Intravesical installation with gemcitabine following transurethral resection of bladder tumor (TURBT) is associated with a reduced recurrence rate of non-muscle invasive bladder cancer in patients with low-grade disease, according to a recent study.
Findings from the study were presented by Edward Messing,University of Rochester (New York), at the Society of Urologic Oncology (SUO) 2017 Annual Meeting (San Francisco, CA).
Although current guidelines recommend the use of post-TURBT chemotherapy installation in patients with low risk or intermediate risk non-muscle invasive bladder cancer, its use is still low in the United States.
For their study, Messing and colleagues recruited 416 patients with non-muscle invasive bladder cancer, of whom 345 underwent TURBT and complete installation in accordance with established guidelines. Patients were treated with either a combination 2g gemcitabine and 100cc saline or with saline alone. Medication dwell time was 60 minutes.
The primary endpoint of the study was disease recurrence, and secondary endpoints included time to recurrence, time to muscle invasive disease, and time to mortality.
Results of an intention-to-treat analysis indicated that immediate installation of gemcitabine following TURBT was associated with a 33% reduction in disease recurrence vs saline alone. Additionally, according to a subgroup analysis of patients with low-grade disease, treatment with gemcitabine post-TURBT was associated with a 47% reduced rate of recurrence.
The researchers noted that treatment with gemcitabine did not significantly impact any of the secondary endpoints. —Christina Vogt