Methods of treating tumor metastasis
The present invention provides methods for treating or suppressing tumor metastasis at a site distinct from the bladder in an individual having a urothelial carcinoma of lower tract, comprising locally delivering to the bladder an effective amount of a chemotherapeutic agent (such as gemcitabine), wherein the chemotherapeutic agent is delivered continuously to the bladder for a sustained period of time (such as at least 24 hours).
1. A method of treating tumor metastasis at a site distinct from the bladder in an individual having a urothelial carcinoma of lower tract, comprising locally delivering to the bladder an effective amount of gemcitabine for at least 24 hours.
2. The method of claim 1 , wherein the individual has bladder cancer.
3. The method of claim 1 , wherein the individual has muscle invasive bladder cancer or carcinoma in situ (CIS).
4. The method of claim 1 , wherein the individual is unfit for or refuses cystectomy.
5. The method of claim 1 , wherein the individual has not undergone transurethral resection of bladder tumors (TURBT) prior to intravesical administration of gemcitbine.
6. The method of claim 1 , wherein the individual has undergone transurethral resection of bladder tumors (TURBT).
7. The method of claim 6 , wherein the individual has residual tumor at the site of resection.
8. The method of claim 1 , wherein the individual is unsuitable for systemic chemotherapy.
9. The method of claim 1 , wherein the gemcitabine is delivered continuously to the bladder of the individual for a period of about seven days to about three weeks.
10. The method of claim 9 , wherein the gemcitabine is delivered continuously to the bladder of the individual for a period of about seven days to about three weeks at least two times.
11. The method of claim 9 , wherein the gemcitabine is delivered by an intravesical device.
12. The method of claim 11 , wherein the intravesical device comprises 225 mg of gemcitabine.
13. The method of claim 1 , wherein the gemcitabine is delivered continuously to the bladder of the individual for about three weeks.
14. The method of claim 1 , wherein the gemcitabine is delivered at a dose of from about 10 mg/day to about 50 mg/day.
15. The method of claim 1 , wherein about 100 mg to about 200 mg of gemcitabine is delivered to the individual over 21 days.
16. The method of claim 1 , wherein the concentration of the gemcitabine in the urine is from about 0.1 μg/mL to about 200 μg/mL during the delivery period.
17. The method of claim 16 , wherein the method comprises an induction delivery period followed by a maintenance delivery period.
18. The method of claim 1 , wherein the metastasis site that is distinct from the bladder is selected from the group consisting of liver, lung, bone, brain, lymph node, pelvic node, peritoneum, skin, prostate, breast, colon, rectum, and cervix.
19. The method of claim 1 , wherein the gemcitabine is delivered by an intravesical delivery device.
20. The method of claim 19 , wherein the intravesical device contains 100 mg to 500 mg of gemcitabine.
21. The method of claim 20 , wherein the intravesical device contains 225 mg of gemcitabine.
22. The method of claim 20 , wherein the method comprises placing a gemcitabine releasing intravesical device in the bladder of the individual, wherein the device remains in the bladder for 21 days, and wherein the gemcitabine is continuously delivered to the bladder.
23. The method of claim 20 , wherein the intravesical device comprises a housing configured for intravesical insertion; and a dosage form comprising the gemcitabine, wherein the housing holds the dosage form and is configured to release gemcitabine.
24. The method of claim 20 , wherein the intravesical drug delivery device comprises a housing which contains and controllably releases the gemcitabine and is elastically deformable between a retention shape configured to retain the device in the individual's bladder and a deployment shape for passage of the device through the individual's urethra.