Dr Katz on a Cystoscopic Cryocatheter in Bladder Cancer

Aaron E. Katz, MD, professor, chair, Department of Urology, NYU Long Island School of Medicine, discusses the rationale for and findings from a preclinical study evaluating the efficacy of a novel cystoscopic cryocatheter for in situ bladder cancer destruction.

Dr Katz on Unmet Needs in Localized Bladder Cancer Ablation

Innovations for the local destruction of bladder tumors has remained stagnant over the past several decades, according to Katz. To address this need, this study investigated the use of a novel 6Fr UroAblate catheter that can fit through, and is easily maneuvered with, a flexible cystoscope and can thermally ablate bladder tumors using liquid nitrogen, Katz explains. This ablation technique could potentially be used in patients with low-grade papillary tumor lesions or those with invasive bladder cancer who are not candidates for cystectomy, Katz says.

In this chronic porcine study, 4 adult female pigs underwent tumor ablation at freeze locations, including the bladder wall and the trigone region. Some animals additionally underwent ureteroscopic ablation of the distal ureter. One goal of this study was to keep the animals alive for a 7-day recovery period. After ablation, the pigs underwent temperature monitoring using cystoscopic and laparoscopic guidance. The ablation process was visible in real time, and after the tumors were frozen for 1.5 minutes, the cryocatheter yielded transmural lesions approximately 1 cm in diameter, regardless of wall thickness.

Dr Katz on Cystoscopic Cryocatheter Efficacy in Bladder Cancer

In the adult pigs used in the study, thermal ablation using a cryocatheter was safe and effective, Katz emphasizes. A kidney analysis on day 4 of the study showed no blockages or swelling, and complete blood cell and serum chemistry revealed elevated creatine kinase as the only significant deviation from baseline. The study investigators aim to further evaluate this bladder cancer cystoscopic ablation technique in a first-in-human clinical trial, Katz concludes.