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Sturm S, Niegisch G, Windolf J, Suschek CV. Exposure of Bladder Cancer Cells to Blue Light (λ = 453 nm) in the Presence of Riboflavin Synergistically Enhances the Cytotoxic Efficiency of Gemcitabine. Int J Mol Sci 2024; 25:4868. [PMID: 38732087 PMCID: PMC11084806 DOI: 10.3390/ijms25094868] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2024] [Revised: 04/25/2024] [Accepted: 04/28/2024] [Indexed: 05/13/2024] Open
Abstract
Non-muscle invasive bladder cancer is a common tumour in men and women. In case of resistance to the standard therapeutic agents, gemcitabine can be used as off-label instillation therapy into the bladder. To reduce potential side effects, continuous efforts are made to optimise the therapeutic potential of drugs, thereby reducing the effective dose and consequently the pharmacological burden of the medication. We recently demonstrated that it is possible to significantly increase the therapeutic efficacy of mitomycin C against a bladder carcinoma cell line by exposure to non-toxic doses of blue light (453 nm). In the present study, we investigated whether the therapeutically supportive effect of blue light can be further enhanced by the additional use of the wavelength-specific photosensitiser riboflavin. We found that the gemcitabine-induced cytotoxicity of bladder cancer cell lines (BFTC-905, SW-1710, RT-112) was significantly enhanced by non-toxic doses of blue light in the presence of riboflavin. Enhanced cytotoxicity correlated with decreased levels of mitochondrial ATP synthesis and increased lipid peroxidation was most likely the result of increased oxidative stress. Due to these properties, blue light in combination with riboflavin could represent an effective therapy option with few side effects and increase the success of local treatment of bladder cancer, whereby the dose of the chemotherapeutic agent used and thus the chemical load could be significantly reduced with similar or improved therapeutic success.
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Affiliation(s)
- Sofia Sturm
- Department of Orthopedics and Trauma Surgery, Medical Faculty, University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, Moorenstr. 5, 40225 Düsseldorf, Germany
| | - Günter Niegisch
- Department of Urology, Medical Faculty, University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, 40225 Düsseldorf, Germany
| | - Joachim Windolf
- Department of Orthopedics and Trauma Surgery, Medical Faculty, University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, Moorenstr. 5, 40225 Düsseldorf, Germany
| | - Christoph V. Suschek
- Department of Orthopedics and Trauma Surgery, Medical Faculty, University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, Moorenstr. 5, 40225 Düsseldorf, Germany
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2
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Zaza MMA, Salem TAEM, El-Sadat AM, Hassan Ali M. Comparative study between mitomycin C versus Bacillus Calmette-Guérin (BCG) in high-risk non-muscle-invasive bladder cancer. Urologia 2024; 91:61-68. [PMID: 37905506 DOI: 10.1177/03915603231206603] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2023]
Abstract
OBJECTIVES We aimed to compare the efficacy and adverse events of Bacillus Calmette-Guérin (BCG) versus Mitomycin C (MMC) in high-risk Non-Muscle-Invasive Bladder Cancer (NMIBC) patients. METHODS This randomized controlled study was conducted over 24 months in four hospitals in Egypt. A sample of 90 patients was randomly assigned to either treatment group, with procedures including baseline examinations, a single postoperative instillation of chemotherapy, a 6-week induction cycle of the assigned drug, and regular follow-up cystoscopies and upper urinary tract imaging. Treatment results and side effects were monitored, with data analyzed via Statistical Package for Social Sciences (SPSS). RESULTS No significant differences were observed in mean age or tumor characteristics (p > 0.05). However, adverse reactions were significantly higher in the BCG group, including cystitis (40% vs. 17.78%, p = 0.020), hematuria (24.44% vs. 4.44%, p = 0.007), overall local reactions (75.56% vs. 26.67%, p < 0.001), fever (13.33% vs. 2.22%, p = 0.049), and fatigue (17.78% vs. 2.22%, p = 0.014). The MMC group had a slightly higher recurrence rate (28.89% vs. 17.78%, hazard ratio 1.89, 95% CI: 0.78-4.55, p = 0.15) with a shorter median time to recurrence (six vs. 12 months). Progression rates were similar (8.89% MMC vs. 4.44% BCG, p = 0.398). CONCLUSION Although BCG and MMC have comparable efficacy in managing high-risk NMIBC, BCG demonstrated a higher rate of adverse reactions. Decision-making should consider this balance, patient preferences, and health status. Further research is needed for the validation and exploration of these findings.
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3
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Martins-Lima C, Chianese U, Benedetti R, Altucci L, Jerónimo C, Correia MP. Tumor microenvironment and epithelial-mesenchymal transition in bladder cancer: Cytokines in the game? Front Mol Biosci 2023; 9:1070383. [PMID: 36699696 PMCID: PMC9868260 DOI: 10.3389/fmolb.2022.1070383] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Accepted: 11/22/2022] [Indexed: 01/11/2023] Open
Abstract
Bladder cancer (BlCa) is a highly immunogenic cancer. Bacillus Calmette-Guérin (BCG) is the standard treatment for non-muscle invasive bladder cancer (NMIBC) patients and, recently, second-line immunotherapies have arisen to treat metastatic BlCa patients. Understanding the interactions between tumor cells, immune cells and soluble factors in bladder tumor microenvironment (TME) is crucial. Cytokines and chemokines released in the TME have a dual role, since they can exhibit both a pro-inflammatory and anti-inflammatory potential, driving infiltration and inflammation, and also promoting evasion of immune system and pro-tumoral effects. In BlCa disease, 70-80% are non-muscle invasive bladder cancer, while 20-30% are muscle-invasive bladder cancer (MIBC) at the time of diagnosis. However, during the follow up, about half of treated NMIBC patients recur once or more, with 5-25% progressing to muscle-invasive bladder cancer, which represents a significant concern to the clinic. Epithelial-mesenchymal transition (EMT) is one biological process associated with tumor progression. Specific cytokines present in bladder TME have been related with signaling pathways activation and EMT-related molecules regulation. In this review, we summarized the immune landscape in BlCa TME, along with the most relevant cytokines and their putative role in driving EMT processes, tumor progression, invasion, migration and metastasis formation.
