Search PubMed⌕ Search
Home/Archive/PubMed

PubMed · 10575270

Modified induction course: a solution to side-effects?

P Bassi·R Spinadin·R Carando·G Balta·F Pagano
View original source ↗Export metadata ↓

Abstract

Side-effects are commonly manifested during intravesical Bacillus Calmette-Guérin (BCG) immunotherapy of superficial bladder cancer. This often causes delays or interruptions of the instillations and consequently reduces the efficacy of treatment. Treatment strategies aimed at reducing the side-effects of BCG immunotherapy while maintaining efficacy are currently being considered in the search for an optimal treatment regimen. The following two approaches to BCG immunotherapy were investigated at the Department of Urology of Padova University by specific Phase II and III trials designed to evaluate the possibility of reducing BCG-related side-effects without compromising therapeutic efficacy: (1) by reducing the dose of BCG per instillation 'low-dose' regimen, (2) by delaying the interval of the instillations 'slow-rate' regimen.

Explore related subjects

Administration, IntravesicalBCG VaccineDisease ProgressionDisease-Free SurvivalHumansNeoplasm Recurrence, LocalSurvival RateTime FactorsUrinary Bladder DiseasesUrinary Bladder NeoplasmsClinical TrialClinical Trial, Phase IIIJournal ArticleRandomized Controlled Trial

Keep this discovery

Explore connections, maps & timelines

BibTeXRIS

P Bassi, R Spinadin, R Carando, G Balta, F Pagano. 2000. Modified induction course: a solution to side-effects?. https://doi.org/10.1159/000052380

Cite the original work for its findings. Save a collection to share your selection of sources.

KEEP EXPLORING

Related citations

PubMed2002

Clinical aspects of drug delivery to tumors.

This report describes our experience on enhancement of drug delivery to solid tumors. Results of our preclinical and clinical studies including a randomized prospective phase III trial have validated the concept that enhanced drug delivery can significantly improve the treatment efficacy of intravesical mitomycin C therapy of superficial bladder cancer. The report further describes the roles of interstitial space, drug removal by capillaries, tissue structure and tissue composition on drug distribution. In general, drug distribution favors interstitial space and vasculature, with little penetration in muscles. The transport of highly protein-bound drugs such as paclitaxel and doxorubicin in a solid tumor is retarded by a high tumor cell density and enhanced by drug-induced apoptosis. Results of in vitro studies using solid tumor histocultures and in vivo studies using tumor-bearing animals demonstrate that the delivery of highly protein-bound drugs to tumor can be enhanced using a pretreatment that induces apoptosis and reduces cell density, and by using treatment schedules designed to take advantage of these drug-induced changes in tumor tissue composition.

Administration, Intravesical↗
PubMed2002

[Treatment of bladder tumors].

The bladder tumour treatment closely depends on initial diagnosis. For superficial bladder tumour a conservative treatment is required using endoscopic resection. Adjuvant instillations (BCG or mitomycine C) can be proposed for high grade tumour. In case of muscular layer invasion or in case of frequent non controlled recurrence, cystectomy is necessary. Progress in anaesthesia, surgery and postoperative care permitted to enteroplasty to be much less morbid, it must be considered as the urinary diversion of choice. To prevent recurrence, both (superficial or infiltrating) tumour require very strict follow-up for many years.

Administration, Intravesical↗
PubMed2002

Intravesical instillation of bacille Calmette-Guérin for carcinoma in situ of the urothelium involving the upper urinary tract using vesicoureteral reflux created by a double-pigtail catheter.

OBJECTIVES: To evaluate the therapeutic efficacy of bacille Calmette-Guérin (BCG) for carcinoma in situ (CIS) of the urothelium involving the upper urinary tract when the vaccine was administered by way of the bladder using vesicoureteral reflux created by a double-pigtail (DP) catheter. METHODS: Thirteen upper urinary tracts of 9 patients with cytologically diagnosed CIS, with concomitant bladder CIS in 4, were treated by intravesical BCG instillation. A DP catheter was placed retrogradely, and the appearance of vesicoureteral reflux was confirmed by cystography. BCG (1 to 2 mg/mL) in a volume sufficient to fill the renal caliceal system was administered into the bladder weekly for 6 weeks. The mean follow-up was 36 months (range 8 to 97). RESULTS: The voided urine cytology turned negative in all 9 patients at a mean of 86 days after the first administration of BCG. The voided urine cytology returned positive afterward in 3 patients, and positive cytology in the upper urinary tract was confirmed in 1 of 13 treated urinary tracts, which were successfully treated by another course of BCG therapy with the DP catheter. Minor adverse effects related to BCG and the DP catheter were seen in 5 patients. CONCLUSIONS: BCG therapy for the CIS involving the upper urinary tract using a DP catheter might have the potential to be an effective procedure preserving renal units and could be adopted not only as an imperative, but also as an elective, treatment option.

Administration, Intravesical↗