Epirubicin for intravesicular therapy – pro
The anthracycline epirubicin has been investigated for intravesical use in patients with superficial bladder cancer. In multicentre, randomised trials, prophylaxis with intravesical epirubicin 30 to 80mg after transurethral resection (TUR) was more effective than no prophylaxis in the prevention of disease recurrence. Intravesical prophylaxis with epirubicin was as effective as that with equivalent dosages of doxorubicin after TUR. Data are conflicting concerning the relative efficacy of intravesical epirubicin and bacillus Calmette-Guerin (BCG) in patients at intermediate risk of recurrence after TUR, but epirubicin was less effective than BCG in those at high risk. The efficacy and tolerability of prophylaxis with epirubicin relative to that with mitomycin is not yet established. The efficacy of epirubicin as prophylaxis after TUR in combination with BCG or interferon–2b, or as treatment in patients with superficial bladder cancer has been evaluated in small, noncomparative trials, but requires clarification.
Intravesical epirubicin has shown efficacy in preventing disease recurrence after TUR of superficial bladder cancer. In comparison with equivalent dosages of doxorubicin, the efficacy of epirubicin for this indication is generally similar, and the tolerability profile may be more favourable. Epirubicin is less effective than BCG as intravesical prophylaxis in patients at high risk of recurrence after TUR but for patients who can’t tolerate BCG, it is a resonable option. The BC policy does not address such a situation.
Onrust S.V.1; Wiseman L.R.1; Goa K.L.1Epirubicin: A Review of its Intravesical Use in Superficial Bladder Cancer Drugs & Aging, Volume 15, Number 4, 1 October 1999 , pp. 307-333(27)