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Affiliation(s)
- Cláudia Martins-Lima
- Cancer Biology and Epigenetics Group, Research Center of IPO Porto (CI-IPOP)/RISE@CI-IPOP (Health Research Network), Portuguese Oncology Institute of Porto (IPO Porto) and Porto Comprehensive Cancer Center (Porto.CCC) Raquel Seruca, Porto, Portugal,Department of Precision Medicine, University of Campania “Luigi Vanvitelli”, Naples, Italy
| | - Ugo Chianese
- Department of Precision Medicine, University of Campania “Luigi Vanvitelli”, Naples, Italy
| | - Rosaria Benedetti
- Department of Precision Medicine, University of Campania “Luigi Vanvitelli”, Naples, Italy
| | - Lucia Altucci
- Department of Precision Medicine, University of Campania “Luigi Vanvitelli”, Naples, Italy,BIOGEM, Molecular Biology and Genetics Research Institute, Avellino, Italy,IEOS, Institute of Endocrinology and Oncology, Naples, Italy
| | - Carmen Jerónimo
- Cancer Biology and Epigenetics Group, Research Center of IPO Porto (CI-IPOP)/RISE@CI-IPOP (Health Research Network), Portuguese Oncology Institute of Porto (IPO Porto) and Porto Comprehensive Cancer Center (Porto.CCC) Raquel Seruca, Porto, Portugal,Department of Pathology and Molecular Immunology at School of Medicine and Biomedical Sciences, University of Porto (ICBAS-UP), Porto, Portugal,*Correspondence: Carmen Jerónimo, , ; Margareta P. Correia,
| | - Margareta P. Correia
- Cancer Biology and Epigenetics Group, Research Center of IPO Porto (CI-IPOP)/RISE@CI-IPOP (Health Research Network), Portuguese Oncology Institute of Porto (IPO Porto) and Porto Comprehensive Cancer Center (Porto.CCC) Raquel Seruca, Porto, Portugal,Department of Pathology and Molecular Immunology at School of Medicine and Biomedical Sciences, University of Porto (ICBAS-UP), Porto, Portugal,*Correspondence: Carmen Jerónimo, , ; Margareta P. Correia,
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4
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Koimtzis G, Alexandrou V, Chalklin CG, Carrington-Windo E, Ramsden M, Karakasis N, Lam KW, Tsakaldimis G. The Role of Adjuvant Single Postoperative Instillation of Gemcitabine for Non-Muscle-Invasive Bladder Cancer: A Systematic Review and Meta-Analysis. Diagnostics (Basel) 2022; 12:diagnostics12051154. [PMID: 35626309 PMCID: PMC9140686 DOI: 10.3390/diagnostics12051154] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Revised: 03/05/2022] [Accepted: 04/29/2022] [Indexed: 02/05/2023] Open
Abstract
Bladder cancer is a heterogeneous disease with variable natural history. Non-muscle-invasive bladder cancer has a favorable prognosis following transurethral resection, but the optimal adjuvant chemotherapy plan is still in debate. The aim of this study was to evaluate the effect of the adjuvant intravesical administration of a single dose of gemcitabine in the outcome of this disease. For that purpose, we performed a systematic review and meta-analysis on available randomized control trials on MEDLINE, EMBASE, Cochrane, Scopus, and Google Scholar databases. Ultimately, two studies were included with a total number of 654 patients. The statistical analysis performed showed that a single post-operative intravesical dose of gemcitabine does not affect the recurrence rate of non-muscle-invasive bladder cancer compared to placebo. Therefore, this therapeutic strategy does not offer any significant improvement on the outcomes of the disease. Nonetheless, due to the plethora of available therapeutic agents and treatment strategies, further research is needed to establish the optimal treatment in this category of patients.
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Affiliation(s)
- Georgios Koimtzis
- Cardiff Transplant Unit, University Hospital of Wales, Cardiff and Vale University Health Board, Cardiff CF14 4XW, UK; (C.G.C.); (E.C.-W.); (M.R.); (K.W.L.)
- Correspondence: ; Tel.: +44-7716466710
| | - Vyron Alexandrou
- Urology Department, General Hospital of Thessaloniki “G. Gennimata-Agios Dimitrios”, Elenis Zografou 2, 546 34 Thessaloniki, Greece; (V.A.); (N.K.); (G.T.)
| | - Christopher G. Chalklin
- Cardiff Transplant Unit, University Hospital of Wales, Cardiff and Vale University Health Board, Cardiff CF14 4XW, UK; (C.G.C.); (E.C.-W.); (M.R.); (K.W.L.)
| | - Eliot Carrington-Windo
- Cardiff Transplant Unit, University Hospital of Wales, Cardiff and Vale University Health Board, Cardiff CF14 4XW, UK; (C.G.C.); (E.C.-W.); (M.R.); (K.W.L.)
| | - Mark Ramsden
- Cardiff Transplant Unit, University Hospital of Wales, Cardiff and Vale University Health Board, Cardiff CF14 4XW, UK; (C.G.C.); (E.C.-W.); (M.R.); (K.W.L.)
| | - Nikolaos Karakasis
- Urology Department, General Hospital of Thessaloniki “G. Gennimata-Agios Dimitrios”, Elenis Zografou 2, 546 34 Thessaloniki, Greece; (V.A.); (N.K.); (G.T.)
| | - Kit W. Lam
- Cardiff Transplant Unit, University Hospital of Wales, Cardiff and Vale University Health Board, Cardiff CF14 4XW, UK; (C.G.C.); (E.C.-W.); (M.R.); (K.W.L.)
| | - Georgios Tsakaldimis
- Urology Department, General Hospital of Thessaloniki “G. Gennimata-Agios Dimitrios”, Elenis Zografou 2, 546 34 Thessaloniki, Greece; (V.A.); (N.K.); (G.T.)
- Department of Medicine, Democritus University of Thrace, Administrative Building, 6th km, 681 00 Alexandroupoli, Greece
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5
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Bell CJ, Potts KG, Hitt MM, Pink D, Tuszynski JA, Lewis JD. Novel colchicine derivative CR42-24 demonstrates potent anti-tumor activity in urothelial carcinoma. Cancer Lett 2022; 526:168-179. [PMID: 34838691 DOI: 10.1016/j.canlet.2021.11.028] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Revised: 11/09/2021] [Accepted: 11/23/2021] [Indexed: 01/03/2023]
Abstract
Bladder cancers, and specifically urothelial carcinoma, have few effective treatment options, and tumors typically develop resistance against standard of care chemotherapies leading to significant mortality. The development of alternative therapies with increased selectivity and improved tolerability would significantly impact this patient population. Here, we investigate a novel colchicine derivative, CR42-24, with increased selectivity for the βIII tubulin subtype as a treatment for urothelial carcinoma. βIII tubulin is a promising target due to its low expression in healthy tissues and its clinical association with poor prognosis. This study demonstrated that CR42-24 is selectively cytotoxic to several cancer cell lines at low nanomolar IC50, with high activity in bladder cancer cell lines both in vitro and in vivo. CR42-24 monotherapy in an aggressive urothelial carcinoma xenograft model results in effective control when treated early. We observed significant ablation of large tumors and patient-derived xenografts at low doses with excellent tolerability. CR42-24 was highly synergistic in combination with the standard of care chemotherapies gemcitabine and cisplatin, further increasing its therapeutic potential as a novel treatment for urothelial carcinoma.
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Affiliation(s)
- Clayton J Bell
- Department of Oncology, University of Alberta, Edmonton, Alberta, T6G 2E1, Canada
| | - Kyle G Potts
- Department Microbiology, Immunology & Infectious Diseases, Alberta Children's Hospital Research Institute, T2N-4N1, Canada
| | - Mary M Hitt
- Department of Oncology, University of Alberta, Edmonton, Alberta, T6G 2E1, Canada
| | - Desmond Pink
- Department of Oncology, University of Alberta, Edmonton, Alberta, T6G 2E1, Canada
| | - Jack A Tuszynski
- Department of Oncology, University of Alberta, Edmonton, Alberta, T6G 2E1, Canada
| | - John D Lewis
- Department of Oncology, University of Alberta, Edmonton, Alberta, T6G 2E1, Canada.
