Intravesical gemcitabine for non-muscle invasive bladder cancer: An abridged Cochrane Review

Purpose: To assess the comparative effectiveness and toxicity of intravesical gemcitabine instillation for non-muscle invasive bladder cancer (NMIBC). Materials and Methods: We performed a comprehensive literature search on 11 September 2020. We included RCTs in which participants received intraves...

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Autores principales:	Mi Ah Han, Philipp Maisch, Jae Hung Jung, Jun Eul Hwang, Vikram Narayan, Anne Cleves, Eu Chang Hwang, Philipp Dahm
Formato:	article
Lenguaje:	EN
Publicado:	Korean Urological Association 2021
Materias:	administration intravesical gemcitabine systematic review urinary bladder neoplasms Diseases of the genitourinary system. Urology RC870-923
Acceso en línea:	https://doaj.org/article/2dbac2240654405ca979bdec4d3b1dce
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spelling	oai:doaj.org-article:2dbac2240654405ca979bdec4d3b1dce2021-11-10T03:01:07ZIntravesical gemcitabine for non-muscle invasive bladder cancer: An abridged Cochrane Review10.4111/icu.202102652466-04932466-054Xhttps://doaj.org/article/2dbac2240654405ca979bdec4d3b1dce2021-11-01T00:00:00Zhttps://icurology.org/pdf/10.4111/icu.20210265https://doaj.org/toc/2466-0493https://doaj.org/toc/2466-054XPurpose: To assess the comparative effectiveness and toxicity of intravesical gemcitabine instillation for non-muscle invasive bladder cancer (NMIBC). Materials and Methods: We performed a comprehensive literature search on 11 September 2020. We included RCTs in which participants received intravesical gemcitabine for primary or recurrent NMIBC. Two review authors independently assessed the included studies and extracted data for the primary outcomes (time to recurrence, time to progression, grade III to V adverse events) and the secondary outcomes (time to death from bladder cancer, time to death from any cause, grade I or II adverse events, and disease-specific quality of life). We performed statistical analyses using a random-effects model and rated the certainty of the evidence using GRADE. Results: We found seven studies with 1,222 participants. Gemcitabine may reduce the risk of recurrence over time, but may have a similar effect on progression and grade III to V adverse events compared to saline. Gemcitabine may reduce recurrence and progression compared to mitomycin. We are uncertain about the effect of gemcitabine on the grade III to V adverse events compared to mitomycin. Gemcitabine may reduce recurrence and progression compared to giving BCG again in recurrent high-risk NMIBC after BCG treatment. Conclusions: Based on the findings of this review, gemcitabine may have a favorable impact on recurrence and progression-free survival than saline and mitomycin but we are uncertain about how major adverse events compare. The same is true when comparing gemcitabine to BCG in individuals with high-risk diseases who have previously failed BCG.Mi Ah HanPhilipp MaischJae Hung JungJun Eul HwangVikram NarayanAnne ClevesEu Chang HwangPhilipp DahmKorean Urological Associationarticleadministrationintravesicalgemcitabinesystematic reviewurinary bladder neoplasmsDiseases of the genitourinary system. UrologyRC870-923ENInvestigative and Clinical Urology, Vol 62, Iss 6, Pp 623-630 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	administration intravesical gemcitabine systematic review urinary bladder neoplasms Diseases of the genitourinary system. Urology RC870-923
spellingShingle	administration intravesical gemcitabine systematic review urinary bladder neoplasms Diseases of the genitourinary system. Urology RC870-923 Mi Ah Han Philipp Maisch Jae Hung Jung Jun Eul Hwang Vikram Narayan Anne Cleves Eu Chang Hwang Philipp Dahm Intravesical gemcitabine for non-muscle invasive bladder cancer: An abridged Cochrane Review
description	Purpose: To assess the comparative effectiveness and toxicity of intravesical gemcitabine instillation for non-muscle invasive bladder cancer (NMIBC). Materials and Methods: We performed a comprehensive literature search on 11 September 2020. We included RCTs in which participants received intravesical gemcitabine for primary or recurrent NMIBC. Two review authors independently assessed the included studies and extracted data for the primary outcomes (time to recurrence, time to progression, grade III to V adverse events) and the secondary outcomes (time to death from bladder cancer, time to death from any cause, grade I or II adverse events, and disease-specific quality of life). We performed statistical analyses using a random-effects model and rated the certainty of the evidence using GRADE. Results: We found seven studies with 1,222 participants. Gemcitabine may reduce the risk of recurrence over time, but may have a similar effect on progression and grade III to V adverse events compared to saline. Gemcitabine may reduce recurrence and progression compared to mitomycin. We are uncertain about the effect of gemcitabine on the grade III to V adverse events compared to mitomycin. Gemcitabine may reduce recurrence and progression compared to giving BCG again in recurrent high-risk NMIBC after BCG treatment. Conclusions: Based on the findings of this review, gemcitabine may have a favorable impact on recurrence and progression-free survival than saline and mitomycin but we are uncertain about how major adverse events compare. The same is true when comparing gemcitabine to BCG in individuals with high-risk diseases who have previously failed BCG.
format	article
author	Mi Ah Han Philipp Maisch Jae Hung Jung Jun Eul Hwang Vikram Narayan Anne Cleves Eu Chang Hwang Philipp Dahm
author_facet	Mi Ah Han Philipp Maisch Jae Hung Jung Jun Eul Hwang Vikram Narayan Anne Cleves Eu Chang Hwang Philipp Dahm
author_sort	Mi Ah Han
title	Intravesical gemcitabine for non-muscle invasive bladder cancer: An abridged Cochrane Review
title_short	Intravesical gemcitabine for non-muscle invasive bladder cancer: An abridged Cochrane Review
title_full	Intravesical gemcitabine for non-muscle invasive bladder cancer: An abridged Cochrane Review
title_fullStr	Intravesical gemcitabine for non-muscle invasive bladder cancer: An abridged Cochrane Review
title_full_unstemmed	Intravesical gemcitabine for non-muscle invasive bladder cancer: An abridged Cochrane Review
title_sort	intravesical gemcitabine for non-muscle invasive bladder cancer: an abridged cochrane review
publisher	Korean Urological Association
publishDate	2021
url	https://doaj.org/article/2dbac2240654405ca979bdec4d3b1dce
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Intravesical gemcitabine for non-muscle invasive bladder cancer: An abridged Cochrane Review

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