Multi-Institution Evaluation of Sequential Gemcitabine and Docetaxel as Rescue Therapy for Nonmuscle Invasive Bladder...

Area of Science:

• Urology
• Oncology
• Pharmacology

Background:

• Intravesical therapies are crucial for managing nonmuscle invasive bladder cancer (NMIBC) after bacillus Calmette-Guérin (BCG) failure.
• Sequential gemcitabine and docetaxel has emerged as a promising salvage option.
• Multi-institutional validation is needed to confirm its efficacy and safety.

Purpose of the Study:

• To evaluate the multi-institutional safety and efficacy of sequential intravesical gemcitabine and docetaxel in patients with BCG-refractory NMIBC.
• To assess recurrence-free survival and identify factors associated with treatment failure.

Main Methods:

• Retrospective review of 276 patients with NMIBC treated between June 2009 and May 2018.
• Analysis included patients with recurrent NMIBC and prior BCG treatment.
• Kaplan-Meier survival analysis and Cox regression models were used.

Main Results:

• One and 2-year recurrence-free survival rates were 60% and 46%, respectively.
• High-grade recurrence-free survival rates were 65% and 52% at 1 and 2 years.
• The therapy was well-tolerated, with only 3.6% experiencing progression on TUR and 15.6% undergoing cystectomy.

Conclusions:

• Sequential intravesical gemcitabine and docetaxel is a well-tolerated and effective salvage treatment for NMIBC after BCG failure.
• The therapy provides a durable response, supporting its use in clinical practice.
• Further prospective studies are warranted to confirm these findings.