PD66-11 HYPERTHERMIC INTRAVESICAL CHEMOTHERAPY FOR BCG-UNRESPONSIVE NON-MUSCLE INVASIVE BLADDER CANCER

Abstract

You have accessJournal of UrologyBladder Cancer: Non-invasive III1 Apr 2018PD66-11 HYPERTHERMIC INTRAVESICAL CHEMOTHERAPY FOR BCG-UNRESPONSIVE NON-MUSCLE INVASIVE BLADDER CANCER Joep de Jong, Kees Hendricksen, Marloes Rosier, Joost Boormans, and Hugh Mostafid Joep de JongJoep de Jong More articles by this author , Kees HendricksenKees Hendricksen More articles by this author , Marloes RosierMarloes Rosier More articles by this author , Joost BoormansJoost Boormans More articles by this author , and Hugh MostafidHugh Mostafid More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2018.02.3007AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Adjuvant intravesical instillations with bacillus Calmette-Guerin (BCG) is the recommended treatment option for patients with intermediate and high-risk non-muscle invasive bladder cancer (NMIBC). Despite adequate BCG treatment, a large proportion of patients experiences a recurrence. Although radical cystectomy is the Gold Standard for BCG-unresponsive NMIBC, a number of patients are unfit for or unwilling to consider this option. The optimal therapy in such cases is unknown. The objective of the present study was to assess the efficacy of hyperthermic intravesical chemotherapy (HIVEC®) in BCG-unresponsive intermediate and high-risk NMIBC patients. METHODS From October 2014 to July 2017 NMIBC patients who were defined BCG-unresponsive (recurrence of high-grade disease after having had a minimum of 5/6 induction and 2/3 maintenance BCG instillations) were prospectively included at three academic institutions. All patients were planned to receive HIVEC® treatment, consisting of an induction phase followed by maintenance therapy. Only patients who had a minimum of 5 HIVEC® instillations were included in the present analysis. Patients were followed by cystoscopy and cytology every three months and a CT-scan yearly. The primary outcome was the recurrence-free survival (RFS). The Common Terminology Criteria for Adverse Events (CTCAE) was used to assess side-effects. RESULTS The study population consisted of 59 BCG-unresponsive NMIBC patients (8% intermediate- and 92% high risk) of whom 55 underwent ≥5 HIVEC® treatments. Histology was urothelial carcinoma in all patients and T-stage was pTis in 31, pTa in 10, pT1 in 9, pT1+CIS in 3 and pTa+CIS in two patients. The median age and follow-up was 72 years and 9.0 months [IQR 7.1 - 19.5]. The overall recurrence rate was 58% and the mean RFS was 16.6 months [SE 2.1] (Fig.1). In patients having carcinoma in situ (n= 36), the recurrence rate was also 58% and the mean RFS was 16.2 months [SE 2.8]. Progression occurred in 3 patients and two patients experienced severe side-effects (CTCAE >2). CONCLUSIONS HIVEC® seems a valid treatment option for BCG-unresponsive intermediate- or high-risk NMIBC patients. We report a mean RFS of >1 year, potentially avoiding or postponing the need for radical surgery in these patients. © 2018FiguresReferencesRelatedDetails Volume 199Issue 4SApril 2018Page: e1234-e1235 Advertisement Copyright & Permissions© 2018MetricsAuthor Information Joep de Jong More articles by this author Kees Hendricksen More articles by this author Marloes Rosier More articles by this author Joost Boormans More articles by this author Hugh Mostafid More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...