Heated Intravesical Chemotherapy

Tan, Wei Phin; Longo, Thomas A.; Inman, Brant A.

doi:10.1016/j.ucl.2019.09.008

Cited by 14 publications

(4 citation statements)

References 60 publications

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“…A detailed discussion on this approach is outside the scope of this review. Interested readers may like to further explore through some recent reviews on this approach (184)(185)(186)(187)(188)(189)(190)(191)(192)(193)(194).…”

Section: Hyperthermia: a Chemosensitizermentioning

confidence: 99%

Integrating Loco-Regional Hyperthermia Into the Current Oncology Practice: SWOT and TOWS Analyses

et al. 2020

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Moderate hyperthermia at temperatures between 40 and 44 • C is a multifaceted therapeutic modality. It is a potent radiosensitizer, interacts favorably with a host of chemotherapeutic agents, and, in combination with radiotherapy, enforces immunomodulation akin to "in situ tumor vaccination." By sensitizing hypoxic tumor cells and inhibiting repair of radiotherapy-induced DNA damage, the properties of hyperthermia delivered together with photons might provide a tumor-selective therapeutic advantage analogous to high linear energy transfer (LET) neutrons, but with less normal tissue toxicity. Furthermore, the high LET attributes of hyperthermia thermoradiobiologically are likely to enhance low LET protons; thus, proton thermoradiotherapy would mimic 12 C ion therapy. Hyperthermia with radiotherapy and/or chemotherapy substantially improves therapeutic outcomes without enhancing normal tissue morbidities, yielding level I evidence reported in several randomized clinical trials, systematic reviews, and meta-analyses for various tumor sites. Technological advancements in hyperthermia delivery, advancements in hyperthermia treatment planning, online invasive and non-invasive MR-guided thermometry, and adherence to quality assurance guidelines have ensured safe and effective delivery of hyperthermia to the target region. Novel biological modeling permits integration of hyperthermia and radiotherapy treatment plans. Further, hyperthermia along with immune checkpoint inhibitors and DNA damage repair inhibitors could further augment the therapeutic efficacy resulting in synthetic lethality. Additionally, hyperthermia induced by magnetic nanoparticles coupled to selective payloads, namely, tumor-specific radiotheranostics (for both tumor imaging and radionuclide therapy), chemotherapeutic drugs, immunotherapeutic agents, and gene silencing, could provide a comprehensive tumor-specific theranostic modality akin to "magic (nano)bullets." To get a realistic overview of the strength (S), weakness (W), opportunities (O), and threats (T) of hyperthermia, a SWOT analysis has been undertaken. Additionally, a TOWS analysis Datta et al.Hyperthermia: SWOT and TOWS Analyses categorizes future strategies to facilitate further integration of hyperthermia with the current treatment modalities. These could gainfully accomplish a safe, versatile, and cost-effective enhancement of the existing therapeutic armamentarium to improve outcomes in clinical oncology.

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Section: Hyperthermia: a Chemosensitizermentioning

confidence: 99%

Integrating Loco-Regional Hyperthermia Into the Current Oncology Practice: SWOT and TOWS Analyses

et al. 2020

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“…Radiofrequency-induced thermo-chemotherapeutic effect (RITE) has been developed to improve intravesical chemotherapy, especially for BCG-unresponsive NMIBC [ 104 , 105 ]. The minitype antenna in the catheter with radiofrequency at 915 MHz is directed at the bladder wall.…”

Section: Physical Methods To Get Drugs Across Bladder Penetrating mentioning

confidence: 99%

Strategies to Get Drugs across Bladder Penetrating Barriers for Improving Bladder Cancer Therapy

et al. 2021

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Bladder cancer is a significant public health concern and social burden due to its high recurrence risk. Intravesical drug instillation is the primary therapy for bladder cancer to prevent recurrence. However, the intravesical drug therapeutic effect is limited by bladder penetrating barriers. The inadequate intravesical treatment might cause the low drug concentration in lesions, resulting in a high recurrence/progression rate of bladder cancer. Many strategies to get drugs across bladder penetrating barriers have been developed to improve intravesical treatment, including physical and chemical methods. This review summarizes the classical and updated literature and presents insights into great therapeutic potential strategies to overcome bladder penetrating barriers for improving the intravesical treatment of bladder cancer.

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“…Thus, the use of alternative intravesical therapies is expanding worldwide [9][10][11][12][13][14]; among these, the combination of a cytotoxic agent (mostly Mitomycin C [MMC]) and hyperthermia delivered intravesically (device-assisted hyperthermic intravesical chemotherapy; HIVEC) has been explored since the late 1990s. Hyperthermia between 40 and 44 • C enhances the cytotoxic effects of chemotherapeutic agents [15]. Although HIVEC using MMC and a microwaveinduced system that heats the bladder wall has shown promising oncological results [16], the treatment may provoke frequent side effects and even severe adverse effects, leading to the discontinuation of treatment in up to 38% of cases [17].…”

Section: Introductionmentioning

confidence: 99%

Hyperthermic Intravesical Chemotherapy (HIVEC) Using Epirubicin in an Optimized Setting in Patients with NMIBC Recurrence after Failed BCG Therapy

Blanc,

Ruggiero,

Lucca

et al. 2024

Cancers

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To evaluate hyperthermic intravesical chemotherapy (HIVEC) using conductive heating and epirubicin in an optimized setting as an alternative to radical cystectomy in patients with recurrent non-muscle invasive bladder cancer (NMIBC) who have failed bacillus Calmette-Guérin (BCG) therapy. We retrospectively analyzed our prospectively recorded database of patients who underwent HIVEC between 11/2017 and 11/2022 at two Swiss University Centers. Cox regression analysis was used for univariate/multivariate analysis, and the Kaplan–Meier method for survival analysis. Of the 39 patients with NMIBC recurrence after failed BCG therapy, 25 (64%) did not recur within the bladder after a median follow-up of 28 months. The 12- and 24-month intravesical RFS were 94.8% and 80%, respectively. Extravesical recurrence developed in 14/39 (36%) of patients. Only 7/39 (18%) patients had to undergo radical cystectomy. Seven patients (18%) progressed to metastatic disease, with five of these (71%) having previously developed extravesical disease. No adverse events > grade 2 occurred during HIVEC. Device-assisted HIVEC using epirubicin in an optimized setting achieved excellent RFS rates in this recurrent NMIBC population at highest risk for recurrence after previously failed intravesical BCG therapy. Extravesical disease during or after HIVEC, however, was frequent and associated with metastatic disease and consecutively poor outcomes.

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Heated Intravesical Chemotherapy

Cited by 14 publications

References 60 publications

Integrating Loco-Regional Hyperthermia Into the Current Oncology Practice: SWOT and TOWS Analyses

Integrating Loco-Regional Hyperthermia Into the Current Oncology Practice: SWOT and TOWS Analyses

Strategies to Get Drugs across Bladder Penetrating Barriers for Improving Bladder Cancer Therapy

Hyperthermic Intravesical Chemotherapy (HIVEC) Using Epirubicin in an Optimized Setting in Patients with NMIBC Recurrence after Failed BCG Therapy

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