Intravesical Instillation of Gemcitabine Postsurgery May Aid in Preventing Bladder Cancer Recurrence
Flushing the bladder with a common chemotherapy drug immediately after surgery significantly reduces the chances of bladder cancer returning, according to a study by Messing et al published in JAMA and led by SWOG. First author Edward M. Messing, MD, is Professor of Urology and Oncology & Pathology at the University of Rochester School of Medicine and Dentistry and a physician at the Wilmot Cancer Institute.
The investigators noted this may be the first phase III trial in the United States to show a benefit from this treatment strategy in 2 decades. European and Canadian urologists have been using it for years, with their own clinical trial data to support the procedure.
“The real importance of this study is that we now have a readily available drug that’s fairly inexpensive, well-tolerated, and effective,” Dr. Messing said. “One of the biggest issues with low-grade bladder cancer is that it frequently returns. I know some patients who have to undergo four surgeries a year, and if we can cut down on these recurrences, we will save a lot of people a lot of pain, money, and time lost to recovery.”
Study Findings
The SWOG team conducted the randomized, double-blind clinical trial involving 406 eligible patients at 23 cancer centers. Surgeons removed all cancerous tissue by transurethral resection of bladder tumor. Then, 201 patients received gemcitabine mixed with saline administered via catheter to the bladder area within 3 hours after surgery. The second group of 205 patients received saline alone.
Researchers followed all patients for 4 years—the time period when most bladder cancers recur—seeking to discover which treatment strategy worked better. Researchers observed a 34% reduction in the risk of recurrence for patients receiving the gemcitabine infusion. Sixty-seven patients in the gemcitabine group, or 35%, experienced a recurrence, compared with 91 patients in the saline group, or 47%.
The study said the findings “support using this therapy” but added that further research is needed to compare various chemotherapy agents for their effectiveness.
The content in this post has not been reviewed by the American Society of Clinical Oncology, Inc. (ASCO®) and does not necessarily reflect the ideas and opinions of ASCO®.
