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Super-selective bladder arterial chemotherapy for muscle invasive bladder cancer
Yawei Li1, Yuxi Liu1, Junqing Xi1
1Department of Interventional Therapy, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Background:
Bladder cancer is a common urinary malignancy. Muscle-invasive bladder cancer (MIBC) has high recurrence, poor prognosis, and limited treatments. Radical cystectomy is invasive. Super-selective bladder arterial chemotherapy is promising but lacks evidence. This study evaluated its efficacy and safety for MIBC.
Methods:
We retrospectively analyzed the data of the patients with MIBC who received super-selective bladder arterial chemotherapy with cisplatin and gemcitabine from January 2018 to September 2024. Treatment responses and adverse events were also assessed.
Results:
Twenty-five MIBC patients underwent 47 courses of super-selective bladder arterial chemotherapy, with a mean participant age of 63.8±13.5 years. The median overall survival (OS) for the cohort was 34.4 months, with 1-, 2- and 3-year survival rates of 75.4% [95% confidence interval (CI): 60.1-94.6%], 50.3% (95% CI: 33.8-74.8%) and 33.5% (95% CI: 19.1-58.9%), respectively. Eleven patients achieved partial response (PR), 9 patients had stable disease (SD), and 2 patients experienced progressive disease (PD). The overall response rate (ORR) and disease control rate (DCR) were 50.0% and 90.9%, respectively. Additionally, 56.0% of patients subsequently underwent surgical resection of bladder tumors after the interventional treatment. No serious complications were reported.
Conclusions:
Super-selective bladder arterial chemotherapy is feasible and well-tolerated for MIBC, with promising tumor response and downstaging efficacy. Larger prospective controlled trials are needed to confirm its clinical value in MIBC management.
Insights
Super-selective bladder arterial chemotherapy shows promise for muscle-invasive bladder cancer (MIBC), offering good tumor response and downstaging. This treatment is feasible and well-tolerated, warranting further investigation in larger trials.
Area of Science:
- Urology
- Oncology
- Interventional Radiology
Background:
- Bladder cancer, particularly muscle-invasive bladder cancer (MIBC), presents significant challenges due to high recurrence rates, poor prognosis, and limited therapeutic options.
- Radical cystectomy, a standard treatment, is highly invasive.
- Super-selective bladder arterial chemotherapy is an emerging approach for MIBC, but robust evidence of its efficacy and safety is needed.
Purpose of the Study:
- To evaluate the efficacy and safety of super-selective bladder arterial chemotherapy in patients with muscle-invasive bladder cancer (MIBC).
- To assess treatment response rates, survival outcomes, and adverse events associated with this minimally invasive approach.
Main Methods:
- A retrospective analysis was conducted on patients with MIBC who received super-selective bladder arterial chemotherapy with cisplatin and gemcitabine.
- Data from January 2018 to September 2024 were analyzed, focusing on treatment responses and adverse events.
Main Results:
- The study included 25 MIBC patients who underwent 47 chemotherapy courses. The median overall survival was 34.4 months, with 3-year survival rates at 33.5%.
- An overall response rate (ORR) of 50.0% and a disease control rate (DCR) of 90.9% were observed. Partial response was achieved by 11 patients, stable disease by 9, and progressive disease by 2.
- 56.0% of patients proceeded to surgical resection post-treatment, and no serious complications were reported, indicating good tolerability.
Conclusions:
- Super-selective bladder arterial chemotherapy demonstrates feasibility and tolerability in MIBC management.
- The treatment shows promising efficacy in tumor response and downstaging, potentially improving outcomes for MIBC patients.
- Larger prospective controlled trials are essential to definitively establish the clinical value of this therapeutic strategy for MIBC.
