MP83-09 CHEMOHYPERTHERMIA WITH MITOMYCIN C AND COMBAT SYSTEM A NEW ALTERNATIVE TO BCB IN HIGH RISK NON MUSCLE INVASIVE BLADDER CANCER?

You have accessJournal of UrologyBladder Cancer: Non-invasive II1 Apr 2018MP83-09 CHEMOHYPERTHERMIA WITH MITOMYCIN C AND COMBAT SYSTEM A NEW ALTERNATIVE TO BCB IN HIGH RISK NON MUSCLE INVASIVE BLADDER CANCER? Ana Plata Bello, Felipe Villacampa, Javier Diaz Goizueta, Emilio Rios, Peter Rimington, Jose Castillo, Jose Luis Pontones, Cajetan Nzeh, Antonin Brisuda, Juan Leon, Francesco Chiancone, Kees Hendricksen, Thomas-Alexander Vögeli, Daniel Wilby, Daniel González-Padilla, Carlos García Alvarez, Luis Llanes, Alejandro Sousa, Eric Frank, D.J Castillo, and Paolo Fedelini Ana Plata BelloAna Plata Bello More articles by this author , Felipe VillacampaFelipe Villacampa More articles by this author , Javier Diaz GoizuetaJavier Diaz Goizueta More articles by this author , Emilio RiosEmilio Rios More articles by this author , Peter RimingtonPeter Rimington More articles by this author , Jose CastilloJose Castillo More articles by this author , Jose Luis PontonesJose Luis Pontones More articles by this author , Cajetan NzehCajetan Nzeh More articles by this author , Antonin BrisudaAntonin Brisuda More articles by this author , Juan LeonJuan Leon More articles by this author , Francesco ChianconeFrancesco Chiancone More articles by this author , Kees HendricksenKees Hendricksen More articles by this author , Thomas-Alexander VögeliThomas-Alexander Vögeli More articles by this author , Daniel WilbyDaniel Wilby More articles by this author , Daniel González-PadillaDaniel González-Padilla More articles by this author , Carlos García AlvarezCarlos García Alvarez More articles by this author , Luis LlanesLuis Llanes More articles by this author , Alejandro SousaAlejandro Sousa More articles by this author , Eric FrankEric Frank More articles by this author , D.J CastilloD.J Castillo More articles by this author , and Paolo FedeliniPaolo Fedelini More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2018.02.2757AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Maintenance intravesical BCG therapy is the gold standard treatment for high risk non-muscle invasive bladder cancer (HR NMIBC). However, adverse effects and recent problems with BCG supply and production has led to a lack of treatment in these patients. The objective is to analize the effectiveness of MMC and chemohyperthermia (CHT) with COMBAT HIVEC™ treatment in HR NMIBC METHODS Multicentre European retrospective analysis of 145 patients with HR NMIBC treated by 14 centres across Europe between December 2014 to October 2017. High risk disease was defined according to EAU risk classification. After transurethral resection of bladder tumour (TURBT), all patients were treated with adjuvant intravesical instillations of 40mg MMC at 43°C, for 60 minutes using COMBAT HIVEC™ device. All cases received CHT instead of BCG because BCG was unavailable, or they had intolerance to BCG due to adverse events. Approval of local ethics committee was obtained in all cases. Treatment protocols differs between although majority received 6 weekly instillations of induction with a variable maintenance regime. ReTURBT prior to instillation was at the discretion of the clinician and local institutional recommendation. Patients had follow up with cystoscopy every 3 months. RESULTS 145 patients were treated with the COMBAT system with a median follow up of 20.8 months. The mean age of patients was 70.6 years. 65% of NMIBC were primary tumours with 65% pT1 and 66% G3. 46% of patients had multiple tumours and 36% were =3cm. 116 patients (80%) received a minimum of 6 weekly instillations as part of induction therapy. 79 patients (55%) received some form of maintenance therapy. In the Intention to Treat analysis (145 patients), mean follow up 21 months, recurrence free rate(RFR) was 82% (27 patients) and progression free rate (PFR) to T2 was 98% (3 patients). In the Per Protocol analysis (at least 6 instillations, 116 patients), mean follow up was 22 months, RFR was 83% (20 patients) and PFR to T2 1 was 93% (2 patients). RFR at one year follow up was 87.3%. CONCLUSIONS CHT with 6 weekly induction 40 mg MMC using the COMBAT system represents an attractive alternative to intravesical BCG therapy. RFR and PFR at 12 months are comparable to EORTC nomograms. Randomised controlled trials are needed to define the true role of CHT in HR NMIBC. © 2018FiguresReferencesRelatedDetails Volume 199Issue 4SApril 2018Page: e1119 Advertisement Copyright & Permissions© 2018MetricsAuthor Information Ana Plata Bello More articles by this author Felipe Villacampa More articles by this author Javier Diaz Goizueta More articles by this author Emilio Rios More articles by this author Peter Rimington More articles by this author Jose Castillo More articles by this author Jose Luis Pontones More articles by this author Cajetan Nzeh More articles by this author Antonin Brisuda More articles by this author Juan Leon More articles by this author Francesco Chiancone More articles by this author Kees Hendricksen More articles by this author Thomas-Alexander Vögeli More articles by this author Daniel Wilby More articles by this author Daniel González-Padilla More articles by this author Carlos García Alvarez More articles by this author Luis Llanes More articles by this author Alejandro Sousa More articles by this author Eric Frank More articles by this author D.J Castillo More articles by this author Paolo Fedelini More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...