e16087 Background: Systemic intravenous gemcitabine is usually used in advanced bladder carcinoma, intravesical G is a novel treatment approach for TCC. In this study we evaluate the efficacy of intravesical Gemcitabine in patients (pts) with superficial bladder carcinoma. METHODS From February 2003 to June 2004, 60 pts (57M/3F) were enrolled in the study (M/F = 57/3). The median age was 59,5 years old (24-84). Nine pts had a carcinoma in situ (Cis) and 51 had pT1 lesions. Three weeks after a total transurethral resection (TUR), patients receive intravesical instillation of 2000 mg G every week for 6 weeks, than every month for six months. They received a total of 720 instillations, Follow up was with cystoscopy and urine cytology every six months. RESULTS At a median follow-up time 60 months, all patients were evaluable for tumor response: 23(38, 3%) patient had a persistant complete remission after treatment, 26 patients (43,3%) had a superficial relapse of TCC, six patients (10%) had progressive disease: four with muscle invasion and two with distant metastasis. CONCLUSIONS Intravesical therapy with gemcitabine is active and well tolerated treatment in patients with superficial TCC carcinoma of the bladder. A phase III trial comparing GEM with intravesical BCG or MMC is warranted No significant financial relationships to disclose.

5078 Background: Systemic intravenous G is usually used in advanced bladder carcinoma. A phase I study of intravesical G has shown safety profile in pts refractory to BCG therapy (Dalbani G et al JCO 2002; 20:3193–98). In this study we evaluate the toxicity and the efficacy of intravesical G in patients (pts) with superficial bladder carcinoma. Methods: The study population criteria were: age = 18 years old, histological diagnosis of transitional cell carcinoma (TCC) of bladder (Cis and pT1) confirmed by transurethral resection (TUR), no prior chemotherapy, a performance status (PS) < 2, good bone marrow reserve, adequate renal and liver function and informed consent. Three weeks after a total TUR, pts receive intravesical instillation of 2,000 mg G every wk for 6 wks, than every month for six months. Evaluation is performed 3–4 wks after the last instillation (CT scan and/or US pelvis, urinary cytology and cystoscopy with biopsy). Results: From February 2003 to June 2004, 60 pts (57M/3F) were enrolled in the study (M/F = 57/3). The median age was 59,5 years old (24–84). Nine pts had a carcinoma in situ (Cis) and 51 had pT1 lesions. They received a total of 720 instillations. All pts were evaluable for toxicity and response Toxicity (CTC/NCI scale) is evaluated over the 720 instillations. Non haematological toxicity was grade 1: irritate bladder reaction (4.7%), asthenia (2.9%), nausea and vomiting (1.8%) and hot flashes (2%). Grade 1 haematological toxicity: anaemia (6.8%), leucopenia (4.5%) and thrombocytopenia (0.4%). After a follow-up time of 30 to 48 months, all pts were evaluable for tumor response: 53 patient had a persistant complete remission after TUR. Five patients (8.3%) had a superficial relapse of TCC (one at six months, 2 at 9 months and 2 others at 12 months). Two patients had progressive disease at 18 months and 27 months. Conclusion: Intravesical G is an active and well tolerated treatment even after repeated instillation in pts with superficial TCC carcinoma of the bladder. No significant financial relationships to disclose.

4601 Background: Intravesical G (2000 mg twice weekly) has been shown in a phase I study to be a safe regimen in bacillus Calmette-Guerin (BCG) refractory TCC (Dalbagni G et al. J Clin Oncol. 2002; 20: 3193–3198). The objectives of this trial were to evaluate the toxicity and efficacy of intravesical G as adjuvant chemotherapy in patients (pts) with superficial TCC of the bladder. Methods: Chemonaive pts with histological diagnosis of TCC confirmed by total (ultrasonographic control) transurethral resection (TUR) received intravesical G 2000 mg/week diluted (inbuffered) in 100 ml of saline solution once weekly for 6 weeks. After Total TUR and three weeks of rest, they received 2000 mg G once a week for 6 weeks. Additional inclusion criteria were: age > 18 yrs, PS ≤ 1, adequate hematologic, hepatic and renal function, and written informed consent. Toxicity was evaluated at every intravesical administartion. Efficacy was evaluated three months after the end of treatment by ultrasonography, cytology, and TUR with bladder biopsy. Results: Twenty-nine pts (28 male, 1 female), recruited in two centers were enrolled in this study. There were 9 pts with carcinoma in situ and 20 pts with pT1 lesions. The median age was 60 yrs (range 24–83). After 348 total instillations (6 months of treatment), 29 pts were evaluable for toxicity in WHO scale. Nonhematological toxicities were grade 1: irritative bladder reaction (7,4%), asthenia (4,8%), nausea (1%) hot flashes (4%). Grade 1 hematologic toxicities were anemia (9%), leucopenia (8%) and thrombocytopenia ( 0,5% ) 2 pts. after a median follow-up time of 12 months ( range 3–15 months), all 29 pts were in complete remission without superficial bladder carcinoma-related events. Conclusions: G as adjuvant intravesical chemotherapy in superficial TCC of the bladder is safe, with minimal toxicity even after repeated instillations. Preliminary results of efficacy appears to be favorable. Author Disclosure Employment or Leadership Consultant or Advisory Stock Ownership Honoraria Research Funding Expert Testimony Other Remuneration Eli Lilly & Co.

