Mitomycin-C Combo May Reduce Recurrences of Bladder Cancer

By David Douglas

NEW YORK (Reuters Health) - In patients with frequent recurrences of non-muscle-invasive bladder cancer, the frequency of recurrences can be reduced with instillation with mitomycin-C followed by bacillus Calmette Guerin (BCG), according to Finnish investigators.

"Intravesical instillation therapy with one perioperative and four weekly mitomycin-C followed by BCG instillations once a month up to one year halves the risk of recurrence among non-muscle-invasive bladder cancer patients with very high risk of recurrence," Dr. Riikka Jarvinen, of Helsinki University Hospital, told Reuters Health by email.

In a paper online March 5 in European Urology, Dr. Jarvinen and colleagues note that they came to this conclusion after studying outcomes in 236 patients were who enrolled in a randomized study between 1992 and 1996.

One group received one perioperative plus four weekly instillations of mitomycin-C followed by monthly BCG. The other group received perioperative mitomycin-C followed by alternating BCG and interferon-alpha2b (IFN-alpha2b).

Treatment lasted for up to one year and median follow-up, which exceeded eight years, ranged as high as 19.8 years. At ten years the mitomycin-C/BCG group frequency of recurrence came to 43%, compared with 78% for the mitomycin-C/BCG/IFN-alpha2b group. At 15 years the difference came to 45% versus 80%.

In addition, said Dr. Jarvinen, "We found that the risk of progression is very low and only a few cases of recurrence took place after 10 years of follow-up."

"These results," she concluded, "may indicate that lifelong follow-up, as the current European Urology guidelines recommend, among these patients might not be necessary."

The authors reported no external funding or disclosures.

SOURCE: https://bit.ly/196b1YX

Eur Urol 2015.

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