New treatment approach makes cancer hot under the collar

Heating the chemotherapy drug mitomycin-C prior to using it for bladder cancer treatment may radically improve its effectiveness, according to scientists from Comarcal Hospital, Monforte, Spain

The ‘Recirculant hyperthermic IntraVEsical chemotherapy (HIVECä)’ treatment devised by the researchers involved heating a solution of mitomycin-C and diluted water to a target temperature of 43 °C prior to delivery into the bladder.

The drugs were recirculated at 200 mL per minute at a stable pressure and the temperature inside the bladder was maintained for 60 minutes.

40 patients took part in the study, published in the International Journal of Hyperthermia.

97% of the patients were able to complete the full course of HIVECä treatments and the majority of participants responded well to the treatment and showed low rates of recurrence, according to the findings.

Commonly Bacillus Calmette–Guérin (BCG) is used as the most effective treatment for non-muscle invasive bladder cancer, according to the researchers.

Mitomycin-C is typically less effective than BCG, but the authors said they believe that heating the solution increases the efficacy of the drug in part due to the increased solubility at higher temperature and in part due to the increased permeability of the bladder lining.

The researchers also treated some patients with HIVEC instead of the standard endoscopic surgery and found that in the majority of patients the tumours completely disappeared and did not come back within their brief follow-up of a few years.

This suggests HIVEC might be a less invasive alternative to surgery in some patients, according to the study.