Thermo&amp;ndash;Chemotherapy and Electromotive Drug Administration of Mitomycin C in Superficial Bladder Cancer Eradication

Colombo, Renzo; Brausi, Maurizio; Pozzo, L.F. Da; Salonia, Andrea; Montorsi, Francesco; Scattoni, Vincenzo; Roscigno, Marco; Rigatti, Patrìzio

doi:10.1159/000052419

Cited by 71 publications

(48 citation statements)

References 28 publications

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“…[6][7][8]10,11,[14][15][16][17][18] In particular, greater temperature differences in the bladder wall because the spatial power distribution of an intracavitary microwave antenna is not evenly distributed over the surface of the bladder wall, and a single antenna offers no option to modify the power distribution. Achieving a good thermal dose over the entire bladder wall can thus easily result in overheating of parts of the bladder wall, resulting in pain and toxicity.…”

Section: Discussionmentioning

confidence: 99%

Novel multi-sensor probe for monitoring bladder temperature during loco-regional chemo-hyperthermia for non-muscle invasive bladder cancer: technical feasibility study

Feijoo¹,

Geijsen²,

Vörding³

et al. 2013

Journal of Endourology

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Background and Purpose: The effectiveness of locoregional hyperthermia combined with intravesical instillation of mitomycin C to reduce the risk of recurrence and progression of intermediate-and high-risk nonmuscleinvasive bladder cancer is currently investigated in clinical trials. Clinically effective locoregional hyperthermia delivery necessitates adequate thermal dosimetry; thus, optimal thermometry methods are needed to monitor accurately the temperature distribution throughout the bladder wall. The aim of the study was to evaluate the technical feasibility of a novel intravesical device (multi-sensor probe) developed to monitor the local bladder wall temperatures during loco-regional C-HT. Materials and Methods: A multisensor thermocouple probe was designed for deployment in the human bladder, using special sensors to cover the bladder wall in different directions. The deployment of the thermocouples against the bladder wall was evaluated with visual, endoscopic, and CT imaging in bladder phantoms, porcine models, and human bladders obtained from obduction for bladder volumes and different deployment sizes of the probe. Finally, porcine bladders were embedded in a phantom and subjected to locoregional heating to compare probe temperatures with additional thermometry inside and outside the bladder wall. Results: The 7.5 cm thermocouple probe yielded optimal bladder wall contact, adapting to different bladder volumes. Temperature monitoring was shown to be accurate and representative for the actual bladder wall temperature. Conclusions: Use of this novel multisensor probe could yield a more accurate monitoring of the bladder wall temperature during locoregional chemohyperthermia.

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Section: Discussionmentioning

confidence: 99%

Novel multi-sensor probe for monitoring bladder temperature during loco-regional chemo-hyperthermia for non-muscle invasive bladder cancer: technical feasibility study

Feijoo¹,

Geijsen²,

Vörding³

et al. 2013

Journal of Endourology

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“…Nei pazienti responsivi al trattamento, il tasso di recidiva e l'intervallo libero da malattia sono stati del 60% e di 10.5 mesi nel gruppo DP/ MMC e del 33% e di 14.5 mesi nel gruppo EMDA/MMC. Uno studio pilota effettuato su pazienti con TVNIM ha mostrato un ridotto tasso di recidiva dopo l'instillazione intravescicale di EMDA/MMC 40 mg e 15 mA per 20 minuti, per 4 settimane e ogni 3 mesi in seguito (25). Dopo un followup medio di 14 mesi 9/16 pazienti (56.6%) non hanno presentato recidive di malattia.…”

Section: Studi Cliniciunclassified

“…Dopo un followup medio di 14 mesi 9/16 pazienti (56.6%) non hanno presentato recidive di malattia. Colombo et al (25), in uno studio retrospettivo su 80 pazienti con TVNIM a rischio intermedio, hanno valutato l'effetto ablativo su una lesione marker della chemio-ipertermia con MMC (n=29), dell'EMDA/MMC (n=15) e della DP/ MMC (n=36). Una risposta completa al trattamento è stata osservata nel 28% dei casi nel gruppo DP/MMC, nel 40% dei casi nel gruppo EMDA/MMC e nel 66% dei casi nel gruppo chemio-ipertermia con MMC.…”

