duration, its use in naïve patients and the intermediate-risk disease are independent determinants of success. Furthermore, a monthly maintenance of adjunct MMC HIVEC diminishes the progression rate of NMIBC.

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“…Bladder cancer (BLCA) is the world's 10th most commonly diagnosed cancer (Babjuk et al, 2022). Although nearly 75% of bladder cancers are non-muscle-invasive (NMIBC), 45%-50% of patients with NMIBC will experience recurrence, and 6%-40% will progress (Slovacek et al, 2021). Patients with NMIBC are prone to develop muscle-invasive bladder…”

Section: Introductionmentioning

confidence: 99%

“…Bladder cancer (BLCA) is the world’s 10th most commonly diagnosed cancer ( Babjuk et al, 2022 ). Although nearly 75% of bladder cancers are non-muscle-invasive (NMIBC), 45%–50% of patients with NMIBC will experience recurrence, and 6%–40% will progress ( Slovacek et al, 2021 ). Patients with NMIBC are prone to develop muscle-invasive bladder cancer (MIBC) after repetition and have a high risk of metastasis and poor prognosis, with a few surviving for more than 5 years ( Chou et al, 2016 ; Malmstrom et al, 2017 ).…”

Section: Introductionmentioning

confidence: 99%

Identification of platinum resistance-related gene signature for prognosis and immune analysis in bladder cancer

Jiang

Yang

et al. 2023

Front. Genet.

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Purpose: Currently, there is limited knowledge about platinum resistance-related long non-coding RNAs (lncRNAs) in bladder cancer. We aim to identify platinum resistance-related lncRNAs and construct a risk model for accurate prognostic prediction of bladder cancer.Methods: Transcriptomic and clinical data were extracted from The Cancer Genome Atlas (TCGA) database, and platinum resistance-related genes were obtained from HGSOC-Platinum. The platinum resistance-related lncRNAs were obtained by the Spearman correlation analysis. Then, we constructed a risk score model through Cox regression analysis and the LASSO algorithm. The model was verified by analyzing the median risk score, Kaplan-Meier curve, receiver operating characteristic (ROC) curve, and heatmap. We also developed a nomogram and examined the relationship between the risk score model, immune landscape, and drug sensitivity. Lastly, we assessed the differential expression of PRR-lncRNAs in the cisplatin-resistant bladder cancer cell line and the normal bladder cancer cell line using qRT-PCR.Results: We developed and validated an eight-platinum resistance-related lncRNA risk model for bladder cancer. The risk model showed independent prognostic significance in univariate and multivariate Cox analyses. Based on multivariate analysis, we developed a nomogram. The modified model is both good predictive and clinically relevant after evaluation. Furthermore, immune-related and drug-sensitivity analyses also showed significant differential expression between high and low-risk groups. The qRT-PCR demonstrated that most of the lncRNAs were upregulated in cisplatin-resistance cancerous tissues than in control tissues.Conclusion: We have developed a predictive model based on eight platinum resistance-related lncRNAs, which could add meaningful information to clinical decision-making.

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Approaches to Non-Muscle-Invasive Bladder Cancer

Cited by 26 publications

References 62 publications

Bladder cancer in patients with HIV infection: a retrospective study of 14 cases

Bladder cancer in patients with HIV infection: a retrospective study of 14 cases

Long-Term Experience with Hyperthermic Chemotherapy (HIVEC) Using Mitomycin-C in Patients with Non-Muscle Invasive Bladder Cancer in Spain

Identification of platinum resistance-related gene signature for prognosis and immune analysis in bladder cancer

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