The management of superficial transitional cell carcinoma of the bladder: a critical assessment of contemporary concepts and future perspectives

Vögeli, Thomas-Alexander

doi:10.1111/j.1464-410x.2005.05928.x

Cited by 4 publications

(2 citation statements)

References 55 publications

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“…It accounts for about 7% and 2% of new cancer cases in men and women, respectively [2] . Bladder carcinoma (BC) is commonly diagnosed following the transurethral resection of bladder tumor (TURBT), determination of the tumor grade and the degree of tumor invasion [3] . However, prediction of the clinical behavior and optimized treatment regimen for BC are challenging up to this day.…”

Section: Introductionmentioning

confidence: 99%

Treatment of non-muscle invasive bladder cancer with Bacillus Calmette–Guerin (BCG): Biological markers and simulation studies

Kiselyov

Bunimovich‐Mendrazitsky

Startsev

2015

BBA Clinical

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Intravesical Bacillus Calmette–Guerin (BCG) vaccine is the preferred first line treatment for non-muscle invasive bladder carcinoma (NMIBC) in order to prevent recurrence and progression of cancer. There is ongoing need for the rational selection of i) BCG dose, ii) frequency of BCG administration along with iii) synergistic adjuvant therapy and iv) a reliable set of biochemical markers relevant to tumor response. In this review we evaluate cellular and molecular markers pertinent to the immunological response triggered by the BCG instillation and respective mathematical models of the treatment. Specific examples of markers include diverse immune cells, genetic polymorphisms, miRNAs, epigenetics, immunohistochemistry and molecular biology ‘beacons’ as exemplified by cell surface proteins, cytokines, signaling proteins and enzymes. We identified tumor associated macrophages (TAMs), human leukocyte antigen (HLA) class I, a combination of Ki-67/CK20, IL-2, IL-8 and IL-6/IL-10 ratio as the most promising markers for both pre-BCG and post-BCG treatment suitable for the simulation studies.The intricate and patient-specific nature of these data warrants the use of powerful multi-parametral mathematical methods in combination with molecular/cellular biology insight and clinical input.

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Section: Introductionmentioning

confidence: 99%

Treatment of non-muscle invasive bladder cancer with Bacillus Calmette–Guerin (BCG): Biological markers and simulation studies

Kiselyov

Bunimovich‐Mendrazitsky

Startsev

2015

BBA Clinical

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“…The further treatment of superficial TCC after TUR depends to the degree of the risk of recurrence and progression of the tumor: low-risk TCC (small monofocal TaG1, still not relapsed) presents a low risk of recurrence and progression (20% recurrence at one year post-TUR) and can be successfully managed with endovesical chemotherapy standard protocols, whereas high-risk TCC (plurifocal T1G2, monoor plurifocal T1G3) presents a high risk of recurrence and progression (90% recurrence at one year post-TUR) and should be treated with endovesical instillation of the immunomodulating agent Bacille Calmette-Guérin (BCG). At the appearance of tumor multiple recurrences or progression after BCG treatment, the only remaining option is the radical cystectomy [2][3][4]. However, more than 50% of the Ta or T1 superficial TCC cannot be classified exactly into the two above-mentioned categories, low and high risk, and they can be defined as intermediate-risk TCC.…”

Section: Introductionmentioning

confidence: 99%

Intravesical thermo-chemotherapy based on conductive heat: a first pharmacokinetic study with Mitomycin C in superficial transitional cell carcinoma patients

Milla

Fiorito

Soria

et al. 2014

Cancer Chemother Pharmacol

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3ABSTRACT Purpose To evaluate, for the first time, the mitomycin C (MMC) pharmacokinetics during intravesical hyperthermia treatment based on conductive heat and the stability and recovery of the drug at the end of the instillation period. MethodsEleven patients with recurrent intermediate risk superficial transitional cell carcinoma of the bladder were treated weekly for 6 cycles with intravesical MMC (40 mg MMC in 50 ml) in local hyperthermia (45°C) with Unithermia ® system. Each instillation lasted 45 min, with the solution being replaced after the first 22 min. The MMC recovery at the end of the two instillation period and the plasmatic pharmacokinetics of MMC were evaluated by high-pressure liquid chromatography (HPLC). ResultsNine patients completed all the 6 planned cycles, whereas 2 patients missed the last cycle because of allergic reactions No other systemic toxicity was observed, the local toxicities were mild. Median MMC concentration in the instillation residual solution decrease from the initial 0.8 mg/ml to 0.22 mg/ml for the 0-22 min instillation period and to 0.38 mg/ml for the 22-45 min instillation period; the median % of MMC recovered after instillation was 66.2 and 99.6, respectively. In all patients MMC plasmatic C max resulted considerably lower than the toxic threshold (400 ng/ml). ConclusionsThe MMC is stable during the instillation and its absorption occurs mainly during the first minutes of the treatment. The plasmatic MMC concentration is always well below the threshold level for myelosuppression, as confirmed by the total lack of hematological toxicity evidenced by the patients. In order to evaluate the efficacy of the treatment performed with UniThermia ® in reducing the disease recurrence rate in short-and long-term follow-up, we are currently carrying out a clinical multicentric study involving a larger number of patients.

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Prognostic significance of tumor location in high-grade non-muscle-invasive bladder cancer

et al. 2011

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The management of high-grade (HG) non-muscle-invasive bladder cancer (NMIBC) continues to be a serious clinical problem. The role of many factors related to efficacy of Bacillus Calmette-Guérin (BCG), which is the most useful intravesical agent for these tumors, is still unknown. This study investigated the prognostic value of tumor location in high-grade non-muscle-invasive bladder cancer. Seventy-four patients with HG non-muscle-invasive bladder cancer, without carcinoma in situ (CIS), were treated by transurethral resection of bladder tumor (TURBT). Twenty-eight patients received adjuvant BCG therapy after TURBT. The relation between tumor location and the recurrence capacity was estimated using a Cox regression model. Our results suggest that tumor location is an important prognostic factor for BCG-therapy response in patients with high-grade non-muscle-invasive bladder cancer. Tumors in the bladder neck might have a higher risk of recurrence after intravesical immunotherapy. In addition, tumors in the lateral and posterior bladder walls might be at higher risk of recurrence when treated by TURBT alone.

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The management of superficial transitional cell carcinoma of the bladder: a critical assessment of contemporary concepts and future perspectives

Cited by 4 publications

References 55 publications

Treatment of non-muscle invasive bladder cancer with Bacillus Calmette–Guerin (BCG): Biological markers and simulation studies

Treatment of non-muscle invasive bladder cancer with Bacillus Calmette–Guerin (BCG): Biological markers and simulation studies

Intravesical thermo-chemotherapy based on conductive heat: a first pharmacokinetic study with Mitomycin C in superficial transitional cell carcinoma patients

Prognostic significance of tumor location in high-grade non-muscle-invasive bladder cancer

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