Pd48-12 Patient-Reported Toxicity During Intravesical Therapy for Non-Muscle Invasive Bladder Cancer

You have accessJournal of UrologyBladder Cancer: Non-invasive III (PD48)1 May 2024PD48-12 PATIENT-REPORTED TOXICITY DURING INTRAVESICAL THERAPY FOR NON-MUSCLE INVASIVE BLADDER CANCER Matthew B. Clements, Nicole Liso, Benjamin Seiden, Timothy Donahue, Alvin Goh, Bernard H. Bochner, and Eugene Pietzak Matthew B. ClementsMatthew B. Clements , Nicole LisoNicole Liso , Benjamin SeidenBenjamin Seiden , Timothy DonahueTimothy Donahue , Alvin GohAlvin Goh , Bernard H. BochnerBernard H. Bochner , and Eugene PietzakEugene Pietzak View All Author Informationhttps://doi.org/10.1097/01.JU.0001008712.53259.7d.12AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Intravesical therapy is the gold standard for intermediate or high risk non-muscle invasive bladder cancer. The most-studied therapy is Bacillus Calmette-Guerin (BCG), however despite more than 40 years of use, the patient-reported toxicity is not clearly defined. Additionally, other intravesical therapies are in widespread clinical use, but have not been compared to the gold standard, BCG. Our objective was to use a validated measure to compare longitudinal toxicity throughout intravesical therapy. METHODS: Patients treated at Memorial Sloan Kettering between 6/2022 to 9/2023 were automatically sent a questionnaire through the electronic patient portal at the time when intravesical therapy was ordered, and at three days following each scheduled treatment. To measure the toxicity of therapy, we chose 18 relevant items from the Patient-Reported Outcomes version of the Common Terminology Criteria for Adverse Events (PRO-CTCAE) to evaluate constitutional, cardiopulmonary, gastrointestinal, mental, and urinary side effects of treatment—the 18 separate symptoms were grouped into these categories for analysis. Toxicity grades range from 0-3. Natural cubic splines were fit to mean scores to visualize outcomes. Linear mixed effects models, adjusting for clinical factors, were used to compare longitudinal toxicity. RESULTS: A total of 267 subjects completed at least one survey during therapy (n=199 BCG, n=35 gemcitabine (gem), n=29 gemcitabine/docetaxel (gem/doce)). Only 4 received mitomycin and were not analyzed as a separate group. A median of 5 surveys were completed per subject. There was no evidence of a difference in constitutional symptoms between BCG and gem (p=0.16) or gem/doce (p=0.54). Urinary symptoms overall were similar (gem p=0.09, gem/doce p=0.5), but for Dysuria, toxicity was greater for BCG – with a coefficient of -0.65 (p<0.001) for gem and -0.32 (p=0.048) for gem/doce. There was no evidence of significant differences in gastrointestinal, mental, or cardiopulmonary symptoms. Overall, toxicity was low, with mean toxicity grades <1 (maximum 3) for all categories over 6 weeks (Figure 1). CONCLUSIONS: Toxicity was low during therapy for BCG, gem, and gem/doce. Contrary to expectation, there wasn't evidence of progressive toxicity during therapy. Dysuria was the only symptom that was meaningfully greater with BCG compared to the other therapies. Download PPT Source of Funding: Sidney Kimmel Center for Prostate and Urologic Cancers at MSKCC, NIH/NCI Cancer Center Support Grant (P30CA008748), NIH/NCI R01/R37CA276946, NCI Specialized Programs of Research Excellence (SPORE) in Bladder Cancer (P50CA221745), Cycle for Survival, Bladder Cancer Advocacy Network Young Investigator Award © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e993 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Matthew B. Clements More articles by this author Nicole Liso More articles by this author Benjamin Seiden More articles by this author Timothy Donahue More articles by this author Alvin Goh More articles by this author Bernard H. Bochner More articles by this author Eugene Pietzak More articles by this author Expand All Advertisement PDF downloadLoading ...