Chemoablative gel preferrable over surgery in adults with nonmuscle-invasive bladder cancer

UGN-102, a nonsurgical, chemoablative gel used as a primary treatment for nonmuscle-invasive bladder cancer (NMIBC), is more patient-centred than standard treatments, according to a recent study.

Sixty-three patients enrolled in the OPTIMA II* from 20 sites participated in this study, of which 44 were in the cohort completing a quarterly patient-reported outcome measure assessing side effects. The authors used the Wilcoxon signed-rank test to assess changes in side effects. They examined the associations of 3-month outcomes with demographic and clinical characteristics using regression and controlling for baseline values.

Of the 44 patients, 10 (23 percent) were interviewed after the trial to evaluate tolerability for future patients making treatment decisions. Standard methods were used to double-code transcripts.

Majority of those in the patient-reported outcome measure cohort were men (61 percent), at least 65 years of age (57 percent), and non-Hispanic White (89 percent).

UGN-102 did not result in any decline in patient-reported urinary symptoms, bloating/flatulence, or malaise at the primary endpoint of 3 months. Sexual function slightly worsened, but future health worries improved. Demographics were not associated with changes.

Sexual function showed an association with new NMIBC, while bloating/flatulence correlated with transurethral resection of bladder tumour within 12 months.

Analysis of interviews revealed that patients were appreciative of a nonsurgical option, would recommend the gel to other patients, and would choose the gel rather than surgery.

Optima II was a phase IIb trial evaluating a nonsurgical alternative as a primary treatment for NMIBC. Patients received 6 weekly instillations of UGN-102, a reverse thermal gel containing mitomycin.

*OPTimized Instillation of Mitomycin for Bladder Cancer Treatment