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Combination chemotherapy for advanced bilharzial bladder carcinoma
H M Khaled1, N Gad el-Mawla, A el-Said
1Department of Medical Oncology, National Cancer Institute, Cairo, Egypt.
Summary
Combination chemotherapy shows activity against advanced bilharzial bladder cancer, with a 46% response rate. However, complete remission and prolonged survival remain rare in this patient group.
Area of Science:
- Oncology
- Uro-oncology
- Cancer Research
Background:
- Bilharzial bladder cancer is prevalent in Egypt, historically treated with surgery.
- Previous phase II trials identified several active single agents.
- This study investigates combinations of these active agents in chemotherapy-naïve patients.
Purpose of the Study:
- To evaluate the efficacy of alternating combination chemotherapy regimens in advanced bilharzial bladder cancer.
- To assess response rates, toxicities, and factors influencing treatment outcomes.
Main Methods:
- 30 patients with inoperable, recurrent, or metastatic bilharzial bladder cancer received alternating cycles of epidoxorubicin/vincristine and etoposide/ifosfamide with mesna uroprotection.
- Chemotherapy courses were repeated every 3-4 weeks.
Main Results:
- Among 22 evaluable patients, the overall response rate was 46% (36.5% partial, 4.5% complete).
- Six patients achieved disease stabilization.
- Myelosuppression was the primary toxicity, and was generally tolerable. No correlation was found between clinicopathological factors and response.
Conclusions:
- Advanced bilharzial bladder cancer demonstrates sensitivity to combination chemotherapy.
- Complete remission and long-term survival are infrequent in advanced stages.
- Further research is necessary to optimize single-agent versus combination therapy strategies.