MP08-12 SEQUENTIAL INTRAVESICAL GEMCITABINE AND DOCETAXEL FOR TREATMENT-NAIVE AND PREVIOUSLY TREATED INTERMEDIATE-RISK NON-MUSCLE INVASIVE BLADDER CANCER

Abstract

You have accessJournal of UrologyCME1 Apr 2023MP08-12 SEQUENTIAL INTRAVESICAL GEMCITABINE AND DOCETAXEL FOR TREATMENT-NAIVE AND PREVIOUSLY TREATED INTERMEDIATE-RISK NON-MUSCLE INVASIVE BLADDER CANCER Ian M. McElree, Joanna Orzel, Ryan L. Steinberg, Sarah L. Mott, Michael A. O'Donnell, and Vignesh T. Packiam Ian M. McElreeIan M. McElree More articles by this author , Joanna OrzelJoanna Orzel More articles by this author , Ryan L. SteinbergRyan L. Steinberg More articles by this author , Sarah L. MottSarah L. Mott More articles by this author , Michael A. O'DonnellMichael A. O'Donnell More articles by this author , and Vignesh T. PackiamVignesh T. Packiam More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003223.12AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Adjuvant intravesical therapy is recommended for patients with intermediate-risk NMIBC. While intravesical gemcitabine-docetaxel (Gem/Doce) has demonstrated favorable outcomes for high-risk NMIBC, its utility in the intermediate-risk setting is not well-described. We report efficacy and tolerance outcomes of Gem/Doce as an adjuvant treatment for intermediate-risk NMIBC. METHODS: We retrospectively identified all patients with intermediate-risk NMIBC by AUA criteria who were treated with Gem/Doce between March 2012 and July 2022. Patients were treated with weekly sequential intravesical instillations of 1 g gemcitabine and 37.5 mg docetaxel for 6 weeks. Monthly maintenance of 2 years was initiated if disease free at first follow up. The primary outcome was recurrence-free survival (RFS). Survival was assessed using the Kaplan-Meier method, indexed from start of Gem/Doce induction. Surveillance was performed according to AUA guidelines. RESULTS: The cohort included 77 patients with median follow-up of 26 (IQR: 14-50) months. Prior to Gem/Doce induction, 67 (87%) patients presented with TaLG, 3 (3.9%) with isolated <3 cm TaHG, 5 (6.5%) with TaLG plus focal TaHG, and 2 (2.6%) with T1LG. A total of 33 (43%) patients received previous intravesical therapy with a median of 1 (IQR: 1-2) prior induction courses. There were 23, 13, and 13 patients with at least 1 previous induction course of BCG, single-agent docetaxel, and mitomycin, respectively. The 2-year RFS was 71% among all patients. Patients who were treatment naïve had superior RFS compared to those previously treated (p=0.04, Figure 1); 2-year estimates were 79% and 64%, respectively. There were 3 patients with a HG recurrence during the study period. There were 29 (38%) patients with adverse events; all were Grade 1-2 except one (1.3%) Grade 3 (acute oxygen desaturation). The most frequent adverse events were urinary urgency/frequency (10.4%), bladder spasms (9.1%), and UTI (5.2%). Three (3.9%) patients did not tolerate a full induction course. CONCLUSIONS: In a heterogenous population of patients with intermediate-risk NMIBC, Gem/Doce was an effective and well-tolerated adjuvant therapy. Further prospective evaluation is needed. Source of Funding: Supported by the John & Carol Walter Family Foundation and the Cancer Center Support Grant. © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e98 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Ian M. McElree More articles by this author Joanna Orzel More articles by this author Ryan L. Steinberg More articles by this author Sarah L. Mott More articles by this author Michael A. O'Donnell More articles by this author Vignesh T. Packiam More articles by this author Expand All Advertisement PDF downloadLoading ...