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[Bladder cancer: chemotherapy of advanced bladder cancer]
Abstract:
Chemotherapy of advanced bladder cancer aims to destroy all the cancer cells in the host. For this purpose the most suitable and effective anticancer agents should be chosen. There have been many methods to select the anti-cancer drugs: sensitivity test. However, no reliable tests are available. We developed new anti-cancer sensitivity test, using the radio-active nucleic acids precursors; C14-Formate and C14-Adenine. This test revealed that Cisplatin, Adriamycin, and Mitomycin C were the most potent for the transitional cell carcinoma of the urinary bladder. Chemotherapy with a single agent was disappointing. Combined use of these agents was rather promising. Among them combination of cis-platin with Adriamycin and/or cyclophosphamide was the most effective. However, the overall response rate was reported around 50%. Multi-disciplinary treatment including surgery, irradiation, chemotherapy, and immunotherapy was disclosed to be useful for the treatment of bladder cancer. Since 1977 25 cases were treated with this mode of therapy in our clinic. Anti-tumor effect was remarkable. The categories, disappeared, and over 50% decrease of the mass, were found in 96% of the patients. Also, down-staging was demonstrated in 20% of the cases. Histologically no cancer cells were found in the surgical specimens of 3 cases and no viable cancer cells in 3 cases respectively. From these results it is now assumed that multi-disciplinary treatment is promising for the treatment of bladder cancer.
Insights
Developing a novel radioactive nucleic acid precursor test identified potent chemotherapy drugs for bladder cancer. Multidisciplinary treatment combining these agents showed remarkable anti-tumor effects and improved patient outcomes.
Area of Science:
- Oncology
- Biochemistry
Context:
- Advanced bladder cancer treatment requires effective chemotherapy drug selection.
- Current anti-cancer drug sensitivity tests lack reliability.
Purpose:
- To develop a novel, reliable anti-cancer drug sensitivity test.
- To identify potent chemotherapeutic agents for transitional cell carcinoma of the urinary bladder.
Summary:
- A new test using radioactive nucleic acid precursors (C14-Formate and C14-Adenine) identified Cisplatin, Adriamycin, and Mitomycin C as potent agents.
- Combined chemotherapy, particularly cisplatin with Adriamycin and/or cyclophosphamide, showed promise, though single-agent therapy was disappointing.
- Multidisciplinary treatment (surgery, irradiation, chemotherapy, immunotherapy) yielded remarkable anti-tumor effects, with 96% of patients showing significant tumor reduction or disappearance.
Impact:
- This research highlights the potential of a new sensitivity test for optimizing bladder cancer chemotherapy.
- Multidisciplinary treatment approaches demonstrate significant efficacy in managing advanced bladder cancer, offering improved patient prognoses.