Table 2.

Summary of studies evaluating the use of electromotive drug administration in nonmuscle-invasive bladder cancer

Study	Inclusion criteria	Timing of EMDA	Treatment regime	Control group	Outcome
Brausi 1998	G1-G2, pTa-T1, <1.5 cm tumor	Adjuvant	EMDA MMC 15 mA (40 mg in 50 ml distilled water) retained in bladder for 20 min weekly for 8 weeks	40 mg MMC in 50 ml distilled water (retained in the bladder for 2 h), weekly for 8 weeks	CR 41% in EMDA group compared to 41.6% in control; RR 33% in EMDA group compared to 60% in control group; DFI 14.5 months in EMDA group compared to 10.5 months in control group
Colombo 2001	G1-G2, pTa-T1, <2 cm tumor	Pre-TURBT	EMDA MMC 20 mA (40 mg on 150 ml distilled water) retained in bladder for 20 min weekly for 4 weeks	40 mg MMC in 50 ml distilled water versus hyperthermia MMC 40 mg MMC in 50 ml distilled water (retained in the bladder for 1 h), weekly for 4 weeks	CR 40.0% in EMDA group compared to 27.7% in control group
Decaestecker 2018	Primary or recurrent, single or multiple, papillary tumors <2 cm	Pre-TURBT	EMDA MMC 25 mA (60 mg in 100 ml distilled water) retained in the bladder for 25 min	N/A	CR occurred in 25%
Di Stasi 2003	Multifocal carcinoma in situ (Tis) +/− concurrent pT1 tumor	Adjuvant	EMDA MMC 20 mA (40 mg in 100 ml water) retained in bladder for 30 min weekly for 6 weeks	40 mg MMC in 100 ml water (retained in bladder for 60 min) weekly for 6 weeks versus 81 mg BCG retained in bladder for 120 min weekly for 6 weeks	CR for EMDA MMC versus passive MMC versus BCG: 53% versus 28% versus 56% at 3 months, 58% versus 31% versus 64% at 6 months; median TTR 35 versus 19.5 versus 26 months
Di Stasi 2006	pT1 bladder cancer (G2 or 3 or pT1+CIS)	Adjuvant	81 mg BCG retained in bladder for 120 min weekly for 2 weeks followed by 40 mg EMDA MMC 20 mA for 30 min weekly as one cycle, for 3 cycles	81 mg BCG retained in bladder for 120 min weekly for 6 weeks	For sequential BCG and EMDA MMC group versus BCG alone: DFI 69 months versus 48 months; RR 41.9% versus 57.9%; PR 9·3% versus 21·9%
Di Stasi 2011	Primary pTa and pT1 tumor	Pre-TURBT	EMDA MMC 20 mA (40 mg in 100 ml sterile water) retained in bladder for 30 min	TURBT alone versus immediate post-TURBT intravesical passive MMC 40 mg in 50 ml sterile water within 6 h of TURBT (retained for 60 min)	RR 38% (EMDA group) versus 59% (passive MMC) versus 64% (TURBT alone); DFI 52 months (EMDA group) versus 16 months (passive MMC) versus 12 months (TURBT alone)
Gan 2016	High-risk NMIBC	Adjuvant	81 mg BCG retained in bladder for 120 min weekly for 2 weeks followed by 40 mg EMDA MMC 20 mA for 30 min weekly as one cycle, for 3 cycles	N/A	CR 71% at 1 year, 63% at 2 years
Riedl 1998a	High-risk NMIBC	Adjuvant	EMDA MMC 15 mA (40 mg in 100 ml water) retained in bladder for 20 min weekly for 4 weeks	N/A	CR 56.6% at mean 14.1 months
Racioppi 2018	BCG refractory (persistent high-grade NMIBC after first or second induction BCG)	After failed induction BCG	EMDA MMC 20 mA (40 mg in 100 ml of sterile water) retained in the bladder for 30 min, induction course of 6 weekly instillations followed by a maintenance course of 6 monthly instillations	N/A	61.5% preserved their native bladder. At 36 months follow-up, disease free rates 75% (TaG3), 71.4% (T1G3), 50% (Cis), 25% (TaT1G3 + Cis)

CR: Complete response, DFI: Disease-free interval, TTR: Time to recurrence, PR: Progression rate, RR: Recurrence rate, MMC: Mitomycin C, EMDA: Electromotive drug administration, NMIBC: Nonmuscle-invasive bladder cancer, TURBT: Transurethral resection of bladder tumor, N/A: Not available, BCG: Bacille calmette-guerin