Long-Term Survival Outcomes with Intravesical Docetaxel for Recurrent Nonmuscle Invasive Bladder Cancer After Previous Bacillus Calmette-Guérin Therapy

No AccessJournal of UrologyAdult Urology1 Mar 2013Long-Term Survival Outcomes with Intravesical Docetaxel for Recurrent Nonmuscle Invasive Bladder Cancer After Previous Bacillus Calmette-Guérin Therapy LaMont J. Barlow, James M. McKiernan, and Mitchell C. Benson LaMont J. BarlowLaMont J. Barlow More articles by this author , James M. McKiernanJames M. McKiernan More articles by this author , and Mitchell C. BensonMitchell C. Benson More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2012.10.068AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: Docetaxel is a safe agent for intravesical therapy. Adding monthly maintenance treatments can extend response durability. We report our cumulative experience with intravesical docetaxel in a larger cohort with extended followup. Materials and Methods: A total of 54 patients received salvage intravesical docetaxel for bacillus Calmette-Guérin refractory nonmuscle invasive bladder cancer between 2003 and 2012, including 18 treated during the original phase I trial. All patients received 6 weekly instillations of intravesical docetaxel. After the phase I trial, those with a complete response to induction treatment were offered single dose monthly maintenance treatments for a total of up to 12 months of docetaxel therapy. Recurrence was defined as positive biopsy or urine cytology. Recurrence-free, disease specific and overall survival was determined by Kaplan-Meier analysis. Results: Median followup was 39.1 months. Of the 54 patients 32 (59%) had a complete initial response after induction therapy, including 18 who received additional monthly maintenance treatments. Median time to recurrence in initial responders treated with vs without docetaxel maintenance was 39.3 vs 19.0 months. One and 3-year recurrence-free survival rates for the entire cohort were 40% and 25%, respectively. Of the 54 patients 17 (24%) underwent radical cystectomy at a median of 24 months of followup. Five-year disease specific and overall survival rates were 85% and 71%, respectively. Conclusions: Intravesical docetaxel appears to be a promising agent with significant efficacy and durability for bacillus Calmette-Guérin refractory nonmuscle invasive bladder cancer. Adding maintenance treatments may increase the duration of recurrence-free survival. References 1 : The World Health Organization/International Society of Urological Pathology consensus classification of urothelial (transitional cell) neoplasms of the urinary bladder: Bladder Consensus Conference Committee. Am J Surg Pathol1998; 22: 1435. Google Scholar 2 : Intracavitary Bacillus Calmette-Guerin in the treatment of superficial bladder tumors. J Urol1976; 116: 180. 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Volume 189Issue 3March 2013Page: 834-839 Advertisement Copyright & Permissions© 2013 by American Urological Association Education and Research, Inc.Keywordsintravesicalurinary bladder neoplasmsadministrationdocetaxelurinary bladderinvestigationaltherapiesMetrics Author Information LaMont J. Barlow More articles by this author James M. McKiernan More articles by this author Mitchell C. Benson More articles by this author Expand All Advertisement PDF downloadLoading ...