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6
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Cadherin switches during epithelial-mesenchymal transition: CDH4/RCAD downregulation reduces bladder cancer progression. Cell Oncol (Dordr) 2022; 45:135-149. [DOI: 10.1007/s13402-021-00657-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/17/2021] [Indexed: 11/03/2022] Open
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7
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Wen YC, Lee LM, Lin YW, Syu SH, Lin KH, Fan YC, Lee HL, Lai BCH, Shih HJ. Loco-regional deep hyperthermia combined with intravesical Mitomycin instillation reduces the recurrence of non-muscle invasive papillary bladder cancer. Int J Hyperthermia 2021; 38:1627-1632. [PMID: 34775895 DOI: 10.1080/02656736.2021.2001582] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Abstract
OBJECTIVES To compare the therapeutic effects of locoregional deep hyperthermia combined with intravesical chemotherapy with those of intravesical chemotherapy alone in patients with intermediate-/high-risk non-muscle invasive bladder cancer (NMIBC). To evaluate the impact of thermal dose in hyperthermia treatment. METHODS We analyzed data retrieved from the medical records of patients with intermediate-/high-risk NMIBC treated with intravesical mitomycin (IM group) or locoregional deep hyperthermia combined with intravesical mitomycin (CHT group) at a single tertiary care hospital between May 2016 and June 2019. The primary and secondary endpoints were the recurrence-free survival rate and progression-free survival rate, respectively. Thermal dose was evaluated and adverse events were also recorded. RESULTS In total, 43 patients (CHT: 18 patients, IM: 25 patients) were enrolled. The median follow-up durations were 14 and 23 months, respectively. The recurrence rate at 12 months was significantly lower in the CHT group than in the IM group (11.1% vs. 44%, p = .048); this trend persisted at 24 months (CHT: 11.1%, IM: 48%; p = .027). The recurrence-free survival was also significantly higher in the CHT group than in the IM group (p = .028). No tumor recurrence was noted in patients who received a thermal dose of ≥4 CEM43. All adverse events were well tolerated, and there was no treatment-related mortality. CONCLUSIONS Intravesical chemotherapy combined with locoregional deep hyperthermia for intermediate-/high-risk papillary NMIBC can significantly decrease the recurrence rate relative to that observed after intravesical chemotherapy alone.
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Affiliation(s)
- Yu-Ching Wen
- Department of Urology, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan.,Department of Urology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.,Research Center of Urology and Kidney, Taipei Medical University, Taipei, Taiwan
| | - Liang-Ming Lee
- Department of Urology, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan.,Department of Urology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Yung-Wei Lin
- Department of Urology, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan.,Department of Urology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Syuan-Hao Syu
- Department of Urology, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan.,Research Center of Urology and Kidney, Taipei Medical University, Taipei, Taiwan
| | - Ke-Hsun Lin
- Department of Urology, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan.,Department of Urology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Yen-Chun Fan
- Department of Anesthesiology, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
| | - Hsin-Lun Lee
- Department of Radiation Oncology, Taipei Medical University Hospital, Taipei Medical University, Taipei, Taiwan.,Department of Radiology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Benjamin Chung Howe Lai
- Department of Urology, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan.,Research Center of Urology and Kidney, Taipei Medical University, Taipei, Taiwan
| | - Hung-Jen Shih
- Department of Urology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.,Division of Urology, Department of Surgery, Changhua Christian Hospital, Changhua, Taiwan.,Department of Recreation and Holistic Wellness, MingDao University, Changhua, Taiwan
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8
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Harada M, Tomisaki I, Minato A, Onishi R, Terado M, Inatomi H, Fujimoto N. Combination therapy with paclitaxel and gemcitabine after platinum-based chemotherapy in patients with advanced urothelial cancer. Int J Urol 2021; 28:970-974. [PMID: 34240471 DOI: 10.1111/iju.14616] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Accepted: 05/12/2021] [Indexed: 12/11/2022]
Abstract
OBJECTIVES To evaluate the efficacy and tolerability of paclitaxel and gemcitabine therapy after platinum-based chemotherapy for patients with advanced urothelial carcinoma. METHODS Consecutive patients with advanced urothelial carcinoma who received paclitaxel and gemcitabine therapy from December 2003 to March 2018 were retrospectively reviewed. The objective response for paclitaxel and gemcitabine therapy, progression-free survival and overall survival, and adverse events were evaluated. The reduction rate among each metastatic site and the associations between the clinical parameters and overall survival or progression-free survival were also assessed. RESULTS We enrolled 58 patients. Complete and partial responses were observed in two (3.4%) and 15 patients (26%), respectively. The median progression-free survival and overall survival were 4.3 months (95% confidence interval 2.9-5.2) and 11.5 months (95% confidence interval 7.7-14.8), respectively. The objective response rates of primary site and metastases in lymph nodes, lung, bone, and liver were 6.0%, 37%, 23%, 0%, and 22%, respectively. Poor performance status (≥1), prior use of gemcitabine and the number of metastatic sites (≥2) were significantly associated with poor overall survival. Although three patients discontinued the treatment because of adverse events, there was no therapy-related death. CONCLUSIONS Paclitaxel and gemcitabine therapy seems to be a valid option as a subsequent treatment after platinum-based chemotherapy for urothelial carcinoma, especially in patients with favorable performance status and no prior use of gemcitabine.
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Affiliation(s)
- Mirii Harada
- Department of Urology, School of Medicine, University of Occupational and Environmental Health, Kitakyushu, Fukuoka, Japan
| | - Ikko Tomisaki
- Department of Urology, School of Medicine, University of Occupational and Environmental Health, Kitakyushu, Fukuoka, Japan
| | - Akinori Minato
- Department of Urology, School of Medicine, University of Occupational and Environmental Health, Kitakyushu, Fukuoka, Japan
| | - Rei Onishi
- Department of Urology, School of Medicine, University of Occupational and Environmental Health, Kitakyushu, Fukuoka, Japan
| | | | - Hisato Inatomi
- Munakata Suikokai General Hospital, Fukutsu, Fukuoka, Japan
| | - Naohiro Fujimoto
- Department of Urology, School of Medicine, University of Occupational and Environmental Health, Kitakyushu, Fukuoka, Japan
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Tripathi MC, Faisal Masood P, Sood R, Singla A, Khattar N, Manasa T, Singh R. A prospective study comparing side-firing KTP laser enucleation vs bipolar transurethral resection of bladder tumor for small bladder tumors in an outpatient setting. Cent European J Urol 2021; 74:215-221. [PMID: 34336241 PMCID: PMC8318012 DOI: 10.5173/ceju.2021.0012.r1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Revised: 03/17/2021] [Accepted: 03/30/2021] [Indexed: 11/22/2022] Open
Abstract
Introduction Laser therapy provides an alternative option for treating non-muscle-invasive bladder cancer. The clinical evidence for potassium-titanyl-phosphate (KTP) laser en bloc resection is still limited. Here, we evaluated the efficacy, safety profile, and outcomes of side-firing KTP laser enucleation with bipolar transurethral resection of bladder tumor (TURBT) in carefully selected patients with small bladder tumors in an office setting. Material and methods A total of 83 patients with small bladder tumors were treated with either side-firing KTP laser enucleation (Group A; n = 40) or bipolar TURBT (Group B; n = 43). Intraoperative and postoperative parameters of interest were recorded and analyzed as per the study so as to evaluate the efficacy, safety profile, and outcome of KTP laser enucleation. Results The mean enucleation time was 23 ±5.24 min in Group A and the mean operative time was 21.98 ±4.77 min in Group B (p = 0.207). Group A had a lower risk of obturator reflex (0 vs 8; p = 0.005) and lesser amount of irrigation used intraoperatively as compared to Group B (6.2 ±0.61 L vs 7.65 ±0.75 L; p <0.0001). There were no perioperative complications. The recurrence rate at 6 months was none in Group A and 2.3% in Group B. Conclusions The present study shows that, in patients with small bladder tumors (<3 cm), KTP laser enucleation is an effective and feasible alternative to bipolar TURBT in an office setting and can be carried out safely with comparable treatment outcomes, lesser use of irrigation fluid and lower risk of obturator reflex. However, further studies in larger cohorts are warranted.
