A Phase 2 randomized study found that giving two preoperative doses of intravesical mitomycin-C before TURBT significantly reduced recurrence and progression in patients with non–muscle-invasive bladder cancer.
The strategy is based on the idea that tumor manipulation during surgery can release cancer cells that later reimplant in the bladder. By administering chemotherapy before surgery, while the tumor is still intact, the drug can target free-floating cells during the procedure and avoid risks associated with postoperative bladder instillation.
In the trial of 71 patients, those who received preoperative mitomycin-C had a 77% lower risk of recurrence or death compared with surgery alone. The 5-year recurrence-free survival rate was 90.7% versus 75.3%, and no disease progression occurred in the treatment group, compared with 15.8% in controls.
Patients received two intravesical doses before surgery, and both groups later received standard guideline-based therapies. Researchers said the findings are promising but require confirmation in larger Phase 3 trials before routine clinical use.