Faculty Collaboration Database

Continuous infusion, intravesical doxorubicin for the treatment of regionally advanced bladder cancer: a phase I-II trial. Am J Clin Oncol 1997 Aug;20(4):331-7

Date

08/01/1997

Pubmed ID

9256884

DOI

10.1097/00000421-199708000-00002

Scopus ID

2-s2.0-0030872570 (requires institutional sign-in at Scopus site)   4 Citations

Abstract

Patients with regionally advanced bladder cancer not considered candidates for definitive surgical intervention underwent continuous antegrade infusion of doxorubicin by percutaneous nephrostomy tube. Doxorubicin was administered for 7 consecutive days at a rate designed to achieve target urinary concentrations (range 5-80 micrograms/ml). Urine and serum concentrations of doxorubicin were monitored daily. Toxicity was assessed by serial renal scans, antegrade nephrostograms, blood counts, and serum chemistries. Patients were restaged after three cycles of therapy. In all, 23 cycles, constituting 156 days of therapy, were administered to 10 patients. Target urinary drug levels were achieved during all cycles. Total doxorubicin dose ranged from 125 to 2,500 mg. No systemic (neutropenia or myocardial dysfunction) or regional toxicity (extravasation, sepsis, stricture) was noted. Five of 10 patients tolerated the planned three treatment cycles. Poor performance status (PS, Eastern Cooperative Oncology Group: ECOG 3) strongly correlated with treatment intolerance and early death from disease. After three cycles of therapy, 2 of 5 evaluable patients had stable disease, I had radiographic partial response (PR) with a biopsy demonstrating extensive tumor necrosis, I had no identifiable tumor at the time of restaging transurethral resection of bladder tumor (TURBT), and a final patient with upper and lower tract carcinoma in situ (CIS) was cytologically staged NED. (no evidence of disease). These findings demonstrate the feasibility and low toxicity of this approach.

Author List

See WA, Dreicer R, Forest PK, Riggs C

MESH terms used to index this publication - Major topics in bold

Administration, Intravesical
Aged
Antibiotics, Antineoplastic
Biopsy
Carcinoma in Situ
Cause of Death
Doxorubicin
Drug Monitoring
Feasibility Studies
Female
Humans
Injections
Intubation
Male
Necrosis
Neoplasm Staging
Nephrostomy, Percutaneous
Remission Induction
Safety
Urinary Bladder Neoplasms