PD17-09 DECADE-LONG EXPERIENCE WITH INTRAVESICAL DOCETAXEL IN THE MANAGEMENT OF NON-MUSCLE-INVASIVE BLADDER CANCER (NMIBC) REFRACTORY TO BCG THERAPY

Abstract

You have accessJournal of UrologyBladder Cancer: Non-invasive II1 Apr 2015PD17-09 DECADE-LONG EXPERIENCE WITH INTRAVESICAL DOCETAXEL IN THE MANAGEMENT OF NON-MUSCLE-INVASIVE BLADDER CANCER (NMIBC) REFRACTORY TO BCG THERAPY LaMont Barlow, Danny Lascano, James McKiernan, and Mitchell Benson LaMont BarlowLaMont Barlow More articles by this author , Danny LascanoDanny Lascano More articles by this author , James McKiernanJames McKiernan More articles by this author , and Mitchell BensonMitchell Benson More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2015.02.666AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Since completing the phase I clinical trial in 2005, intravesical docetaxel has demonstrated significant activity in patients with recurrent NMIBC after BCG therapy. We now present our cumulative experience in the largest cohort of intravesical taxane therapy ever reported. METHODS Patients who received salvage intravesical docetaxel for BCG-refractory NMIBC between 2003 and 2014 were identified, including 18 patients treated during the original phase I trial. All patients were treated with 6 weekly instillations of intravesical docetaxel. Patients in the latter portion of the study period with a complete response to induction treatment were given single-dose monthly maintenance treatments starting at month 3 for a total of up to 12 months of docetaxel therapy. Recurrence was defined as either a positive biopsy or positive urine cytology. Recurrence-free survival, disease-specific survival, and overall survival were determined using Kaplan-Meier analyses. RESULTS 68 patients have been treated, including 25 patients with T1 disease, 18 patients with Ta disease, and 25 patients with Tis prior to docetaxel therapy. 40/68 patients (59%) had at least two prior induction courses of intravesical therapy. The median age was 72 (range: 38-90); median follow-up was 45.6 months (range: 3-137 months). 41/68 patients (60%) had a complete initial response after induction therapy. 27/41 patients with a complete initial response received additional monthly maintenance treatments. Median time to recurrence in initial responders treated with and without docetaxel maintenance was 39.3 and 19.0 months, respectively. 1 and 3-year recurrence-free survival rates for the entire cohort were 42% and 27%, respectively. 49/68 patients (72%) kept their bladders during follow-up, and 19/68 patients (28%) underwent radical cystectomy. In this high-risk group, 5-year disease-specific survival (DSS) and overall survival (OS) rates for the entire cohort were 84% and 71%, respectively; 5-year DSS and OS rates for patients undergoing cystectomy were both 83%. CONCLUSIONS After over a decade of experience, salvage intravesical docetaxel continues to demonstrate a very high response rate with durability that appears to surpasses other salvage intravesical therapies. This agent, when used in a combined induction and maintenance regimen, is a powerful tool in the management of recurrent NMIBC after BCG therapy. © 2015 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 193Issue 4SApril 2015Page: e384 Advertisement Copyright & Permissions© 2015 by American Urological Association Education and Research, Inc.MetricsAuthor Information LaMont Barlow More articles by this author Danny Lascano More articles by this author James McKiernan More articles by this author Mitchell Benson More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...