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Related Concept Videos

Urinary Tract Calculi III: Medical Management01:30

Urinary Tract Calculi III: Medical Management

The diagnosis of renal calculi involves several imaging techniques, including non-contrast CT scans and ultrasound. These methods help visualize kidney stones, assess their size and location, and detect possible obstructions. Additionally, Measuring urine pH is useful for diagnosing specific stone types, such as struvite (alkaline pH) and uric acid stones (acidic pH). Cystine stones are primarily linked to cystinuria, a genetic condition. A urinalysis helps detect blood in the urine (hematuria)...

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Related Experiment Video

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Induction of Invasive Transitional Cell Bladder Carcinoma in Immune Intact Human MUC1 Transgenic Mice: A Model for Immunotherapy Development
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Neoadjuvant Intravesical Mitomycin C for NMIBC: A Phase III Single-Center, Open-Label Randomized Clinical Trial.

Roberto Contieri1,2, Alberto Saita2, Marco Paciotti1,2

  • 1Department of Biomedical Sciences, Humanitas University, 20072 Pieve Emanuele, Italy.

Cancers
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PubMed
Summary

Neoadjuvant intravesical mitomycin C (neoMMC) before transurethral resection of bladder tumor (TURBT) was safe and well-tolerated for non-muscle-invasive bladder cancer. However, this underpowered study did not show a significant improvement in recurrence-free survival.

Keywords:
immunogenic cell deathintravesical chemotherapymitomycin Cneoadjuvant therapynon-muscle invasive bladder cancerrecurrence-free survival

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Area of Science:

  • Urology
  • Oncology
  • Clinical Trials

Background:

  • Transurethral resection of bladder tumor (TURBT) is standard for non-muscle-invasive bladder cancer (NMIBC).
  • High recurrence rates after TURBT necessitate improved treatment strategies.
  • Neoadjuvant intravesical mitomycin C (neoMMC) is being investigated to reduce recurrence and enhance surgical outcomes.

Purpose of the Study:

  • To evaluate the safety, tolerability, and efficacy of neoMMC prior to TURBT in NMIBC patients.
  • To assess the impact of neoMMC on recurrence-free survival (RFS) and surgical quality.
  • To explore the effects of neoMMC on histopathologic response and urinary microbiota.

Main Methods:

  • A randomized phase III trial comparing neoMMC plus TURBT versus standard TURBT alone.
  • 95 patients with primary or recurrent NMIBC were randomized 1:1.
  • The primary endpoint was 12-month RFS; secondary endpoints included surgical quality and safety.

Main Results:

  • No significant difference in RFS between the neoMMC and control groups at 12 or 18 months.
  • Neoadjuvant MMC was well tolerated with only grade 1-2 adverse events.
  • Exploratory analyses suggested neoMMC modulated urinary microbiota diversity.

Conclusions:

  • Neoadjuvant intravesical MMC before TURBT is feasible and safe for NMIBC.
  • This underpowered trial did not demonstrate a significant improvement in RFS.
  • Larger, powered studies are required to confirm the oncologic efficacy of neoadjuvant MMC.