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Affiliation(s)
- Mahesh Chandra Tripathi
- Department of Urology and Renal Transplant, Atal Bihari Vajpayee Institute of Medical Sciences & Dr. Ram Manohar Lohia Hospital, New Delhi, India
| | - Pirzada Faisal Masood
- Department of Urology and Renal Transplant, Atal Bihari Vajpayee Institute of Medical Sciences & Dr. Ram Manohar Lohia Hospital, New Delhi, India
| | - Rajeev Sood
- Department of Urology and Renal Transplant, Atal Bihari Vajpayee Institute of Medical Sciences & Dr. Ram Manohar Lohia Hospital, New Delhi, India
| | - Anurag Singla
- Department of Urology and Renal Transplant, Atal Bihari Vajpayee Institute of Medical Sciences & Dr. Ram Manohar Lohia Hospital, New Delhi, India
| | - Nikhil Khattar
- Department of Urology, Medanta the Medicity, Gurugram, India
| | - T Manasa
- Department of Urology and Renal Transplant, Atal Bihari Vajpayee Institute of Medical Sciences & Dr. Ram Manohar Lohia Hospital, New Delhi, India
| | - Rajpal Singh
- Department of Anesthesia, Atal Bihari Vajpayee Institute of Medical Sciences & Dr. Ram Manohar Lohia Hospital, New Delhi, India
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10
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Strandgaard T, Nordentoft I, Lamy P, Christensen E, Thomsen MBH, Jensen JB, Dyrskjøt L. Mutational Analysis of Field Cancerization in Bladder Cancer. Bladder Cancer 2020. [DOI: 10.3233/blc-200282] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
BACKGROUND: Morphologically normal tissue, adjacent to tumors, contains multiple molecular changes, the so-called field cancerization. The multifocal and recurrent nature of bladder cancer has been hypothesized to originate from this. However, further studies are required to explore the mutational composition of normal tissue adjacent to tumors. OBJECTIVE: To analyze field cancerization in bladder cancer patients using a non-tumor guided approach. METHODS: We investigated the mutational landscape of normal appearing urothelium and paired bladder tumors from four patients by applying deep-targeted sequencing. RESULTS: Sequencing of 509 cancer driver genes revealed the presence of 2– 13 mutations exclusively localized in normal tissue (average target read depth 634×). Furthermore, 6– 13 mutations were shared between tumor and normal samples and 8– 75 mutations were exclusively detected in tumor samples. More mutations were observed in normal samples from patients with multifocal disease compared to patients with unifocal disease. Mutations in normal samples had lower variant allele fractions (VAF) compared to tumor mutations (p < 2.2*10–16). Furthermore, significant differences in the type of nucleotide changes between tumor, normal and shared mutations (p = 2.2*10–5) were observed, and mutations in APOBEC context were observed primarily among tumor mutations (p = 0.02). No differences in functional impact between normal, shared and tumor mutations were observed (p = 0.61). CONCLUSION: Overall, these findings support the presence of more than one field in the bladder, and document non-tumor specific driver mutations to be present in normal appearing bladder tissue.
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Affiliation(s)
- Trine Strandgaard
- Department of Molecular Medicine, Aarhus University Hospital, Aarhus N, Denmark
- Department of Clinical Medicine, Health, Aarhus University, Aarhus C, Denmark
| | - Iver Nordentoft
- Department of Molecular Medicine, Aarhus University Hospital, Aarhus N, Denmark
| | - Philippe Lamy
- Department of Molecular Medicine, Aarhus University Hospital, Aarhus N, Denmark
| | - Emil Christensen
- Department of Molecular Medicine, Aarhus University Hospital, Aarhus N, Denmark
- Department of Clinical Medicine, Health, Aarhus University, Aarhus C, Denmark
| | | | - Jørgen Bjerggaard Jensen
- Department of Clinical Medicine, Health, Aarhus University, Aarhus C, Denmark
- Department of Urology, Aarhus University Hospital, Aarhus N, Denmark
| | - Lars Dyrskjøt
- Department of Molecular Medicine, Aarhus University Hospital, Aarhus N, Denmark
- Department of Clinical Medicine, Health, Aarhus University, Aarhus C, Denmark
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11
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Kamalov AA, Sorokin NI, Dymov AM, Kislyakov DA, Kamalov DM, Dzitiev VK, Pshihachev AM, Strigunov AA, Afanasyevskaya EV, Tivtikyan AS, Nesterova OY. TECHNICAL ASPECTS OF LASER EN BLOC RESECTION OF THE BLADDER TUMOR FOR NON-MUSCLE-INVASIVE BLADDER CANCER. SURGICAL PRACTICE 2020. [DOI: 10.38181/2223-2427-2020-1-53-58] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Abstract: In recent decades bladder cancer has become one of the most topical problems of modern healthcare due to its widespread distribution. This makes it necessary to investigate new effective methods of surgical treatment.Objective: Assessment of the effectiveness of en bloc resection of the bladder with tumor by analyzing scientific publications on this matter.Materials and methods: We have analyzed current articles related to this topic on the databases Pubmed and Google Scholar. The search was performed using the keywords «Bladder Tumor», «En bloc resection of the bladder wall», «non-muscle-invasive bladder cancer».Results: Most studies confirm the advantages of laser en bloc resection over other methods in terms of such parameters as the frequency of recurrence, macrohematuria, and the quality of morphological material.Conclusions: Laser en bloc resection of a bladder tumor without invasion of the muscle layer is a safe and effective operation that has a number of advantages over classical transurethral resection, namely: no obturator syndrome, high-quality material for pathomorphological research, low recurrence rate.
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Affiliation(s)
| | | | - A. M. Dymov
- Federal State Autonomous Educational Institution of Higher Education I.M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University)
| | - D. A. Kislyakov
- Federal State Autonomous Educational Institution of Higher Education I.M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University)
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12
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Enikeev D, Taratkin M, Margulis V, Sorokin N, Severgina L, Paramonova N, Kislyakov D, Kozlov V, Rapoport L, Shariat SF, Glybochko P. Safety and Short-Term Oncological Outcomes of Thulium Fiber Laser En Bloc Resection of Non-Muscle-Invasive Bladder Cancer: A Prospective Non-Randomized Phase II Trial. Bladder Cancer 2020. [DOI: 10.3233/blc-200275] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND: Ongoing efforts aim at overcoming the challenges of conventional transurethral resection of bladder tumor (TURBT) such as the high recurrence rate, difficulty of pathologic interpretation and complications including wall injury. OBJECTIVE: To prospectively assess the safety and efficacy of Thulium fiber en bloc resection of bladder tumor (Tm-fiber ERBT) compared to TURBT. MATERIALS AND METHODS: The prospective non-randomized study included 129 patients with non-muscle-invasive bladder cancer (NMIBC) divided into two groups: 58 patients underwent conventional TURBT and 71 –Tm-fiber ERBT with FiberLase U1 (NTO IRE-Polus, Russia). Relapse-free survival (RFS), detrusor presence and complication rates were assessed. For multivariable analysis we used the Pearson chi-squared Hosmer-Lemeshow goodness of fit test; to compare survival –Cox regression analysis; for operative data comparison –chi-square test with Fisher’s correction; for survival analysis –the Kaplan–Meier method and logrank test. RESULTS: RFS rates at 3 and 6 months were 84.5% and 67.2% for conventional TURBT versus 97.2% and 91.5% for Tm-fiber ERBT (p = 0.011 and p < 0.001, respectively). Detrusor muscle was present in 58.6% of cases treated with conventional TURBT vs 91.6% for the Tm-fiber ERBT group (p < 0.001). The obturator nerve reflex and bleeding were noted in 17.2% and 10.3% of TURBT cases, respectively; and in none of cases treated with Tm-fiber ERBT. Limitations included the non–randomized nature and the small sample size. CONCLUSIONS: Tm-fiber ERBT seems to be a safe and efficacious treatment option for NMIBC. Tm-fiber ERBT had fewer adverse events, was more likely to secure detrusor muscle in the specimen and resulted in better RFS rates than conventional TURBT. Based on these promising data, we have started a prospective randomized clinical trial comparing en bloc TURBT with conventional TURBT (ClinicalTrials.gov NCT03718754).
