Bladder Cancer

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Among the most exciting new anticancer products presented at the 2001 ASCO meeting were new drugs that block the epidermal growth factor receptor (EGFR). About 30% to 90% of carcinomas express high levels of EGFR. These include, among others, head and neck cancer, lung cancer, pancreatic cancer, colon cancer, breast cancer, ovarian cancer, and bladder cancer.

Fenretinide (N-4-hydroxyphenyl-retinamide, or 4-HPR) is a semisynthetic retinoid that was initially developed as a low-dose chemopreventative agent.[1-3] Unlike other naturally occurring retinoids such as all-trans, 13-cis, and 9-cis retinoic acids, fenretinide does not induce systemic catabolism that interferes with the maintenance of effective plasma levels during long-term use. This characteristic, combined with the agent’s low toxicity and its ability to block aspects of carcinogenesis, provided the rationale for the development of fenretinide in lower doses as a chemoprevention agent for breast, prostate, and bladder cancer.

ANAHEIM, California-A phase III Intergroup trial has provided strong evidence that neoadjuvant MVAC-methotrexate, vinblastine, doxorubicin (Adriamycin), cisplatin (Platinol)-provides a survival benefit in patients with locally advanced bladder cancer, David Crawford, MD, said at the American Urological Association (AUA) annual meeting (abstract 1069).

ANAHEIM, California-In patients with superficial bladder cancer, it is possible to optimize treatment with mitomycin (Mutamycin) by enhancing the drug concentration in urine, according to the results of a multicenter study presented at the American Urological Association annual meeting (abstract 776).

BOSTON-A combination of transurethral resection (TUR) and radiochemotherapy with cisplatin (Platinol) and fluorouracil (5-FU) produced the most promising results in a German study of bladder-sparing protocols for patients with invasive bladder cancer.

CARPINTERIA, Calif-A newly available fluorescent-based immunocytologic test to detect superficial bladder cancer, ImmunoCyt, used in conjunction with urinary cytology, will likely reduce the need for periodic cystoscopies in patients with transitional cell bladder cancer and enhance the early detection of recurrent disease.

Researchers who conducted a large, randomized clinical trial across Europe, Great Britain, and Canada found that in order to improve safety and reduce toxicity, advanced bladder cancer patients can be treated with a combination of gemcitabine (Gemzar) and cisplatin (Platinol). This combination (known as GC) did not extend survival, but it was much less toxic than the currently used combination, MVAC (methotrexate, vinblastine, doxorubicin [Adriamycin], and cisplatin).