Introduction. Xeroderma pigmentosum (XP) is a rate autosomal recessive disorder related to DNA repair defects. Recently, modifications of oncogenes and mutations of the p53 suppressor gene have been reported in skin tumors of XP patients. The purpose is to study, through a series of 40 patients admitted to the Dermatologic Clinic of Algiers, the characteristics of XP in Algeria. Patients and methods. For each patient, familiality, clinical and biological examinations and therapeutic results were studied. Biological studies have been axed mainly on analysis of DNA extracted from skin tumors of 18 patients to detect oncogene modifications by Southern blot and hybridization. A technic, based on single strand DNA conformation polymorphism (SSCP), has been carried out to detect rapidly mutations on the p53 gene. Results. A consanguinity in the first degree is noted in 95 p. 100 of cases and a familiality in 63 p. 100 of cases. The median age of patients is 10 years; sex ratio is close to one; 32 patients (80 p. 100) are classic XP and 8 (20 p. 100) are XP variant. In 18 tumors analysed, the Ha-ras gene is amplified and/or modified in 50 p. 100 of cases. Only 3 tumors (16.6 p. 100) show mutations of the p53 gene (transitions C --> T). Surgical treatment isolated or associated to polychemotherapy permitted to resolve tumors in 75 p. 100 of cases. Discussion. In Algeria, XP are mainly classic with a particularly high frequency of occular (62 p. 100) and neurological manifestations (62 p. 100). Genetic studies confirm modifications of the Haras gene in direct relation with unrepaired UV lesions in classic XP and mutations of the p53 tumor suppressor gene characteristic of mutation spectra induced by UV. Surgery is the treatment of choice for tumors; polychemotherapy is an alternative in advanced cases.

INTRODUCTIONXeroderma pigmentosum (XP) is a rate autosomal recessive disorder related to DNA repair defects. Recently, modifications of oncogenes and mutations of the p53 suppressor gene have been reported in skin tumors of XP patients. The purpose is to study, through a series of 40 patients admitted to the Dermatologic Clinic of Algiers, the characteristics of XP in Algeria.PATIENTS AND METHODSFor each patient, familiarity, clinical and biological examinations and therapeutic results were studied. Biological studies have been axed mainly on analysis of DNA extracted from skin tumors of 18 patients to detect oncogene modifications by Southern blot and hybridization. A technic, based on single strand DNA conformation polymorphism (SSCP), has been carried out to detect rapidly mutations on the p53 gene.RESULTSA consanguinity in the first degree is noted in 95 p. 100 of cases and a familiarity in 63 p. 100 of cases. The median age of patients is 10 years; sex ratio is close to one; 32 patients (80 p. 100) are classic XP and 8 (20 p. 100) are XP variant. In 18 tumors analysed, the Ha-ras gene is amplified and/or modified in 50 p. 100 of cases. Only 3 tumors (16.6 p. 100) show mutations of the p53 gene (transitions C-T). Surgical treatment isolated or associated to polychemotherapy permitted to resolve tumors in 75 p. 100 of cases.DISCUSSIONIn Algeria, XP are mainly classic with a particularly high frequency of occular (62 p. 100) and neurological manifestations (62 p. 100). Genetic studies confirm modifications of the Haras gene in direct relation with unrepaired UV lesions in classic XP and mutations of the p53 tumor suppressor gene characteristic of mutation spectra induced by UV. Surgery is the treatment of choice for tumors; polychemotherapy is an alternative in advanced cases.