Impact of Urinary Tract Analgesics on Bladder Cancer Growth In Vitro

Author: Bindu Kshetri Bhattarai

Kshetri Bhattarai, Bindu, 2024 Impact of Urinary Tract Analgesics on Bladder Cancer Growth In Vitro, Flinders University, College of Medicine and Public Health

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Abstract

Bladder cancer is the 10th most common cancer in the world. Approximately 70-75% of bladder cancers are classified as non-muscle invasive (NMIBC). The gold standard treatment for NMIBC is surgical resection of the bladder tumor. Additionally, patients with intermediate and high risk NMIBC will undergo further BCG-immunotherapy. BCG (Bacillus Calmette-Guérin), a live attenuated strain of Mycobacterium bovis, is the most successful immunotherapy for bladder cancer. While BCG therapy is effective in preventing cancer progression and recurrence, up to 70% of patients experience local bladder side effects including bladder pain, urinary urgency, and urinary frequency that significantly reduce quality of life during treatment. In 7-20% of patients these side effects are so severe that they require cessation of therapy. If BCG therapy ceases, limited alternative treatment options exist. Despite this, there is no standard-of-care therapy to ease NMIBC patient suffering and improve treatment adherence. Urinary tract analgesics represent a possible therapeutic option, but the impact of analgesics on bladder cancer growth is unclear. This study aimed to investigate the impact of urinary tract analgesics lidocaine and phenazopyridine in bladder cancer growth in vitro using mouse bladder cancer cell line (MB49). Cell proliferation was measured using an Incucyte S3, cytotoxicity measured using a nuclear stain for cell death, and metabolism measured using an XTT assay. Lidocaine and phenazopyridine (30 µM, 10 µM, 3 µM, 1 µM, 300nM) had no impact on cell proliferation (p > 0.05), metabolism (p > 0.05) or cytotoxicity (p > 0.05). These findings suggest that phenazopyridine and lidocaine may be a potential therapeutic option for managing the side effects of BCG-immunotherapy for NMIBC. However, further studies are required to determine the potential impacts of urinary tract analgesics on the BCG response.

Keywords: NMIBC, BCG therapy, XTT , lidocaine, phenazopyridine, MB49 cells

Subject: Biotechnology thesis

Thesis type: Masters
Completed: 2024
School: College of Medicine and Public Health
Supervisor: Dr Luke Grundy