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Affiliation(s)
- Dmitry Enikeev
- Institute for Urology and Reproductive Health, Sechenov University, Moscow, Russia
| | - Mark Taratkin
- Institute for Urology and Reproductive Health, Sechenov University, Moscow, Russia
| | - Vitaly Margulis
- Department of Urology, UT Southwestern Medical Center, Dallas, TX, USA
| | - Nikolay Sorokin
- Institute for Urology and Reproductive Health, Sechenov University, Moscow, Russia
| | - Lubov Severgina
- Department of Pathology, Sechenov University, Moscow, Russia
| | - Nina Paramonova
- Centralized Pathology Department, Sechenov University, Moscow, Russia
| | - Dmitry Kislyakov
- Institute for Urology and Reproductive Health, Sechenov University, Moscow, Russia
| | - Vasiliy Kozlov
- Department of Public Health and Healthcare Organization, Sechenov University, Moscow, Russia
| | - Leonid Rapoport
- Institute for Urology and Reproductive Health, Sechenov University, Moscow, Russia
| | - Shahrokh F. Shariat
- Institute for Urology and Reproductive Health, Sechenov University, Moscow, Russia
- Department of Urology, UT Southwestern Medical Center, Dallas, TX, USA
- Department of Urology and Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria
- Weill Medical College of Cornell University, New York, NY, USA
- Department of Urology, Second Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Petr Glybochko
- Institute for Urology and Reproductive Health, Sechenov University, Moscow, Russia
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13
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Evaluation of autofluorescence and photodynamic diagnosis in assessment of bladder lesions. Photodiagnosis Photodyn Ther 2020; 30:101719. [PMID: 32165336 DOI: 10.1016/j.pdpdt.2020.101719] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2019] [Revised: 02/16/2020] [Accepted: 03/06/2020] [Indexed: 12/24/2022]
Abstract
The ability to detect and diagnose bladder cancer early and precisely is crucial for effective treatment. The aim of this study is to assess the utility of optical biopsy performed with autofluorescence cystoscopy (AFC) using the Onco-LIFE system with numerical color values (NCVs) and by ALA/PDD. Histopathological examination of material obtained during TURBT and/or biopsy of the bladder was carried out in 251 patients. In the case of 35 patients, the selection of the specimen collected for histopathological examination was based using ALA/PDD. In the remaining 216 patients, tissue was collected based on the findings of AFC with NCV. Using AFC, the observed NCV ranged from 0 to 3.86; the highest mean NCV was observed in neoplastic muscle invasive lesions and was equal to 3.18. Furthermore, non-muscle invasive tumors were characterized by a mean NCV equal to 1.54. Tissue with inflammation, metaplasia, and healthy tissue demonstrated significantly lower mean NCV values. The presence of a muscle-invasive tumor increased the NCV by approximately 2.86 compared to healthy tissue. The rates of postoperative complications depend on the examining operator and are observed more often, as much as 65.7 % during ALA/PDD. AFC with NCV using the Onco-LIFE system, as well as ALA/PDD are helpful tools for early diagnosis of bladder precancerous and cancer lesions and for performing targeted biopsies. A significant correlation was found between lesion NCV index and the grade of dysplasia or tumor malignancy. Tissue with inflammation, metaplasia, and healthy tissue demonstrated significantly lower mean NCV values. AFE with NCV have a significantly higher sensitivity than specificity. Low rates of postoperative complications are correlated to the experience of the endoscopist and with AFE/NCV in comparison of ALA/PDD.
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14
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Cassell A, Yunusa B, Jalloh M, Mbodji MM, Diallo A, Ndoye M, Diallo Y, Labou I, Niang L, Gueye SM. Non-Muscle Invasive Bladder Cancer: A Review of the Current Trend in Africa. World J Oncol 2019; 10:123-131. [PMID: 31312279 PMCID: PMC6615913 DOI: 10.14740/wjon1210] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2019] [Accepted: 06/21/2019] [Indexed: 01/02/2023] Open
Abstract
Bladder cancer is the fourth most common cancer in men and the 11th most common cancer in woman accounting for 6.6% of all cancer cases. Approximately 70-75% bladder cancers are non-muscle invasive bladder cancer (NMIBC). A few African studies have provided considerable rates of NMIBC as compared to western settings 70% to 85%. Critical step in the management of NMIBC is to prevent tumor recurrence which include transurethral resection of the bladder tumor (TURBT) for staging and histological diagnosis. A second TURBT for high grade tumor, T1 tumors and intravesical adjuvant chemotherapy and immunotherapy are essential to reduce recurrence rate. Nevertheless, variant histology, multiple, progressive and recurrent high-grade tumors are best treated with early radical cystectomy. The African literature is scanty on the management of NMIBC. Most of the histological types are squamous cell bladder cancer and may not conform to transurethral resection only but rather radical cystectomy. Most of these patients are not suitable for any form of treatment as they present with advanced disease. However, there is an increasing incidence of urothelial cancer in Africa over the years due to urbanization. It is best that major investment is made in uro-oncological care to address the growing challenge of these subtypes.
