Enhanced antitumor effect of combination intravesical mitomycin c and bacillus calmette-guerin therapy in an orthotopic bladder cancer model

Masashi Matsushima, Minoru Horinaga, Ryuichi Fukuyama, Hitoshi Yanaihara, Eiji Kikuchi, Makoto Kawachi, Masahiro Iida, Yoko Nakahira, Mototsugu Oya, Hirotaka Asakura

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11 Citations (Scopus)


Intravesical immunotherapy with bacillus Calmette-Guerin (BCG) is currently the most successful adjuvant agent for the treatment and/or prophylaxis of non-muscle-invasive bladder cancer (NMIBC). However, NMIBCs recur in 60-70% of cases and 30% of these recurrent tumors present with a higher grade and more invasive properties. Patients that do not respond to intravesical BCG therapy are considered to be a challenge for urologists. Thus, novel conservative possibilities should be explored. To test the efficacy of a novel therapeutic approach, we examined the antitumor effect of combination therapy by intravesical administration of mitomycin C (MMC) plus BCG, infusing the two drugs simultaneously, in an orthotopic bladder cancer model. Intravesical BCG and MMC administration showed a dose-dependent survival (n=8 per group). The combination of MMC and BCG provided a significant survival advantage compared to the BCG-alone (p=0.035) and MMC-alone groups (p=0.040) (n=8 per group). The group with combined MMC/BCG exhibited a survival period similar to that achieved with an amount eight times higher that of BCG (n=10 per group). Ki-67 labeling index of cancer cells, showing tumor proliferation, was significantly lower in the combined group compared to the BCG-alone (p<0.05), MMC-alone (p<0.01) and control groups (p<0.01). No difference was detected between the combined group and the BCG-alone group with regard to CD3, T-cell infiltration and CD68 macrophage activity. The combined MMC/BCG treatment decreased the tumor appearance rate, improved the survival period and reduced the cellular proliferation rate in tumors compared to the BCG-alone treatment. The results suggest that the combined intravesical MMC/BCG treatment induced an enhanced antitumor effect against bladder tumors. The combined MMC/BCG treatment also showed a survival period similar to that achieved using a dose eight times higher of BCG-alone.

Original languageEnglish
Pages (from-to)13-19
Number of pages7
JournalOncology Letters
Issue number1
Publication statusPublished - 2011 Jan


  • Bladder neoplasms
  • Immunochemotherapy
  • Mitomycin C
  • Mycobacterium bovis
  • Urinary bladder

ASJC Scopus subject areas

  • Oncology
  • Cancer Research


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