Intravesical Gemcitabine for NMIBC After BCG Treatment Failure

Elahe Mirzaee and the team aimed to evaluate the effectiveness of intravesical gemcitabine in patients diagnosed with non-muscle invasive bladder cancer (NMIBC) who had experienced treatment failure following Bacillus Calmette-Guérin (BCG) therapy within the last year.

Researchers enrolled 28 patients with recurrent NMIBC between 2021 and 2023. All patients had previously undergone intravesical therapy within the past year, declined, or were unsuitable for cystectomy.

Participants were administered 2,000 mg/100 mL of gemcitabine weekly for 6 weeks. Response assessments occurred at 8 weeks, with follow-up evaluations scheduled every three months over 1 year.

The results demonstrated that 20 out of 28 patients (71.4%) responded completely to intravesical gemcitabine. About 8 patients (28.6%) did not achieve a complete response. There were significant differences in treatment response based on age, while gender did not influence outcomes.

Additionally, the results showed no notable association between tumor stage or grade and treatment response. Complete response rates were 66.7% for low-grade and 72.7% for high-grade tumors. During 1 year of follow-up, 28.6% of complete responders did not experience recurrence, while 42.9% developed recurrent disease. Only 1 patient developed muscle-invasive bladder cancer 10 months post-treatment and underwent cystectomy.

The study concluded that intravesical gemcitabine could be a viable option for patients with NMIBC unresponsive to BCG therapy, particularly those ineligible for or unwilling to undergo cystectomy.

No funding information was given.

Source: https://pubmed.ncbi.nlm.nih.gov/39342596/

Mirzaee E, Novin K, Fadavi P, et al. (2024). “Intravesical Gemcitabine for Non-Muscle Invasive Bladder Cancer after Bacillus Calmette-Guerin Treatment Failure: A Prospective Study.” Asian Pac J Cancer Prev. 2024;25(9):3173-3177. Published 2024 Sep 1. doi:10.31557/APJCP.2024.25.9.3173