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Researchers Find a Minimally Invasive Option for Recurrent NMIBC
In DaBlaCa-13, intravesical mitomycin C reduced procedural burden and matched TURBT outcomes in select recurrent NMIBC patients.
The DaBlaCa-13 trial has brought promising insights into the management of recurrent, intermediate-risk non–muscle-invasive bladder cancer (NMIBC), showing that chemoresection with intravesical mitomycin C (MMC) is a safe and effective alternative to standard surgical care with transurethral resection of bladder tumor (TURBT). This approach offers patients a minimally invasive option while maintaining long-term oncological outcomes.
The study followed 120 patients randomized 1:1 to either 6 MMC instillations over 2 weeks or TURBT/biopsy followed by adjuvant instillations, with a median follow-up of 5 years. The results revealed a significant reduction in procedural burden for the MMC group, where 64% underwent TURBT compared with 89% in the standard-care group. Furthermore, 17% of MMC-treated patients avoided procedures entirely versus 0% in the TURBT arm.
In terms of recurrence-free survival (RFS), outcomes were comparable between the groups, with no significant difference at 5 years (14% for MMC vs 28% for TURBT; P=.3). Patients with fewer baseline tumors demonstrated better RFS (P=.012), emphasizing the importance of patient selection.
These findings suggest that MMC chemoresection can be integrated as a less-invasive option for carefully selected patients with NMIBC, particularly those with recurrent Ta disease and limited tumor burden. This approach not only minimizes procedural risks but also alleviates the healthcare burden associated with TURBT.
While the trial highlighted the potential of MMC chemoresection, it is important to note the limitations, including the small number of high-grade tumors at baseline. Nonetheless, these results pave the way for a more patient-centered, minimally invasive approach to NMIBC management.
By adopting MMC chemoresection for suitable patients, oncology teams can reduce surgical interventions while ensuring effective, long-term cancer control.
Reference
Klingenberg S, Lindgren MS, Jakobsen JK, et al. DaBlaCa-13 study: five-year follow-up from the randomized controlled trial of chemoresection with intravesical mitomycin c in recurrent Ta non-muscle invasive bladder cancer. Eur Urol Oncol. 2026 Mar 20. Epub ahead of print.
The DaBlaCa-13 trial has brought promising insights into the management of recurrent, intermediate-risk non–muscle-invasive bladder cancer (NMIBC), showing that chemoresection with intravesical mitomycin C (MMC) is a safe and effective alternative to standard surgical care with transurethral resection of bladder tumor (TURBT). This approach offers patients a minimally invasive option while maintaining long-term oncological outcomes.
The study followed 120 patients randomized 1:1 to either 6 MMC instillations over 2 weeks or TURBT/biopsy followed by adjuvant instillations, with a median follow-up of 5 years. The results revealed a significant reduction in procedural burden for the MMC group, where 64% underwent TURBT compared with 89% in the standard-care group. Furthermore, 17% of MMC-treated patients avoided procedures entirely versus 0% in the TURBT arm.
In terms of recurrence-free survival (RFS), outcomes were comparable between the groups, with no significant difference at 5 years (14% for MMC vs 28% for TURBT; P=.3). Patients with fewer baseline tumors demonstrated better RFS (P=.012), emphasizing the importance of patient selection.
These findings suggest that MMC chemoresection can be integrated as a less-invasive option for carefully selected patients with NMIBC, particularly those with recurrent Ta disease and limited tumor burden. This approach not only minimizes procedural risks but also alleviates the healthcare burden associated with TURBT.
While the trial highlighted the potential of MMC chemoresection, it is important to note the limitations, including the small number of high-grade tumors at baseline. Nonetheless, these results pave the way for a more patient-centered, minimally invasive approach to NMIBC management.
By adopting MMC chemoresection for suitable patients, oncology teams can reduce surgical interventions while ensuring effective, long-term cancer control.
Reference
Klingenberg S, Lindgren MS, Jakobsen JK, et al. DaBlaCa-13 study: five-year follow-up from the randomized controlled trial of chemoresection with intravesical mitomycin c in recurrent Ta non-muscle invasive bladder cancer. Eur Urol Oncol. 2026 Mar 20. Epub ahead of print.
