Electro-mediated drug administration of mitomycin C in preventing non-muscle-invasive bladder cancer recurrence and progression after transurethral resection of the bladder tumour in intermediate- and high-risk patients

Roberto Carando; Emiliano Soldini; Simone Cotrufo; Michele Zazzara; Giuseppe M Ludovico

doi:10.1080/2090598X.2020.1816150

Electro-mediated drug administration of mitomycin C in preventing non-muscle-invasive bladder cancer recurrence and progression after transurethral resection of the bladder tumour in intermediate- and high-risk patients

Arab J Urol. 2020 Aug 31;19(1):71-77. doi: 10.1080/2090598X.2020.1816150.

Authors

Roberto Carando^{1

2

3

4}, Emiliano Soldini⁵, Simone Cotrufo⁶, Michele Zazzara⁶, Giuseppe M Ludovico⁶

Affiliations

¹ Klinik für Urologie, Luzerner Kantonsspital, Luzern, Switzerland.
² Clinica Luganese Moncucco, Lugano, Switzerland.
³ Clinica S. Anna, Sorengo, Switzerland.
⁴ Clinica S. Chiara, Locarno, Switzerland.
⁵ Department of Business Economics, Health and Social Care, Research Methodology Competence Centre, University of Applied Sciences and Arts of Southern Switzerland, Manno, Switzerland.
⁶ Department of Urology, Ospedale F. Miulli, Acquaviva delle Fonti, Bari, Italy.

Abstract

Objective: To evaluate the effectiveness of electro-mediated drug administration of mitomycin C (EMDA/MMC) after transurethral resection of the bladder tumour (TURBT) in preventing non-muscle-invasive bladder cancer (NMIBC) recurrence and progression and to explore clinical and demographic factors associated with treatment response.

Patients and methods: Between April 2016 and August 2019, 112 patients diagnosed with intermediate- or high-risk NMIBC underwent a TURBT followed by an EMDA/MMC treatment. The percentage of treatment responders and progression-free survivors at 3 and 6 months were evaluated.

Results: Follow-up data were available for 101 patients (90%) at 3 months and 92 (82%) at 6 months. Response rates to EMDA/MMC treatment were 85% at 3 months and 75% at 6 months, and progression-free rates were 94% and 90%, respectively. No statistically significant differences were seen between intermediate- and high-risk patients. A higher risk of tumour recurrence and progression was associated with previous Bacillus Calmette-Guérin (BCG) failure. According to the Clavien-Dindo classification, only low-grade complications were observed.

Conclusions: EMDA/MMC after TURBT was associated with high response and progression-free rates at 3 and 6 months, with only low-grade adverse events. These results confirm the efficacy and safety of EMDA/MMC as a therapeutic option for both intermediate- and high-risk patients. However, patients with BCG failure responded poorly to EMDA/MMC.Abbreviations: ACCI: age-adjusted Charlson Comorbidity Index; CHT: chemohyperthermia; CIS: carcinoma in situ; EMDA: electro-mediated drug administration; EORTC: European Organisation for Research and Treatment of Cancer; IQR: interquartile range; (N)MIBC: (non-)muscle-invasive bladder cancer; MMC: mitomycin C; OR, odds ratio; TURBT: transurethral resection of the bladder tumour.

Keywords: Bladder cancer; electro-mediated drug administration; intermediate and high risk; mitomycin C; non-muscle invasive; transurethral resection.

Grants and funding

This research did not provide any specific grant from funding agencies in the public, commercial or not-for-profit sectors.