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|EMDA- Electromotive Drug Administration + BCG|
Innovative approach from Italy improves efficacy of sequential BCG and Mitomycin C
Immunotherapy with BCG has become standard of care for high grade, non invasive bladder tumors, and has been shown to have a positive influence on recurrence and progression, while intravesical chemotherapy with various drugs has consistently demonstrated reduction in short-term tumor recurrence rates but no impact on disease progression. Intravesical treatments using chemotherapy drugs are limited because the effects wear off within two years.
BCG treatments followed by a novel delivery system using electromotively delivered Mitomycin C are showing some of the most surprising recurrence-free response rates ever seen in superficial bladder cancer treatments.
Mitomycin C followed by electromotive drug administration/EMDA is more able to penetrate the bladder lining. Experimental and clinical reports demonstrate that electric current significantly increases the transport of mytomicin.
U.S. experts from MD Anderson wrote in a recent review, "Could the addition of BCG (which causes local inflammation) increase the absorption of mitomycin such that the added benefit is, in part, due to systemic exposure to low-dose (‘metronomic’) chemotherapy? This would explain the rather remarkable improvement in disease specific mortality (almost 3 fold, from 16.2% to 5.6%) seen in patients receiving combination therapy."2
Experts in Italy have been working with Physion, the company that designed the electromotive drug delivery system. From the Physion site, "EMDA utilizes an electrical current to impart an accelerated, directional (towards the tissues) movement of ionized drugs in an intravesical solution, which results in greater quantities of drugs being delivered to greater tissue depths than is achievable by passive diffusion. Furthermore, the rate of drug administration is fully controllable simply by varying the intensity of the electric current."
1.Sequential BCG and electromotive mitomycin versus BCG alone for high-risk superficial bladder cancer: a randomised controlled trial. * Di Stasi SM, * Giannantoni A, * Giurioli A, * Valenti M, * Zampa G, * Storti L, * Attisani F, * De Carolis A, * Capelli G, * Vespasiani G, * Stephen RL. Department of Surgery/Urology, Tor Vergata University, Rome, Italy. Lancet Oncol. 2006 Jan;7(1):43-51. PMID: 16389183
2.A combination of intravesical and BCG electromotive mitomycin for high-risk superficial bladder cancer; Ashish M Kamat* and Colin PN Dinney Correspondence *Department of Urology, Unit 1373, University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX 77030-4009, USA Nature Clinical Practice Urology (Nov. 2006) 3, 472-473 doi:10.1038/ncpuro0559