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Recombinant tumor necrosis factor for superficial bladder tumors
C N Sternberg1, M G Arena, V Pansadoro
1Regina Elena Cancer Institute, Rome, Italy.
Summary
Intravesical tumor necrosis factor (TNF) showed modest activity in superficial bladder cancer patients. The treatment was well-tolerated with minimal systemic absorption and no antibody formation, suggesting potential for this immunotherapy.
Area of Science:
- Oncology
- Immunology
- Urology
Background:
- Superficial bladder cancer (Ta, T1, Tis) requires effective intravesical therapies.
- Tumor necrosis factor (TNF) is a cytokine with potential anti-cancer properties.
Purpose of the Study:
- To evaluate the safety and efficacy of intravesical TNF in patients with superficial bladder cancer.
- To assess systemic absorption and immunogenicity of intravesical TNF.
Main Methods:
- Twenty patients with superficial bladder cancer received intravesical TNF (400-1800 micrograms).
- Pharmacokinetic studies monitored systemic absorption.
- Marker lesions were assessed for response.
- Antibody formation was evaluated.
Main Results:
- Two of 18 patients with marker lesions achieved a complete response (8+ and 18 months).
- Two patients had partial responses, subsequently receiving other therapies.
- Minimal systemic TNF absorption occurred in 4/20 patients.
- No patients developed antibodies to intravesical TNF.
- TNF was well-tolerated up to 1800 micrograms with no significant side effects.
Conclusions:
- Intravesical TNF demonstrates modest activity in superficial bladder cancer, including pretreated patients.
- The treatment is safe and well-tolerated with limited systemic exposure and no observed immunogenicity.
- Further investigation into intravesical TNF for bladder cancer is warranted.