Methods of treatment and maintenance therapy for bladder cancer using gemcitabine
Provided are methods of treating urothelial carcinomas of the lower tract comprising administering comprising administering gemcitabine continuously and locally to the bladder of an individual in an induction therapy and/or maintenance therapy.
1. A method of treating muscle invasive bladder cancer in an individual comprising
i) a first phase comprising administering about 225 mg of gemcitabine locally to the bladder over at least one week during a first phase gemcitabine delivery period,
ii) a rest period of at least one month, and
iii) a maintenance phase comprising at least two maintenance phase delivery periods, each comprising administering about 225 mg of gemcitabine locally to the bladder over at least one week, wherein the maintenance phase delivery periods are separated by at least one month.
2. The method of claim 1 , wherein the maintenance phase delivery periods are each 3 weeks.
3. The method of claim 1 , wherein the gemcitabine is delivered by an intravesicular device in the maintenance phase delivery periods.
4. The method of claim 1 , wherein the concentration of gemcitabine in the urine is from about 1 μg/mL to about 10 μg/mL for at least one week during the maintenance phase delivery periods.
5. The method of claim 1 , wherein the maintenance phase comprises delivering gemcitabine locally to the bladder of the individual every three months.
6. The method of claim 5 , wherein the maintenance phase delivery periods are each three weeks.
7. The method of claim 1 , wherein the first phase comprises two or more consecutive first phase gemcitabine delivery periods.
8. The method of claim 7 , wherein each first phase gemcitabine delivery period is three weeks.
9. The method of claim 1 , wherein the individual is ineligible for or has refused cisplatin-based chemotherapy.
10. The method of claim 1 , wherein the individual is unfit for, ineligible for or has refused a radical cystectomy.
11. The method of claim 1 , wherein the individual has cT2, cT3, T3, or T4a muscle invasive bladder cancer.
12. The method of claim 1 , wherein the maintenance phase continues for at least one year.
13. The method of claim 1 , wherein the gemcitabine is delivered by an intravesicular device in the first phase gemcitabine delivery period.
14. The method of claim 1 , wherein the average concentration of gemcitabine in the urine is from about 5 μg/mL to about 20 μg/mL for one week during the maintenance phase delivery periods.
15. A method of providing maintenance therapy for an individual with muscle invasive bladder cancer comprising
administering gemcitabine continuously to the bladder of the individual two or more times during two or more maintenance phase delivery periods each at least one week, wherein the maintenance therapy follows at least one previous therapy,
wherein the previous therapy comprises delivering gemcitabine locally to the bladder of the individual continuously for at least one week, and
wherein there is a rest period between each maintenance phase delivery period of at least one month.
16. The method of claim 15 , wherein the gemcitabine is delivered at a dose from about 1 mg/day to about 300 mg/day during the maintenance phase delivery periods.
17. The method of claim 15 , wherein 225 mg of gemcitabine is administered during each maintenance phase delivery period.
18. The method of claim 15 , wherein the gemcitabine is delivered by an intravesicular device.
19. The method of claim 15 , wherein the concentration of gemcitabine in the urine is from about 1 μg/mL to about 10 μg/mL for at least one week during the maintenance phase delivery periods.
20. The method of claim 15 , wherein the maintenance therapy comprises delivering gemcitabine locally to the bladder of the individual every three months.
21. The method of claim 15 , wherein the previous therapy comprises two or more consecutive first phase gemcitabine delivery periods.
22. The method of claim 21 , wherein each first phase gemcitabine delivery period is about three weeks.
23. The method of claim 22 , wherein 225 mg of gemcitabine is administered to the individual during each first phase gemcitabine delivery period.
24. The method of claim 23 , wherein the gemcitabine is delivered by an intravesicular device during each first phase gemcitabine delivery period.
25. The method of claim 15 , wherein the individual is ineligible for or has refused cisplatin-based chemotherapy.
26. The method of claim 15 , wherein the individual is unfit for, ineligible for or has refused a radical cystectomy.
27. The method of claim 15 , wherein the individual has cT2, cT3, T3, or T4a muscle invasive bladder cancer.
28. The method of claim 18 , wherein the intravesicular device comprises about 225 mg of gemcitabine.
29. The method of claim 24 , wherein the intravesicular device comprises about 225 mg of gemcitabine.
30. The method of claim 28 , wherein the intravesicular device delivers about 100 mg to about 225 mg of gemcitabine over three weeks.
31. The method of claim 29 , wherein the intravesicular device delivers about 100 mg to about 225 mg of gemcitabine over three weeks.
32. The method of claim 15 , wherein the maintenance phase continues for at least one year.
33. The method of claim 15 , wherein the average concentration of gemcitabine in the urine is from about 5 μg/mL to about 20 μg/mL for at least one week during the maintenance phase delivery periods.
34. The method of claim 3 , wherein the intravesicular device delivers about 100 mg to about 225 mg of gemcitabine over three weeks.
35. The method of claim 1 , wherein the maintenance phase delivery periods are at least 2 weeks.
36. The method of claim 5 , wherein the maintenance therapy comprises delivering gemcitabine locally to the bladder of the individual about six times.
37. The method of claim 5 , wherein the individual receives the maintenance therapy for about 18 months.