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Affiliation(s)
- Ayun Cassell
- Department of Urology and Andrology, Hopital General de Grand Yoff, Dakar, Senegal
| | - Bashir Yunusa
- Department of Surgery, Liberia College of Physicians and Surgeons, Monrovia, Liberia
| | - Mohamed Jalloh
- Department of Urology and Andrology, Hopital General de Grand Yoff, Dakar, Senegal
| | - Mouhamadou M Mbodji
- Department of Urology and Andrology, Hopital General de Grand Yoff, Dakar, Senegal
| | - Abdourahmane Diallo
- Department of Urology and Andrology, Hopital General de Grand Yoff, Dakar, Senegal
| | - Madina Ndoye
- Department of Urology and Andrology, Hopital General de Grand Yoff, Dakar, Senegal
| | | | - Issa Labou
- Department of Urology and Andrology, Hopital General de Grand Yoff, Dakar, Senegal
| | - Lamine Niang
- Department of Urology and Andrology, Hopital General de Grand Yoff, Dakar, Senegal
| | - Serigne M Gueye
- Department of Urology and Andrology, Hopital General de Grand Yoff, Dakar, Senegal
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15
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Lu BS, Yin YW, Zhang YP, Guo PY, Li W, Liu KL. Upregulation of NPL4 promotes bladder cancer cell proliferation by inhibiting DXO destabilization of cyclin D1 mRNA. Cancer Cell Int 2019; 19:149. [PMID: 31164795 PMCID: PMC6543671 DOI: 10.1186/s12935-019-0874-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2019] [Accepted: 05/27/2019] [Indexed: 12/11/2022] Open
Abstract
Background NPL4 is an important cofactor of the valosin-containing protein (VCP)–NPL4–UFD1 complex. The VCP–NPL4–UFD1 has been considered as a ubiquitin proteasome system (UPS) regulator and response to protein degradation. While NPL4 plays important roles in various diseases, little is known about its functions in bladder cancer (BC). Methods MTT assays and colony forming test were performed to evaluate cell proliferation ability and Western blotting was used to detect protein expression. Cyclin D1 mRNA expression was detected using qRT-PCR, and coimmunoprecipitation (CoIP) was used to detect protein–protein interactions. Results NPL4 was upregulated in BC tissue and correlated with poor prognosis. Upregulation of NPL4 promoted cell proliferation while suppression of NPL4 reduced BC cell proliferation. Upregulation of NPL4 led to overexpression of cyclin D1 by enhancing its mRNA stability. Moreover, NPL4 was found to bind directly to DXO and induce its degradation. DXO was downregulated in BC tissue and regulated BC cell proliferation by destabilizing cyclin D1 mRNA. DXO-mediated NPL4 regulated BC cell proliferation by stabilizing cyclin D1 expression. Conclusions The NPL4/DXO/cyclin D1 axis exert crucial role in BC cell growth and is associated with prognosis and may represent a potential therapeutic target for BC.
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Affiliation(s)
- Bao-Sai Lu
- Department of Urology, The Second Hospital of Hebei Medical University, No. 215, Heping West Road, Shijiazhuang, 050000 Hebei People's Republic of China
| | - Yue-Wei Yin
- Department of Urology, The Second Hospital of Hebei Medical University, No. 215, Heping West Road, Shijiazhuang, 050000 Hebei People's Republic of China
| | - Yan-Ping Zhang
- Department of Urology, The Second Hospital of Hebei Medical University, No. 215, Heping West Road, Shijiazhuang, 050000 Hebei People's Republic of China
| | - Ping-Ying Guo
- Department of Urology, The Second Hospital of Hebei Medical University, No. 215, Heping West Road, Shijiazhuang, 050000 Hebei People's Republic of China
| | - Wei Li
- Department of Urology, The Second Hospital of Hebei Medical University, No. 215, Heping West Road, Shijiazhuang, 050000 Hebei People's Republic of China
| | - Kai-Long Liu
- Department of Urology, The Second Hospital of Hebei Medical University, No. 215, Heping West Road, Shijiazhuang, 050000 Hebei People's Republic of China
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16
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Sharma J, Deb B, George IA, Kapil S, Coral K, Kakkar N, Pattanaik S, Mandal AK, Mavuduru RS, Kumar P. Somatic Mutations Profile of a Young Patient With Metastatic Urothelial Carcinoma Reveals Mutations in Genes Involved in Ion Channels. Front Oncol 2019; 9:435. [PMID: 31192134 PMCID: PMC6549525 DOI: 10.3389/fonc.2019.00435] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2019] [Accepted: 05/07/2019] [Indexed: 11/15/2022] Open
Abstract
Background: Urothelial carcinoma is the most common malignancy of the bladder and is primarily considered as a disease of the elderly. Studies that address bladder tumor occurrence in young age groups are rare. Case Presentation: A 19-year-old male presented with a gross total painless hematuria. A histology after biopsy revealed a high-grade transitional cell carcinoma with lymph node metastasis. The patient succumbed to the disease on day 72 of the treatment. Here, we used whole-exome sequencing of a paired tumor-normal sample to identify the somatic mutations and the possible targets of treatment. Result: We predicted eight potential driver mutations (TP53 p.V157L, RB1 c.1498+1G>T, MED23 p.L1127P, CTNND1 p.S713C, NSD1 p.P2212A, MED17 p.G556V, DPYD p.Q814K, and SPEN p.S1078*). In addition, we predicted deleterious mutations in genes involved in the ion channels (CACNA1S p.E1581K, CACNG1 p.P71T, CACNG8 p.G404W, GRIN2B p.A1096T, KCNC1 p.G16V, KCNH4 p.E874K, KCNK9 p.R131S, P2RX7 p.A296D, and SCN8A p.R558H). Conclusions: Most likely, mutations in genes involved in ion channels may be responsible for the aggressive behavior of a tumor. Ion channels are the second largest class of drug targets, and may thus serve as a putative potential therapeutic target in advanced stage urothelial carcinoma.
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Affiliation(s)
- Jyoti Sharma
- Institute of Bioinformatics, International Technology Park, Bangalore, India.,Manipal Academy of Higher Education (MAHE), Manipal, India
| | - Barnali Deb
- Institute of Bioinformatics, International Technology Park, Bangalore, India.,Manipal Academy of Higher Education (MAHE), Manipal, India
| | - Irene A George
- Institute of Bioinformatics, International Technology Park, Bangalore, India
| | | | | | - Nandita Kakkar
- Department of Histopathology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Smita Pattanaik
- Department of Pharmacology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Arup Kumar Mandal
- Department of Urology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Ravimohan S Mavuduru
- Department of Urology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Prashant Kumar
- Institute of Bioinformatics, International Technology Park, Bangalore, India.,Manipal Academy of Higher Education (MAHE), Manipal, India
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17
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Synergistic effect of phototherapy and chemotherapy on bladder cancer cells. JOURNAL OF PHOTOCHEMISTRY AND PHOTOBIOLOGY B-BIOLOGY 2019; 193:148-154. [PMID: 30884284 DOI: 10.1016/j.jphotobiol.2019.02.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/20/2018] [Revised: 01/21/2019] [Accepted: 02/15/2019] [Indexed: 11/22/2022]
Abstract
Drug resistance as an important barrier to cancer treatment, has a close relation with alteration of cancer metabolism. Therefore, in this study the synergistic effect of phototherapy and chemotherapy were investigated on the bladder cancer cells viability. The cytotoxicity effect of blue light irradiation was measured by the MTT assay. Glucose consumption, lactate and ammonium formation were analyzed in the blue LED-irradiated cancer cells culture. Also, the expression of some genes involved in apoptosis and epithelial-mesenchymal transition was assessed using real-time PCR in comparison with the control group. The analysis of the results indicated that blue light irradiation inhibited the cell viability in a dose-dependent manner. Blue light irradiation decreased the cell viability by 7% and 19% (p < .05) in 5637 cells at doses of 8.7 J/cm2 and 17.5 J/cm2 in comparison with the control group respectively. Glucose consumption, lactate and ammonium formation diminished in the blue LED-irradiated 5637 cells in both doses. The real time PCR results indicated that the expression of Bax increased in blue light-irradiated cells. In addition, the cell cycle analysis showed that blue light irradiation arrested the bladder cancer in the G1 phase. Also, the effect of combination therapy on cancer cells was investigated in presence of blue light irradiation and cisplatin. The obtained results of the MTT assay indicated that blue light irradiation enhance the cytotoxicity effect of cisplatin on bladder cancer cells.
