Current therapy of bladder carcinoma

Effects of intravesical instillation of antitumor chemotherapeutic and immunotherapeutic agents on bladder lesion development in rats pretreated with N-butyl-N-(4-hydroxybutyl)nitrosamine

The effects of 12 weeks of intravesical instillation of bleomycin, cisplatinum and picibanyl on development of urinary bladder tumors and preneoplastic lesions were examined in rats pretreated with N-butyl-N-(4-hydroxybutyl)-nitrosamine (BBN) for four weeks. Upon sacrifice at week 36, histopathological examination revealed a significantly reduced incidence of PN hyperplasia and a tendency for decreased papilloma generation in rats given cisplatinum. However, the other treatments were not associated with any effect on carcinogen-induced lesion development. The results demonstrate that cisplatinum has a potential for postinitiation inhibition of rat bladder carcinogenesis.

Effects of intravesical instillation of antitumor chemotherapeutic agents on bladder carcinogenesis in rats treated with N-butyl-N-(4-hydroxybutyl)nitrosamine

The effects of intravesical instillation of Adriamycin (doxorubicin) (ADR), and mitomycin C (MMC), as inhibitors of development of rat bladder tumors, were examined in rats treated with N-butyl-N-(4-hydroxybutyl)nitrosamine (BBN). Intravesical instillation of ADR or MMC once a week for 12 weeks into rats pretreated with BBN for 4 weeks markedly enhanced development of bladder tumors. That is, one week after the end of intravesical instillation of these compounds the incidence of papillary or nodular hyperplasias, namely preneoplastic lesions, was significantly increased, and at the end of the experiment the incidence of not only papillary or nodular hyperplasias but also of papillomas and cancers was significantly increased. These results indicate that the intravesical instillation of ADR or MMC promotes two-stage bladder carcinogenesis in rats.

Adjuvant chemotherapy of superficial transitional cell bladder carcinoma: preliminary results of a European organization for research on treatment of cancer. Randomized trial comparing doxorubicin hydrochloride, ethoglucid and transurethral resection alone

Patients with superficial transitional cell carcinoma of the bladder were entered in a randomized clinical trial to compare the efficacies of transurethral resection alone or followed by bladder instillation of doxorubicin hydrochloride or ethoglucid (Epodyl) for 1 year. Results showed that adjuvant chemotherapy with the selected drugs prolonged the mean interval between recurrences. Mild systemic toxicity and chemical cystitis were observed in 3 and 3 per cent, respectively, of the patients given ethoglucid, and in 5 and 4 per cent, respectively, of those taking doxorubicin.

Oral administration of 5-fluorouracil: renal clearance and urinary concentration in man

The pharmacokinetics of 5-fluouracil were studied in 9 patients with a history of bladder malignancies. A single dose of 250 mg. 5-fluorouracil was given orally and the renal clearance of active 5-fluorouracil was approximately 40 ml. per minute. The maximum serum (1,100 ng./ml. serum) and urinary concentrations (49,000 ng./ml. urine) of 5-fluorouracil occurred 20 and 40 minutes after administration, respectively. The urinary concentration per se is highly cytotoxic, whereas the short-lasting serum concentration previously has been proved to be without general cytotoxic effects even after continuous use of the drug for years. Although high concentrations of 5-fluorouracil are noted in the urine the antitumor effects of this treatment must be investigated further.

Treatment of malignant bladder tumors by iridium-192 wiring

Small tumors of the mobile portion of the bladder may be treated by means of interstitial irradiation by iridium-192 wiring. Twenty-six tumors (mostly T1, but also T2 and T3) were treated by this procedure. Good results are attained in 89 per cent of 19 cases followed over three years. This method has the benefit of avoiding irradiation to the surgeon's hands, and of delivering to a specific site a dose of 6,000 rads. No bladder contraction was observed.

Cell surface A, B, or O(H) blood group antigens as an indicator of malignant potential in stage A bladder carcinoma

The major blood group antigens A, B or O(H) are present on normal bladder epithelium. The presence or absence of these antigens on the cell surface of bladder tumors has been determined in a retrospective longitudinal study using biopsy material from 322 patients who fit the following criteria: 1) the patient presented initially with a superficial bladder tumor, 2) the patient had followup examination for at least 5 years or until evidence of tumor invasion of bladder muscle and 3) the paraffin-embedded tumor specimens were still available. Of 80 patients with stage A tumors that subsequently became invasive 71 (88 per cent) showed deletion of A, B or H antigens from the original superficial tumor. On the other hand, of 146 patients who had no recurrence of superficial tumor for at least 5 years 127 (87 per cent) retained A, B or H antigens. Of 96 patients who had 1 or more superficial recurrences 87 (90 per cent) retained antigens on the initial and subsequent tumors. Analysis of transitional cell surface antigens should help in the identification of those patients with superficial disease who are at greatest risk for invasive bladder cancer.