The novel use of intravesical docetaxel for the treatment of non-muscle invasive bladder cancer refractory to BCG therapy: a single institution experience

• Published in: World journal of urology 2009-06, Vol.27 (3), p.331-335
• Main Authors: Barlow, LaMont J., McKiernan, James M., Benson, Mitchell C.
• Format: Article
• Language: English
• Subjects: Administration, Intravesical; Adult; Aged; Aged, 80 and over; Antineoplastic Agents - administration & dosage; BCG Vaccine - therapeutic use; Bladder cancer; Female; Humans; Male; Medicine; Medicine & Public Health; Middle Aged; Neoplasm Invasiveness; Nephrology; Oncology; Retrospective Studies; Taxoids - administration & dosage; Topic Paper; Treatment Failure; Urinary Bladder Neoplasms - drug therapy; Urinary Bladder Neoplasms - pathology; Urology
• ISSN: 0724-4983; 1433-8726
• DOI: 10.1007/s00345-009-0377-1

Objectives Since the success of our Phase I trial of intravesical docetaxel for treatment-refractory non-muscle invasive bladder cancer (NMIBC), we have found this agent to be a favorable alternative for BCG-refractory patients unable or unwilling to undergo cystectomy. This study analyzes the safety and efficacy of intravesical docetaxel in a larger patient population with extended follow-up. Methods A retrospective analysis of all patients who received salvage intravesical docetaxel at our institution was conducted, including 18 patients treated during the Phase I trial and 15 patients treated after the trial’s completion. Toxicity, efficacy and recurrence-free survival were analyzed. Results Thirty-three patients with refractory NMIBC received salvage intravesical docetaxel therapy between 2003 and 2008 at a single institution. Twenty of thirty-three (61%) patients had a complete response (CR) after six weekly induction treatments. Ten patients with CRs were given maintenance docetaxel therapy, and one patient received maintenance BCG and interferon. With a median follow-up of 29 months, 1 and 2-year recurrence-free survival rates were and 45 and 32%, respectively. Twelve of thirty-three patients (36%) had Grade 1 or 2 local toxicities. No patients experienced Grade 3 or 4 toxicities. Conclusions Docetaxel is a promising intravesical agent with minimal toxicity and significant efficacy and durability for the management of BCG-refractory NMIBC.