A clinical trial of neoadjuvant hyperthermic intravesical chemotherapy (HIVEC) for treating intermediate and high-risk non-muscle invasive bladder cancer.

Journal Article

PURPOSE: Ths paper reports a pilot/feasibility trial of neoadjuvant hyperthermic intravesical chemotherapy (HIVEC) prior to transurethral resection of bladder tumour (TURBT) for non-muscle invasive bladder cancer (NMIBC). MATERIALS AND METHODS: A pilot/feasibility clinical trial was performed and 15 patients with intermediate to high-risk NMIBC received HIVEC prior to TURBT. HIVEC consisting of eight weekly instillations of intravesical MMC (80 mg in 50 mL) delivered with the novel Combat BRS® system at a temperature of 43 °C for 60 min. Treatment-related adverse effects were measured and patients were followed for 2 years for disease recurrence. RESULTS: A total of 119 HIVEC treatments occurred. Grade 1 adverse events consisted of irritative bladder symptoms (33%), bladder spasms (27%), pain (27%), haematuria (20%) and urinary tract infection (UTI; 14%). Grade 2 adverse events were bladder calcification (7%) and reduced bladder capacity (7%). No grade 3 or higher toxicity was observed. At TURBT, eight patients (53%) were complete responders (pT0) while seven (47%) were partial responders. With a median follow-up of 29 months, the 3-year cumulative incidence of recurrence was 15%. CONCLUSIONS: The Combat BRS® system achieved target bladder temperatures and delivered HIVEC with a favourable side-effect profile. Our pilot trial also provides preliminary evidence of treatment efficacy.

Full Text

Duke Authors

Cited Authors

  • Sousa, A; Inman, BA; Piñeiro, I; Monserrat, V; Pérez, A; Aparici, V; Gómez, I; Neira, P; Uribarri, C

Published Date

  • May 2014

Published In

Volume / Issue

  • 30 / 3

Start / End Page

  • 166 - 170

PubMed ID

  • 24697672

Electronic International Standard Serial Number (EISSN)

  • 1464-5157

International Standard Serial Number (ISSN)

  • 0265-6736

Digital Object Identifier (DOI)

  • 10.3109/02656736.2014.900194

Language

  • eng