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Cancer Resources > Cancer News > Cancer News from Reuters > Reuters Cancer News > 2009 > November
Gemcitabine superior to mitomycin for recurrent bladder cancer
Will Boggs, MD
Last Updated: 2009-11-04 15:50:17 -0400 (Reuters Health)
NEW YORK (Reuters Health) - Gemcitabine is more effective and less toxic than mitomycin for patients with recurrent superficial bladder cancer, report investigators from Italy in the October 19th Journal of Clinical Oncology.
"Gemcitabine is a valid option....(and) a logical candidate for intra-bladder therapy" in these patients, Dr. Raffaele Addeo from S. Giovanni di Dio Hospital, Naples, told Reuters Health in an email.
Dr. Addeo and colleagues compared the benefits of mitomycin and gemcitabine in a randomized trial involving 120 patients with recurrent transitional cell carcinoma of the bladder, 109 of whom completed the planned treatment.
Patients received either 6 weeks of gemcitabine infusions or a 4-week course of mitomycin C. Initial responders who were free of recurrence received maintenance therapy (10 monthly treatments) in the first year. Median follow-up was 36 months in both arms.
Thirty-nine of 54 (72%) gemcitabine patients and 33 of 55 (61%) mitomycin C patients remained free of recurrence. When the risk of recurrence was stratified by grade and T stage, "there was a higher benefit for patients with grade 3 tumors treated with gemcitabine," the authors report.
Among tumors that did recur, 10 in the mitomycin group and 6 in the gemcitabine group had progressive disease by stage, "reflecting a positive trend regarding tumor progression, even if the rates did not significantly differ between the two treatment groups."
Adverse effects, and in particular, dysuria and chemical cystitis, were significantly less frequent in the gemcitabine group, the researchers note. Local adverse events delayed intravesical treatment in 10% of mitomycin patients and 5% of gemcitabine patients.
There was no life-threatening systemic toxicity or hematologic or biochemical abnormalities with either treatment.
"This study indicates that our gemcitabine regimen may modify the biologic behavior of recurrent superficial transitional cell carcinoma of the bladder and suggests that patients with tumors at grade 3 are more appropriate for gemcitabine therapy," the authors conclude.
J Clin Oncol 2009.
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