Researchers from Columbia University have reported that induction and maintenance therapy with intravesical Taxotere® (docetaxel) is well tolerated and effective for treatment of patients with non-muscle-invasive bladder cancer who are refractory to Bacilli Calmette-Guerin (BCG) therapy. The details of this study were reported in the October 2009 issue of British Journal of Urology International.[1]

Bladder cancer is a common cancer; approximately 55,000 new cases are diagnosed in the United States each year. Superficial bladder cancer refers to cancer that remains localized within the outermost layers of the bladder and has not spread to deeper layers. Patients with superficial bladder cancer are routinely treated with surgical removal of the cancer and adjuvant therapy in order to decrease the risk of cancer recurrence or progression to more invasive disease.

Despite standard treatment, many patients with superficial bladder cancer experience a recurrence of their cancer. Following the removal of the cancer, patients with superficial bladder cancer are usually treated with adjuvant intravesical therapy with mitomycin C or Bacille Calmette-Guérin (BCG).  While this therapy is beneficial, recurrences are common; more than 50% of patients have recurrent disease. Researchers are evaluating ways to enhance the effectiveness of intravesical therapy to reduce the risk of recurrences in patients with superficial bladder cancer and ultimately preserve the bladder. Patients who recur after BCG are often treated with Mutamycin® (mitomycin C), although a recent study suggests that Gemzar® (gemcitabine) is more effective. Researchers involved in the current study have previously reported that six weekly bladder instillations of Taxotere was an effective treatment option for patients with superficial bladder cancer that recurred following standard therapies.

In the current study, these same investigators evaluated the effects of monthly maintenance treatment with intravesical Taxotere following six weekly cycles of induction therapy. This study included 13 patients who were treated with six weekly intravesical instillations of 75 mg of Taxotere followed by nine single-dose monthly maintenance treatments. The median follow-up of this study was 13 months. Ten of 13 patients had a complete response, and six remained free of disease. Only one patient in this study has had a cystectomy.

Comments: These data would suggest that the addition of monthly maintenance after Taxotere induction therapy was more effective than stopping therapy after six weekly treatments.

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