Adjuvant Intravesical Gemcitabine for Low-Grade Bladder Cancer

Low-grade, non–muscle invasive bladder cancer is a common neoplasm that is among the most expensive to treat given its natural history of frequent recurrences, mandating long periods of observation with cystoscopy, cytology, and transurethral resection of bladder tumor (TURBT). Although level I evidence supports adjuvant administration of mitomycin C or epirubicin to reduce the risk for recurrence following TURBT, this practice is not common in the U.S.

Intravesical administration of gemcitabine, an agent widely used in advanced urothelial cancer, has demonstrated efficacy and safety in phase II and III studies. To further test its effectiveness, investigators have conducted a multicenter, randomized, double-blind, phase III study in which 4…