MP54-14 SEQUENTIAL INTRAVESICAL GEMCITABINE/DOCETAXEL PROVIDES A DURABLE REMISSION IN RECURRENT HIGH RISK NMIBC FOLLOWING BCG THERAPY

Abstract

You have accessJournal of UrologyCME1 May 2022MP54-14 SEQUENTIAL INTRAVESICAL GEMCITABINE/DOCETAXEL PROVIDES A DURABLE REMISSION IN RECURRENT HIGH RISK NMIBC FOLLOWING BCG THERAPY Kendrick Yim, Kevin Melnick, Sarah L. Mott, Vani Gupta, Timothy N. Clinton, Filipe L.F. Carvalho, Matthew Mossanen, Graeme S. Steele, Kent Mouw, Michael A. O'Donnell, and Mark A. Preston Kendrick YimKendrick Yim More articles by this author , Kevin MelnickKevin Melnick More articles by this author , Sarah L. MottSarah L. Mott More articles by this author , Vani GuptaVani Gupta More articles by this author , Timothy N. ClintonTimothy N. Clinton More articles by this author , Filipe L.F. CarvalhoFilipe L.F. Carvalho More articles by this author , Matthew MossanenMatthew Mossanen More articles by this author , Graeme S. SteeleGraeme S. Steele More articles by this author , Kent MouwKent Mouw More articles by this author , Michael A. O'DonnellMichael A. O'Donnell More articles by this author , and Mark A. PrestonMark A. Preston More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002633.14AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Bacillus Calmette-Guerin (BCG) is the standard of care for high risk non-muscle invasive bladder cancer (NMIBC), but half of patients eventually fail BCG and radical cystectomy (RC) remains the alternative with best oncologic outcomes. However, RC is morbid surgery; many patients are poor surgical candidates and desire bladder-sparing alternatives. Intravesical regimens for BCG unresponsive NMIBC are limited. We report the safety and durable efficacy of sequential gemcitabine/docetaxel (gem/doce) in high risk NMIBC after BCG failure. METHODS: Single institution retrospective analysis of patients treated with induction intravesical gem/doce (≥5/6 instillations) for high risk NMIBC from May 2018 to May 2021. BCG failures were grouped as BCG unresponsive, intolerant or early relapsing. Maintenance therapy was provided to patients without evidence of high grade (HG) recurrence on surveillance cystoscopy per physician preference. Kaplan-Meier curves were generated to estimate survival probabilities. RESULTS: Seventy-four patients were included in this study (median age 72.0, median follow-up 18 months). Six-, 12, and 24-month HG recurrence free survival rates (RFS) were 81%, 67%, and 49% respectively (Figure 1A). Four patients experienced disease progression on transurethral resection. Fourteen patients underwent radical cystectomy (median 22 months from induction) (Figure 1B), with only 4 patients progressing to muscle invasion. Forty-eight (65%) patients experienced mild to moderate grade adverse effects (AE), but only 7% experienced a delay in treatment schedule. Most common AE were urinary frequency/urgency in 36 (49%) and dysuria in 12 (16%). CONCLUSIONS: In an independent study of high-risk BCG failures, sequential intravesical gem/doce appears to be an effective and well tolerated alternative to early cystectomy, validating prior reports of its utility. A prospective trial is warranted to better characterize efficacy and compare to other intravesical therapies. Source of Funding: None © 2022 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 207Issue Supplement 5May 2022Page: e932 Advertisement Copyright & Permissions© 2022 by American Urological Association Education and Research, Inc.MetricsAuthor Information Kendrick Yim More articles by this author Kevin Melnick More articles by this author Sarah L. Mott More articles by this author Vani Gupta More articles by this author Timothy N. Clinton More articles by this author Filipe L.F. Carvalho More articles by this author Matthew Mossanen More articles by this author Graeme S. Steele More articles by this author Kent Mouw More articles by this author Michael A. O'Donnell More articles by this author Mark A. Preston More articles by this author Expand All Advertisement PDF DownloadLoading ...