Section: Studi Cliniciunclassified

Intravesical Therapy with Mitomycin through Electromotive Drug Administration

et al. 2013

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Intravesical therapy with Mitomycin through Electromotive Drug Administration In the management of non-muscle invasive bladder cancer (NMIBC), high-level evidence supports the widespread practice of intravesical therapy with mitomycin-C (MMC). Randomized trials showed a significant reduction in short-term recurrence compared with transurethral resection of bladder tumor (TURBT) alone, but little effect on long-term and no impact at all in preventing progression. Electromotive drug administration (EMDA®) offers a means of controlling and enhancing the tissue transport of certain drugs, in order to increase their efficacy. In both laboratory and clinical studies, intravesical electromotive drug administration (EMDA) increases MMC bladder uptake, resulting in an improved Accepted: June 20, 2013 ORIGINAL ARTICLE Tis) (2). La resezione trans-uretrale delle neoplasie della vescica (TURBT) costituisce lo step iniziale della gestione di questa malattia e rappresenta un trattamento efficace e uno strumento essenziale per la diagnosi e la stadiazione patologica. Nonostante l'utilizzo di terapie intravescicali adiuvanti dopo TURBT, queste neoplasie mostrano a 5 anni tassi di recidiva e progressione della malattia rispettivamente del 31-78% e dell'1-45% (3). Le ripetute TURBT e terapie intravescicali, sono spesso causa di effetti indesiderati e complicanze e rendono il trattamento del tumore della vescica, dalla diagnosi al decesso del paziente, il più costoso tra i trattamenti dei tumori maligni (4). Il concetto

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“…Laboratory and clinical studies have been conducted on intravesical electromotive delivery of oxybutynin [29,30], mitomycin C (MMC) [31][32][33], RTX [34,35], verapamil and dexamethasone [36], bethanecol [37], and lidocaine and epinephrine [38] (Tables 1 and 2). …”

Section: Recent Developments In Physical Approachesmentioning

confidence: 99%

New Frontiers in Intravesical Therapies and Drug Delivery

et al. 2006

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e u r o p e a n u r o l o g y 5 0 ( 2 0 0 6 ) 1 1 8 3 -1 1 9 3 a v a i l a b l e a t w w w . s c i e n c e d i r e c t . c o m j o u r n a l h o m e p a g e : w w w . e u r o p e a n u r o l o g y . c o m Article info AbstractObjectives: The intravesical route permits site-specific delivery of drugs with a reduced side-effect profile as compared to oral delivery systems, either by avoiding first-pass metabolism or by obtaining a local effect. We investigated mechanisms related to urothelium permeability and new physical and chemical developments in intravesical drug delivery that potentially permit successful treatment of several bladder dysfunction. Methods: A literature review. Results: Pharmacologic agents increasing urothelial permeability and useful for clinical purposes have been described, such as dimethylsulfoxide, protamine sulphate, chitosan, and nystatin. Among physical approaches, electromotive drug administration appears to be more effective than intravesical passive diffusion in delivering drugs through the urothelium into deeper layers of the bladder. Experimental and clinical reports demonstrated that electric current significantly increases the transport of local anaesthetics, mytomicin C, oxybutynin, resiniferatoxin, epinephrine, and dexamethasone. Among new chemical approaches, cell-penetrating peptides posses the ability to translocate macromolecular drugs across membranes of urothelial cells. The therapeutic benefits of sustained delivery afforded by thermosensitive hydrogel, which forms a depot for hydrophilic and hydrophobic drugs, have been demonstrated by delivering anti-inflammatory drugs. Liposomes improve the aqueous solubility of several hydrophobic drugs such as taxol, amphotericin, and capsaicin. Conclusions: Electromotive drug administration, new in situ delivery systems, and bioadhesive liposomes may make it possible to extend intravesical therapy and drug administration to many bladder diseases. Research to expand knowledge of the chemical and physical properties of the bladder and processes regulating drug transport across biologic membranes is needed to make this a reality.

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Thermo–Chemotherapy and Electromotive Drug Administration of Mitomycin C in Superficial Bladder Cancer Eradication

Cited by 71 publications

References 28 publications

Novel multi-sensor probe for monitoring bladder temperature during loco-regional chemo-hyperthermia for non-muscle invasive bladder cancer: technical feasibility study

Novel multi-sensor probe for monitoring bladder temperature during loco-regional chemo-hyperthermia for non-muscle invasive bladder cancer: technical feasibility study

Intravesical Therapy with Mitomycin through Electromotive Drug Administration

New Frontiers in Intravesical Therapies and Drug Delivery

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