Review
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World J Clin Urol. Nov 24, 2014; 3(3): 195-200
Published online Nov 24, 2014. doi: 10.5410/wjcu.v3.i3.195
From the battlefield to the bladder: The development of thioTEPA
Sean M Gallagher, Steven H Selman
Sean M Gallagher, Steven H Selman, Department of Urology, The University of Toledo College of Medicine and Life Sciences, Toledo, OH 43614, United States
Steven H Selman, Department of Urology, University of Toledo Medical Center, Toledo, OH 43614, United States
Author contributions: Gallagher SM and Selman SH contributed equally to the conception, research, composition and editing of this manuscript.
Supported by The Frank D Stranahan Endowment for Oncologic Research
Correspondence to: Steven H Selman, MD, Department of Urology, University of Toledo Medical Center, 3000 Arlington Ave., Toledo, OH 43614, United States. sean.gallagher@rockets.utoledo.edu
Telephone: +1-419-3833584 Fax: +1-419-3833785
Received: April 24, 2014
Revised: July 31, 2014
Accepted: August 27, 2014
Published online: November 24, 2014
Processing time: 208 Days and 18.3 Hours
Abstract

Effective medications for the treatment of cancer were nonexistent in the early twentieth century. Ironically the widespread use of toxic chemical weapons, chlorine and sulfur mustard gas, during the “Great War” led to the first successful chemotherapeutic treatment of cancer patients. Soon after the introduction of poisonous gas on the battlefield, reports of the resulting pancytopenia in exposed combatants appeared in the medical literature. The biologic effect of chemical weaponry on rapidly dividing cells eventually was recognized for its salutary potential in the treatment of cancer. Once this potential was appreciated, hundreds of similar compounds were synthesized and evaluated as chemotherapeutic agents. One such compound, thioTEPA, would eventually open the era of intravesical treatment of urothelial cancer.

Keywords: ThioTEPA; Bladder cancer; Urothelial cancer; Intravesical chemotherapy; Mustard gas; Mitomycin C

Core tip: We attempt to outline the lineage of intravesical chemotherapy. Specifically, we look at its relationship to poisonous gas used in wartime and chronicle its journey to the bedside.