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18
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Huang D, Jin YH, Weng H, Huang Q, Zeng XT, Wang XH. Combination of Intravesical Bacille Calmette-Guérin and Chemotherapy vs. Bacille Calmette-Guérin Alone in Non-muscle Invasive Bladder Cancer: A Meta-Analysis. Front Oncol 2019; 9:121. [PMID: 30881921 PMCID: PMC6405446 DOI: 10.3389/fonc.2019.00121] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2018] [Accepted: 02/11/2019] [Indexed: 12/18/2022] Open
Abstract
Background: About 75% of newly diagnosed bladder cancer cases suffer from non-muscle invasive bladder cancer (NMIBC), which used to recur and progress despite transurethral resection of bladder tumor (TURBT). This meta-analysis was conducted to examine if combined application of intravesical bacille Calmette-Guérin (BCG) with chemotherapy is associated with better prognosis. Methods: Systematic searches of randomized controlled trials (RCTs) concerning NMIBC were performed in PubMed, EMbase, CENTRAL, CNKI, WanFang, VIP, CBM databases, and some specialized websites. Two researchers independently implemented study selection, quality assessment and data extraction. Hazard ratios (HRs) and their 95% confidence intervals (CIs) for treatment effects on recurrence-free survival (RFS), progression-free survival (PFS), overall survival (OS) and disease-specific survival (DSS) were directly extracted, if available, or estimated using relevant data from included studies. Side effects, such as fever, gastrointestinal reaction, cystitis, irritative bladder symptoms and hematuria, were also extracted as outcome measurements, and associated relative risks (RRs) were calculated to assess treatment safety. RevMan 5.3 software was used to perform statistical analyses. Results: Thirteen RCTs containing 1,754 patients with NMIBC were included in this meta-analysis. Compared with BCG alone, the combination therapy significantly improved RFS (HR = 0.53, 95% CI: 0.43-0.66, P < 0.01), OS (HR = 0.66, 95%CI: 0.50-0.86, P = 0.002), and DSS (HR = 0.48, 95%CI: 0.29-0.80, P = 0.005). While PFS showed no obvious difference between combination therapy and BCG alone (HR = 0.65, 95%CI: 0.25-1.68, P = 0.38). The rate of fever (RR = 0.50, 95%CI: 0.27-0.91, P = 0.02), irritative bladder symptoms (RR = 0.69, 95%CI: 0.52-0.90, P = 0.007) and hematuria (RR = 0.50, 95%CI: 0.28-0.89, P = 0.02) were significantly decreased in patients treated with combination therapy compared to those with BCG alone. There were no statistically significant differences between combination therapy and BCG alone in toxicity (RR = 0.69, 95%CI: 0.34-1.40, P = 0.30), gastrointestinal reaction (RR = 2.54, 95%CI: 0.61-10.60, P = 0.20) or cystitis (RR = 0.67, 95%CI: 0.29-1.54, P = 0.34). Conclusions: Combined application of intravesical BCG and chemotherapy appears to be an effective treatment for patients with intermediate- to high-risk NMIBC, but not for those with tumor in situ alone or recurrent bladder cancer.
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Affiliation(s)
- Di Huang
- Center for Evidence-Based and Translational Medicine, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Ying-Hui Jin
- Center for Evidence-Based and Translational Medicine, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Hong Weng
- Center for Evidence-Based and Translational Medicine, Zhongnan Hospital of Wuhan University, Wuhan, China.,Department of Urology, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Qiao Huang
- Center for Evidence-Based and Translational Medicine, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Xian-Tao Zeng
- Center for Evidence-Based and Translational Medicine, Zhongnan Hospital of Wuhan University, Wuhan, China.,Department of Urology, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Xing-Huan Wang
- Center for Evidence-Based and Translational Medicine, Zhongnan Hospital of Wuhan University, Wuhan, China.,Department of Urology, Zhongnan Hospital of Wuhan University, Wuhan, China
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19
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Teke K, Yilmaz H, Uslubas AK, Akpinar G, Kasap M, Mutlu O, Yildiz DK, Guzel N, Dillioglugil O. Histopathologic and molecular comparative analyses of intravesical Aurora kinase-A inhibitor Alisertib with bacillus Calmette-Guérin on precancerous lesions of bladder in a rat model. Int Urol Nephrol 2018; 50:1417-1425. [PMID: 29931492 DOI: 10.1007/s11255-018-1914-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2018] [Accepted: 06/13/2018] [Indexed: 11/24/2022]
Abstract
PURPOSE Recent studies have shown that Aurora-A expression is associated with bladder cancer initiation and progression. In this study, the effects of intravesical Aurora-A inhibitor Alisertib (ALS) and bacillus Calmette-Guérin (BCG) were compared on bladder carcinogenesis. METHODS Two mg N-Methyl-N-nitrosourea was administered intravesically to forty of Wistar-albino rats every other week for 8 weeks. At week 10, rats were divided into four groups (10/group): No-treatment (vehicle), ALS-alone, BCG-alone, and ALS + BCG. The intravesical treatment of ALS, BCG, and ALS plus BCG was performed once a week for 6 weeks. At week 16, bladders were collected for immunohistopathological and Western blot analysis. The cell cycle regulators p53, p21, Aurora-A, phosphorylated Aurora-A (p-Aurora-A), and apoptotic marker cleavage of poly [ADP-ribose] polymerase (c-PARP) were determined by Western blot. RESULTS Histopathologically relatively healthy urothelium was observed in ALS + BCG group (87.5%) compared to the ALS-alone (50%) and the BCG-alone (50%) groups. The lowest expression of p21 and p53 was detected in the BCG-alone, while the highest level of expression was evident in no-treatment group. The ALS treatment alone caused a slight decrease in Aurora-A while there was a dramatic decrease in p-Aurora-A in comparison to no-treatment group. In overall combined treatment with ALS + BCG significantly increased c-PARP compared to all mono-treatments, and decreased all cell cycle parameters compared to no-treatment group. CONCLUSIONS Although intravesical ALS treatment has similar antiproliferative effects like BCG, ALS + BCG combined treatment led to a best histopathologic and apoptotic response. Consequently, BCG combined with Aurora-A inhibition may provide a new intravesical treatment modality in the prevention of bladder carcinogenesis.
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Affiliation(s)
- Kerem Teke
- Department of Urology, Kocaeli University School of Medicine, 41380, Kocaeli, Turkey.
