Intravesical mitomycin C for superficial transitional cell carcinoma

Bolenz, Christian; Cao, Yimei; Arancibia, Mario Fernández; Trojan, Lutz; Alken, P.; Michel, Maurice Stephan

doi:10.1586/14737140.6.8.1273

Cited by 24 publications

(17 citation statements)

References 67 publications

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“…Early and late side effects were negligible occurring in 10% (5/40) of the patients. There was no change compared to that reported in the literature for type and frequency of complications: cystitis and allergic skin reactions were the most frequent adverse effects reported, occurring in 40 and 16%, respectively [7] . Intravesical chemotherapy is a universally accepted therapy in the prophylaxis of NMIBC recurrences.…”

Section: Discussioncontrasting

confidence: 54%

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Intensive Intravesical Mitomycin C Therapy in Non-Muscle-Invasive Bladder Cancer: A Dose Intensity Approach

Racioppi

Volpe²,

Cappa³

et al. 2010

Urol Int

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Objective: The aim of this work was to verify the tolerability and the preliminary clinical results of intensive intravesical instillations of a mitomycin C (MMC) regimen. Patients and Methods: From September 2007 to November 2009, 40 consecutive evaluable patients with pathologically confirmed intermediate-risk non-muscle-invasive bladder cancer (NMIBC) were enrolled after complete transurethral resection of all visible tumors. The mean age of the patients was 64.5 years. 40 mg MMC diluted in 50 ml of saline was instilled in the bladder three times a week for 2 weeks. The median follow-up was 9 months. Results: All patients fulfilled the scheduled treatment. The local adverse events seen were negligible, while no significant deviation from normal values was observed in blood counts for each patient. Twenty-three of 40 patients (57.5%) showed negative at the cystoscopic control which was performed every 3 months with normal spontaneous and washing cytological exams. Conclusion: MMC is a well-known chemotherapeutic agent for the intravesical therapy of NMIBC. With a view to improving its results, we changed the frequency and intensity of the instillations. No significant local or systemic toxicity was reported. Intensive intravesical instilllations of MMC might become a tool in the management of NMIBC.

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Section: Discussioncontrasting

confidence: 54%

“…Mitomycin C (MMC) is currently used for intravesical therapy in doses ranging from 40 to 50 mg in 40-50 ml of sterile solution by weekly (6)(7)(8) instillations. The aim of this study was to evaluate the feasibility of a higher dose intensity intravesical MMC treatment.…”

Section: Introductionmentioning

confidence: 99%

Intensive Intravesical Mitomycin C Therapy in Non-Muscle-Invasive Bladder Cancer: A Dose Intensity Approach

Racioppi

Volpe²,

Cappa³

et al. 2010

Urol Int

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“…Therefore, intravesical mitomycin C chemotherapy must be considered as a treatment that can cause or contribute to fatal interstitial pneumonia. This is important information since intravesical mitomycin C chemotherapy is associated with a lower incidence of systemic adverse effects and considered a safer treatment than systemic chemotherapy [3]. …”

Section: Discussionmentioning

confidence: 99%

Intravesical Mitomycin-C-Induced Interstitial Pneumonia

et al. 2010

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An 84-year-old man with no evidence of pre-existing interstitial pneumonia developed fatal interstitial pneumonia and respiratory failure that could only be explained as an adverse effect of intravesical mitomycin C chemotherapy. He had undergone transurethral resection of bladder cancer 3 times, followed by intravesical mitomycin C chemotherapy 1 month later. He had received intravesical mitomycin C chemotherapy every week for 2 months, and he had complained of dyspnea on exertion 5 days before the last intravesical mitomycin C chemotherapy session. Interstitial infiltration was detected in both the upper and lower lobes of the left lung on the day of the last instillation of mitomycin C. Despite discontinuation of mitomycin C and administration of methylprednisolone, his condition deteriorated and he died. Diagnostic evaluation of other causes of pneumonia, including infection and collagen-vascular diseases, was negative. The autopsy demonstrated diffuse alveolar damage in the lung; there were no remarkable findings in other organs. To our knowledge, this is the first pathologically confirmed case of fatal interstitial pneumonia due to intravesical mitomycin C chemotherapy.

