# Sequential intravesical Bacillus Calmette-Güerin and mitomycin C applied with electromotive drug administration therapy for non-muscle invasive bladder cancer

**Authors:** Mirko Bakula, Tvrtko Hudolin, Tomislav Kulis, Toni Zekulic, Jerko Andelic, Zoran Zimak, Bojan Cikic, Ilija Juric, Zeljko Kastelan

PMC · DOI: 10.3389/fonc.2025.1682918 · Frontiers in Oncology · 2025-10-08

## TL;DR

A new treatment combining BCG and Mitomycin C using EMDA shows very low recurrence rates in bladder cancer patients.

## Contribution

This study demonstrates the effectiveness of sequential BCG and Mitomycin C via EMDA in treating non-muscle invasive bladder cancer.

## Key findings

- Sequential BCG and MMC EMDA resulted in a 4% recurrence rate in 25 NMIBC patients.
- The median follow-up was 16 months with only one recurrence after three months of therapy.
- The treatment was effective for both primary and recurrent intermediate- and high-risk NMIBC cases.

## Abstract

Intravesical therapy plays a crucial role in reducing the risk of recurrence and progression in patients with non-muscle invasive bladder cancer (NMIBC). Among the most widely used intravesical treatments is Bacillus Calmette-Guérin (BCG). To enhance therapeutic outcomes, sequential treatment strategies have been explored, including the combination of BCG with Mitomycin C (MMC) delivered via Electromotive Drug Administration (EMDA). In this retrospective clinical study, we report the results of sequential intravesical administration of BCG and MMC administered via EMDA (MMC EMDA) in 25 patients with intermediate- and high-risk NMIBC. Primary tumors were observed in 11 patients, while 14 had recurrent disease. Only one patient experienced recurrence during follow-up, after the 3 months of the therapy, resulting in an overall recurrence rate of 4%. The median follow-up duration was 16 months. In conclusion, our results support and expand the evidence indicating that sequential BCG and MMC EMDA offer a highly effective treatment approach for patients with intermediate- and high-risk NMIBC.

## Linked entities

- **Chemicals:** Mitomycin C (PubChem CID 5746)
- **Diseases:** bladder cancer (MONDO:0004986)

## Full-text entities

- **Diseases:** NMIBC (MESH:D000093284), tumors (MESH:D009369)
- **Chemicals:** MMC (MESH:D016685)
- **Species:** Homo sapiens (human, species) [taxon 9606]

## Full text

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## Figures

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## References

30 references — full list in the complete paper: https://tomesphere.com/paper/PMC12540080/full.md

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Source: https://tomesphere.com/paper/PMC12540080