Between 2007 and 2011, 1,614 patients with presumed TaG1-2 NMIBC were randomized either to placebo or apaziquone post-transurethral resection (TUR). There were 1,146 patients with TaG1-2 disease. WHO 2004 grading was also performed with 700 patients having both grades recorded. Study assessment was based on central review by Bostwick Laboratories and cystoscopic follow up occurred every 3 months for 2 years. In the cohort of TaG1-2 patients, central review diagnosed PUNLMP more often than low-grade disease (519:181). Local and central 2004 grading were compared in 312 patients for concurrence. PUNLMP by central review was diagnosed locally as PUNLMP in 51 patients, low-grade in 179, and high-grade in 11 patients. The 2-year recurrence rate for patients with PUNLMP was 45% and 53% for patients with low-grade tumors. Both PUNLMP (OR 0.71) and low-grade tumors (OR 0.69) had improved 2-year recurrence rates after a single dose of apaziquone.
In summary, the incidence of PUNLMP increases with central pathology review. Furthermore, based on post-hoc analysis of prospective trial data the 2-year recurrence rate for PUNLMP is 45%, which improves with of a single intravesical dose apaziquone. The authors conclude that further research on the PUNLMP diagnosis, its clinical significance and response to intravesical therapy is warranted.
Presented by: Neal Shore, Carolina Urologic Research Center, Myrtle Beach, SC
Co-Authors: Anne Simoneau, Larry Karsh, David Bostwick, Mark Soloway, Sharon Leu, and Gajanan Bhat
Written By: Zachary Klaassen, MD, Society of Urologic Oncology Fellow, University of Toronto, Princess Margaret Cancer Centre @zklaassen_md at the 18th Annual Meeting of the Society of Urologic Oncology, November 20-December 1, 2017 – Washington, DC