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“…In general, mitomycin C is known for its necrotizing properties, resulting also in severe complications in the kidneys such as ureteral inflammation and stenosis (24). Studies on intravesical instillation of mitomycin C revealed a transurothelial resorption of 1%25% of mitomycin C due to its molecular weight of 334 Da (25,26).…”

Section: Discussionmentioning

confidence: 99%

“…Although yielding a reduction of recurrence of 14%217%, the application of mitomycin C after TUR generally has limited benefits against disease progression (28). Because current intravesical treatment strategies using chemotherapy for urothelial carcinoma after TUR are of limited efficacy (24,29), the aim of this study was to develop a new therapeutic concept and to evaluate it in an appropriate orthotopic model for bladder carcinoma.…”

Section: Discussionmentioning

confidence: 99%

Intravesical α-Radioimmunotherapy with ²¹³Bi-Anti-EGFR-mAb Defeats Human Bladder Carcinoma in Xenografted Nude Mice

Pfost¹,

Seidl

Autenrieth

et al. 2009

J Nucl Med

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Transurethral resection of urothelial carcinoma often results in tumor recurrence due to disseminated tumor cells. Therefore, new therapeutic strategies are urgently needed. The aim of this study was to establish an orthotopic human bladder carcinoma mouse model using the epidermal growth factor receptor (EGFR)-overexpressing bladder carcinoma cell line EJ28 and to compare therapeutic efficacy of intravesically instilled a-particle-emitting 213 Bi-anti-EGFR-monoclonal antibody (mAb) with mitomycin C. Methods: Female Swiss nu/nu mice were intravesically inoculated with luciferase-transfected EJ28 human bladder carcinoma cells after the induction of urothelial lesions by electrocautery. At different time points after cell inoculation, mice were treated intravesically with 213 Bi-anti-EGFR-mAb, mitomycin C, or unlabeled anti-EGFR-mAb. Tumor development and therapeutic response were evaluated via bioluminescence imaging. Results: Mice without therapy and those treated with unlabeled anti-EGFR-mAb reached a median survival of 41 d and 89 d, respectively. Mice that underwent therapy with 0.925 MBq of 213 Bi-anti-EGFR-mAb 1 h, 7 d, or 14 d after cell instillation survived more than 300 d in 90%, 80%, and 40% of the cases, respectively. Therapy with 0.37 MBq 1 h or 7 d after tumor cell inoculation resulted in survival of more than 300 d in 90% and 50% of mice, respectively. Mitomycin C treatment after 1 h and 7 d prolonged survival to more than 300 d in 40% and 50%, respectively; however, treatment turned out to be nephrotoxic. In contrast, no signs of nephrotoxicity could be observed after 213 Bi-anti-EGFR-mAb treatment. Conclusion: The study suggests that radioimmunotherapy using intravesically instilled 213 Bi-anti-EGFR-mAb is a promising option for treatment of bladder cancer in patients.

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Intravesical mitomycin C for superficial transitional cell carcinoma

Cited by 24 publications

References 67 publications

Intensive Intravesical Mitomycin C Therapy in Non-Muscle-Invasive Bladder Cancer: A Dose Intensity Approach

Intensive Intravesical Mitomycin C Therapy in Non-Muscle-Invasive Bladder Cancer: A Dose Intensity Approach

Intravesical Mitomycin-C-Induced Interstitial Pneumonia

Intravesical α-Radioimmunotherapy with ²¹³Bi-Anti-EGFR-mAb Defeats Human Bladder Carcinoma in Xenografted Nude Mice

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Intravesical mitomycin C for superficial transitional cell carcinoma

Cited by 24 publications

References 67 publications

Intensive Intravesical Mitomycin C Therapy in Non-Muscle-Invasive Bladder Cancer: A Dose Intensity Approach

Intensive Intravesical Mitomycin C Therapy in Non-Muscle-Invasive Bladder Cancer: A Dose Intensity Approach

Intravesical Mitomycin-C-Induced Interstitial Pneumonia

Intravesical α-Radioimmunotherapy with 213Bi-Anti-EGFR-mAb Defeats Human Bladder Carcinoma in Xenografted Nude Mice

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Product

Resources

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Intravesical α-Radioimmunotherapy with ²¹³Bi-Anti-EGFR-mAb Defeats Human Bladder Carcinoma in Xenografted Nude Mice