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The following is a summary of “Sequential intravesical gemcitabine and docetaxel for treatment-naïve and previously treated intermediate-risk nonmuscle invasive bladder cancer,” published in the December 2023  issue of Urology by McElree,  et al.

People who have nonmuscle invasive bladder cancer (NMIBC) with a moderate risk should get adjuvant intravenous treatment. Intravesical gemcitabine-docetaxel (Gem/Doce) is effective for high-risk NMIBC, but its use in intermediate-risk cases is poorly understood. 

For a study, researchers sought to discuss how Gem/Doce worked as an adjuvant treatment for NMIBC with a moderate risk.

Based on AUA criteria, they looked back at patients with intermediate-risk NMIBC who were treated with Gem/Doce after TURBT between 2012 and 2022. For 6 weeks, patients were given 1 g of gemcitabine and 37.5 mg of docetaxel intravenously, one week after the other. If the person was disease-free at the start of monitoring, they were put on monthly upkeep for two years. The main result was recurrence-free survival (RFS), measured with the Kaplan-Meier method. The group had 77 patients, and the average time between follow-up visits was 26 months (IQR 14–50 months). Before the induction, 67 (87%) of the patients had Ta low-grade (LG) lesions, 3 (3.9%) had Ta high-grade (HG) lesions, 5 (6.5%) had TaLG plus local TaHG, and 2 (2.6%) had T1LG. 33 patients (43% of the total) had past intravenous treatment, which included BCG (23), mitomycin (13), and docetaxel alone (12). 

The RFS at 2 years was 71% for all cases. Treatment-naïve patients had a better RFS than previously treated patients (P = 0.04); estimates for 2 years were 79% for treatment-naïve patients and 64% for previously treated patients. Twenty-nine patients, or 38%, had bad events; all but one (1.3%) had Grade 3 events (acute oxygen desaturation). Three patients (3.9%) could not handle the full induction treatment. This study looked at a group of patients with intermediate-risk NMIBC and found that Gem/Doce was a useful and well-tolerated supplemental treatment. More research needs to be done in this setting in the future.

Source: sciencedirect.com/science/article/abs/pii/S1078143923002284