MP73-01 SEQUENTIAL ADMINISTRATION OF BACILLUS CALMETTE-GUERIN (BCG) AND ELECTROMOTIVE DRUG ADMINISTRATION (EMDA) OF MITOMYCIN C (MMC) FOR THE TREATMENT OF HIGH GRADE NON MUSCLE INVASIVE BLADDER CANCER AFTER BCG FAILURE

Abstract

You have accessJournal of UrologyBladder Cancer: Non-invasive IV (MP73)1 Apr 2020MP73-01 SEQUENTIAL ADMINISTRATION OF BACILLUS CALMETTE-GUERIN (BCG) AND ELECTROMOTIVE DRUG ADMINISTRATION (EMDA) OF MITOMYCIN C (MMC) FOR THE TREATMENT OF HIGH GRADE NON MUSCLE INVASIVE BLADDER CANCER AFTER BCG FAILURE Tristan Juvet*, Christopher Wallis, Lior Krimus, Cynthia Kuk, Annette Erlich, Andrea Mari, Girish Kulkarni, Neil Fleshner, and Alexandre Zlotta Tristan Juvet*Tristan Juvet* More articles by this author , Christopher WallisChristopher Wallis More articles by this author , Lior KrimusLior Krimus More articles by this author , Cynthia KukCynthia Kuk More articles by this author , Annette ErlichAnnette Erlich More articles by this author , Andrea MariAndrea Mari More articles by this author , Girish KulkarniGirish Kulkarni More articles by this author , Neil FleshnerNeil Fleshner More articles by this author , and Alexandre ZlottaAlexandre Zlotta More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000000959.01AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: There is a need for effective non-surgical treatment options in patients with non-muscle invasive bladder cancer (NMIBC) in whom Bacillus Calmette-Guerin (BCG) therapy has failed. We aimed to determine the efficacy of Electromotive Drug Administration (EMDA) of mitomycin C (MMC) in BCG unresponsive patients. METHODS: A retrospective review of NMIBC BCG unresponsive patients who received BCG/EMDA-MMC between 2013 and 2017 was performed. Patients had received at least one full regimen of BCG. Progression and overall survival time were calculated using Kaplan-Meier curves. Progression was defined as development of muscle invasive disease, presence of metastasis on imaging or treatment. RESULTS: 26 patients were included. Initial pathology was carcinoma in situ (CIS) in 53.8% (14/26), pT1 in 34.6% (9/26) and pTa HG disease in 11.6% (3/26). 12/26 patients progressed (46.2%). Following BCG/EMDA-MMC treatment, progression-free survival rates were 62.2% (95% CI 43.4-81.0) at 1 year and 53.2% (95% CI 33.4-80.0) at 2 years from the date of induction of BCG/EMDA-MMC, respectively. Side effects included dysuria (19.2%), hematuria (19.2%), and frequency (11.5%). 3 patients were admitted for side effects but managed conservatively. Four patients (15.4%) died of bladder cancer over the course of the study. CONCLUSIONS: BCG/EMDA-MMC represents a viable option in patients with BCG unresponsive NMIBC with over 50% progression-free survival at 2 years. However, the window of curability is narrow with 15% cancer specific mortality in these high-risk patients. Source of Funding: none © 2020 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 203Issue Supplement 4April 2020Page: e1121-e1121 Advertisement Copyright & Permissions© 2020 by American Urological Association Education and Research, Inc.MetricsAuthor Information Tristan Juvet* More articles by this author Christopher Wallis More articles by this author Lior Krimus More articles by this author Cynthia Kuk More articles by this author Annette Erlich More articles by this author Andrea Mari More articles by this author Girish Kulkarni More articles by this author Neil Fleshner More articles by this author Alexandre Zlotta More articles by this author Expand All Advertisement PDF downloadLoading ...