Sarcopenia Predicts Disease Progression in Patients with T1 High-grade Non–muscle-invasive Bladder Cancer Treated with Adjuvant Intravesical Bacillus Calmette-Guérin: Implications for Decision-making?

Soria, Francesco; D’Andrea, David; Barale, M.; Gust, Kilian M.; Pisano, Francesca; Mazzoli, Sandra; Bellis, M. de; Rosazza, Matteo; Livoti, Simone; Dutto, Daniele; Lillaz, B.; Pradère, Benjamin; Moschini, Marco; Tamandl, Dietmar; Shariat, Shahrokh F.

doi:10.1016/j.euros.2023.02.001

Cited by 3 publications

(2 citation statements)

References 24 publications

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“…They included 1422 patients, of which 316 were females. Prognostic factors included age, gender, number, tumor stage pTa-pT1 and grade G1-G3 (12)(13)(14)(15)(16)(17)(18)(19). The recurrence rate was lower for patients treated with BCG instillations [20][21][22][23][24] and regarding progression the difference was limited or no difference was noticed [20,21], see Table 2.…”

Section: Epirubicin Versus Bcgmentioning

confidence: 99%

“…A full year regimen is nowadays considered as a minimum for best efficacy of the drugs (6 weekly instillations followed by instillation at 6 weeks intervals for a year) [10]. However, a shared decision-making regarding adjuvant therapy with the patient relies also on various factors, including age [11], stage, grade, and risk stratification of bladder cancer, as well as individual patient characteristics such as sarcopenia [12].…”

Section: Introductionmentioning

confidence: 99%

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Epirubicin and Non-Muscle Invasive Bladder Cancer Treatment: A Systematic Review

Chiujdea,

Ferro,

Vartolomei

et al. 2024

Preprint

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(1) Background: Intravesical Chemotherapy is standard of care in intermediate risk non-muscle-invasive bladder cancer (NMIBC). Different agents are used across the world based on availability, cost and practice patterns. Epirubicin (EPI), one of these agents is used by many centers over many decades. However, its true differential efficacy compared to other agents and its tolerability is still poorly reported. We aimed to assess the differential efficacy and safety of intravesical EPI in NMIBC patients. (2) Methods: A systematic search of PUBMED, Webofscience, clinicaltrials.gov, and Google Scholar databases was performed on December 31, 2023. We reviewed 28 studies that included patients treated EPI after TURBT (transurethral resection of bladder tumors) for NMIBC and who compared oncological outcomes such as recurrence and progression to other adjuvant treatment such as Mitomycin C (MMC), Gemcitabine (GEM) and BCG. Further, we looked at the safety profile of EPI at room temperature under hyperthermia intravesically and at the oncological outcomes when administrated with hyperthermia; (3) Results: When compared to other chemotherapeutics (MMC/GEM), EPI seemed to be equally effective; however, EPI seems less effective in preventing disease management recurrence compared to BCG intravesical. The most common adverse events of EPI include cystitis, dysuria, and pollakiuria. (4) Conclusions: EPI exhibits similar oncological performances to Gemcitabine and Mitomycin C currently used for adjuvant therapy in NMIBC. Novel delivery mechanisms such as hyperthermia are promising newcomers.

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Section: Epirubicin Versus Bcgmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Epirubicin and Non-Muscle Invasive Bladder Cancer Treatment: A Systematic Review

Chiujdea,

Ferro,

Vartolomei

et al. 2024

Preprint

View full text Add to dashboard Cite

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Prognostic Effects of Sarcopenia on Patients with Bladder Cancer: A Systematic Review and Meta-Analysis

Zeng,

Cai,

Pan

2024

Cancer Investigation

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Epirubicin and Non-Muscle Invasive Bladder Cancer Treatment: A Systematic Review

Chiujdea,

Ferro,

Vartolomei

et al. 2024

JCM

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(1) Background: Intravesical chemotherapy is the standard of care in intermediate-risk non-muscleinvasive bladder cancer (NMIBC). Different agents are used across the world based on availability, cost, and practice patterns. Epirubicin (EPI), one of these agents, has been used by many centers over many decades. However, its true differential efficacy compared to other agents and its tolerability are still poorly reported. We aimed to assess the differential efficacy and safety of intravesical EPI in NMIBC patients. (2) Methods: This study aimed to systematically review the efficacy and safety profile of Epirubicin (EPI) in the management of non-muscle invasive bladder cancer (NMIBC) compared to other adjuvant therapies. A systematic search of the PUBMED, Web of Science, clinicaltrials.gov, and Google Scholar databases was conducted on 31 December 2023, using relevant terms related to EPI, bladder cancer, and NMIBC. The inclusion criteria targeted studies that evaluated patients treated with EPI following the transurethral resection of bladder tumors (TURBT) for NMIBC and compared oncological outcomes such as recurrence and progression with other adjuvant therapies, including Mitomycin C (MMC), Gemcitabine (GEM), and Bacillus Calmette-Guérin (BCG). Additionally, studies investigating the safety profile of EPI administered intravesically at room temperature and under hyperthermia, as well as oncological outcomes associated with hyperthermic intravesical EPI administration, were included. (3) Results: Eleven studies reported adverse events after adjuvant intravesical instillations with EPI; the most frequently reported adverse events included cystitis (34%), dysuria, pollakiuria, hematuria, bladder irritation/spasms, fever, nausea and vomiting, and generalized skin rash (2.3%). Nine studies compared EPI to BCG in terms of recurrence and progression rates; BCG instillations showed a lower recurrence rate compared to EPI, with limited or non-significant differences in progression rates. Two studies found no significant differences between EPI and MMC regarding progression and recurrence rates. One study showed statistically significant lower recurrence and progression rates with GEM in high-risk NMIBC patients. Another study found no significant differences between EPI and GEM regarding recurrence and progression. (4) Conclusions: EPI exhibits similar oncological performances to Gemcitabine and Mitomycin C currently used for adjuvant therapy in NMIBC. Novel delivery mechanisms such as hyperthermia are interesting newcomers.

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Sarcopenia Predicts Disease Progression in Patients with T1 High-grade Non–muscle-invasive Bladder Cancer Treated with Adjuvant Intravesical Bacillus Calmette-Guérin: Implications for Decision-making?

Cited by 3 publications

References 24 publications

Epirubicin and Non-Muscle Invasive Bladder Cancer Treatment: A Systematic Review

Epirubicin and Non-Muscle Invasive Bladder Cancer Treatment: A Systematic Review

Prognostic Effects of Sarcopenia on Patients with Bladder Cancer: A Systematic Review and Meta-Analysis

Epirubicin and Non-Muscle Invasive Bladder Cancer Treatment: A Systematic Review

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