| | - Hasan Yilmaz
- Department of Urology, Kocaeli University School of Medicine, 41380, Kocaeli, Turkey
| | - Ali Kemal Uslubas
- Department of Urology, Kocaeli University School of Medicine, 41380, Kocaeli, Turkey
| | - Gurler Akpinar
- Department of Medical Biology, Kocaeli University School of Medicine, Kocaeli, Turkey
| | - Murat Kasap
- Department of Medical Biology, Kocaeli University School of Medicine, Kocaeli, Turkey
| | - Oguz Mutlu
- Department of Pharmacology, Kocaeli University School of Medicine, Kocaeli, Turkey
| | - Demir Kursat Yildiz
- Department of Pathology, Kocaeli University School of Medicine, Kocaeli, Turkey
| | - Nil Guzel
- Department of Medical Biology, Kocaeli University School of Medicine, Kocaeli, Turkey
| | - Ozdal Dillioglugil
- Department of Urology, Kocaeli University School of Medicine, 41380, Kocaeli, Turkey
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20
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Novel in-situ gel for intravesical administration of ketorolac. Saudi Pharm J 2018; 26:845-851. [PMID: 30202226 PMCID: PMC6128712 DOI: 10.1016/j.jsps.2018.03.014] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2017] [Accepted: 03/25/2018] [Indexed: 11/22/2022] Open
Abstract
The urinary bladder stores urine until the time of urination. Systemic administration of drugs to treat bladder diseases faces several limitations. Therefore, intravesical drug delivery is a promising alternative route of administration. An in-situ gel is used to form a gel inside the bladder cavity and ensure continuous release of the drug even after urination. The objective of the present study was to optimize an in-situ gel formulation of poloxamer and chitosan for intravesical delivery of ketorolac tromethamine. The gelling temperature of the prepared combinations ranged from 20.67 to 25.8 °C. In-vitro release of KT was sustained for up to 7 h using a poloxamer concentration ranging from 17% to 19% and a chitosan concentration ranging from 1% to 2%. Design-Expert® 10 was used to select the optimized formulation (poloxamer/chitosan 17/1.589% w/w) which significantly (p < 0.05) extended the drug release more than each polymer alone. An ex-vivo study showed the ability of the optimized formulation to sustain drug release after emptying two times to mimic urination. Furthermore, the formed gel adhered to the bladder tissue throughout the time period of the experiment. Intravesical administration of the optimized formulation to rabbits via catheter showed no obstruction of urine flow and continuous release of the drug for 12 h.
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21
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Urinary Bladder Cancer in Egypt: Are There Gender Differences in Its Histopathological Presentation? Adv Urol 2018; 2018:3453808. [PMID: 29725350 PMCID: PMC5872673 DOI: 10.1155/2018/3453808] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2017] [Revised: 01/22/2018] [Accepted: 02/04/2018] [Indexed: 11/17/2022] Open
Abstract
We investigated gender differences in the histopathologic presentation of bladder cancer cases in Egypt, where both urothelial cell carcinoma (UC) and squamous cell carcinoma (SCC) types are highly prevalent. We used logistic regression to estimate the unadjusted (OR) and adjusted odds ratio (AOR) and 95% confidence interval (CI) of the associations between gender and different histopathologic and sociodemographic parameters of 2,186 confirmed cases of primary bladder cancer (1,775 males and 411 females; 784 SCC and 1,402 UC). There were no statistically significant gender differences in tumor grade, stage, mucosal ulcer, or inflammatory cystitis, regardless of the cancer type, but men were less likely than women to have undergone cystectomy with pelvic lymphadenectomy. Having Schistosoma haematobium (SH) ova in the bladder tissue was significantly associated with male gender in the fully adjusted model of either SCC (AOR (95% CI) = 2.12 (1.15-3.89)) or UC cases (3.78 (1.89-7.55)). Compared to females, male cases were significantly older at time of diagnosis and smokers. In Egypt, regardless of the type of bladder cancer (SCC or UC), male more than female cases had evidence of SH infection, but not other histopathologic differences, in bladder tissue specimens.
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22
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Yang X, Shi Y, Yan J, Fan H. Downregulation of FoxM1 inhibits cell growth and migration and invasion in bladder cancer cells. Am J Transl Res 2018; 10:629-638. [PMID: 29511457 PMCID: PMC5835828] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2017] [Accepted: 12/24/2017] [Indexed: 06/08/2023]
Abstract
The FoxM1 (Forkhead Box M1) transcription factor plays a key role in regulation of cell growth, cell cycle, and transformation. Higher expression of FoxM1 has been observed in various types of human cancers including bladder cancer. However, the exact function of FoxM1 in bladder cancer has not been elucidated. To investigate the cellular and molecular function of FoxM1 in bladder cancer, we measured the consequences of downregulation and upregulation of FoxM1 in bladder cancer cells using MTT assay, wound healing assay, and invasion assay. We found that downregulation of FoxM1 inhibited cell growth, but induced apoptosis in bladder cancer cells. Moreover, we found that inhibition of FoxM1 retarded cell migration and invasion. In line with this, upregulation of FoxM1 led to cell growth promotion and inhibited cell apoptosis in bladder cancer cells. Consistently, upregulation of FoxM1 led to increased cell migration and invasion. Our Western blotting results identified that downregulation of FoxM1 increased p27 level and inhibited VEGF, while overexpression of FoxM1 reduced p27 level and increased VEGF. Our findings suggest that FoxM1 could be a useful target for the treatment of bladder cancer.
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Affiliation(s)
- Xinping Yang
- Department of Urological Surgery, The Jilin Province Tumor HospitalChangchun 130012, Jilin, China
| | - Yuanyuan Shi
- Department of Nursing, The Second Hospital, Jilin UniversityChangchun 130041, Jilin, China
| | - Jingzhe Yan
- Department of Abdominal Oncosurgery, Jilin Province Cancer HospitalChangchun 130012, Jilin, China
| | - Haitao Fan
- Department of Urological Surgery, The Second Hospital, Jilin UniversityChangchun 130041, Jilin, China
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Wen W, Li J, Wang L, Xing Y, Li X, Ruan H, Xi X, Xiong J, Kuang R. Inhibition of NEDD4 inhibits cell growth and invasion and induces cell apoptosis in bladder cancer cells. Cell Cycle 2017; 16:1509-1514. [PMID: 28745938 DOI: 10.1080/15384101.2017.1338220] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Abstract
The neural precursor cell expressed developmentally downregulated protein 4 (NEDD4) plays a pivotal oncogenic role in various types of human cancers. However, the function of NEDD4 in bladder cancer has not been fully investigated. In the present study, we aim to explore whether NEDD4 governs cell proliferation, apoptosis, migration, and invasion in bladder cancer cells. Our results showed that downregulation of NEDD4 suppressed cell proliferation in bladder cancer cells. Moreover, we found that inhibition of NEDD4 significantly induced cell apoptosis. Furthermore, downregulation of NEDD4 retarded cell migration and invasion. Notably, overexpression of NEDD4 enhanced cell growth and inhibited apoptosis. Consistently, upregulation of NEDD4 promoted cell migration and invasion in bladder cancer cells. Mechanically, our Western blotting results revealed that downregulation of NEDD4 activated PTEN and inhibited Notch-1 expression, whereas upregulation of NEDD4 reduced PTEN level and increased Notch-1 level in bladder cancer cells. Our findings indicated that NEDD4 exerts its oncogenic function partly due to regulation of PTEN and Notch-1 in bladder cancer cells. These results further revealed that targeting NEDD4 could be a useful approach for the treatment of bladder cancer.
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Affiliation(s)
- Wu Wen
- a The Second Affiliated Hospital of Nanchang University , Jiangxi , China
| | - Jingying Li
- a The Second Affiliated Hospital of Nanchang University , Jiangxi , China
| | - Longwang Wang
- a The Second Affiliated Hospital of Nanchang University , Jiangxi , China
| | - Yifei Xing
- b The Union Hospital of Wuhan , Hubei , China
| | - Xuechao Li
- b The Union Hospital of Wuhan , Hubei , China
| | | | - Xiaoqing Xi
- a The Second Affiliated Hospital of Nanchang University , Jiangxi , China
| | - Jianhua Xiong
- a The Second Affiliated Hospital of Nanchang University , Jiangxi , China
| | - Renrui Kuang
- a The Second Affiliated Hospital of Nanchang University , Jiangxi , China
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