AUA 2017: High risk non-muscle invasive bladder cancer treated with sequential BCG/electromotive drug administration mitomycin C (EDMA-MMC): 2% disease-specific mortality at 4 years’ follow-up
The authors retrospectively assessed patients treated with sequential BCG/EDMA-MMC from 2009-2013 at Guy’s Hospital. All patients underwent a 9 week induction regimen consisting of BCG at weeks 1 and 2 then 4 and 5 and finally 7 and 8 with EDMA-MMC at weeks 3, 6 and 9. Maintenance consisted of BCG for 3 weeks at 3 and 9 months post-induction.
Median age was 68 with the majority being male (87%) and 74% being their index presentation. Primary histology was high grade Ta/T1 (48%), high grade/T1 + CIS (32%) and CIS only (18%). After a median follow-up of 47 months, 35% patients had recurrent disease with 3% progressed to muscle-invasive disease. Overall and cancer-specific mortality was 16% and 2%, respectively. The authors concluded that despite the challenge of a 4-year recurrence rate of 35%, a low progression rate of 5% and cancer-specific mortality of 2% continue to support the oncologic efficacy of sequential BCG/ EDMA-MMC.
Unfortunately EDMA-MMC is not approved in the United States, however, it appears the purported oncologic benefit has been demonstrated in prior randomized studies and now in this retrospective study. Current methods to expedite FDA approval among bladder cancer therapies are underway and hopefully this option may soon be available to these patients globally.
Presented by: Leyshon Griffiths, Guy’s Hospital London, UK
Written By: Stephen B. Williams, M.D., Assistant Professor in Urology, The University of Texas Medical Branch, Galveston, TX. and Ashish M. Kamat, M.D. Professor, Department of Urology, Division of Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX.
at the 2017 AUA Annual Meeting - May 12 - 16, 2017 – Boston, Massachusetts, USA