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Combat Bladder Recirculation


The Combat BRS System is an innovative recirculation system designed to deliver hyperthermic intravesical chemotherapy (HIVEC™) for the treatment of non-muscle invasive bladder cancer (NMIBC).

Already in clinical use since 2011, the Combat BRS technology has shown to significantly increase the effectiveness of Mitomycin-C (MMC) by harnessing the proven synergistic effects of chemo-hyperthermia to target NMIBC¹ ². The treatment has similar patient tolerability to MMC at room temperature.³


The Combat BRS uses an external dry conductive recirculation system. This aluminium heat exchanger ensures efficient heat transfer and accurate temperature control within ± 0.2°C (4) of the set temperature, while providing homogeneous drug and heat distribution throughout the bladder.

The introduction of thermal energy into cancer tumours affects the cancer cells due to their inability to manage heat as well as healthy cells (5). Mitomycin C (MMC) is stable at temperatures up to 50°C and has shown to be 1.4 times more active at 43°C (6). At 43°C the cytotoxicity increases by 10 times, without any increase in the toxicity to the patient (6).



  • Portable, robust, and easy to use
  • Easily integrates in your current treatment practice
  • Minimal set up, no continuous monitoring


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1. Lammers, R. J. M. et al. The role of a combined regimen with intravesical chemotherapy and hyperthermia in the management of non-muscle-invasive bladder cancer: a systematic review. Eur. Urol. 60, 81–93 (2011).
2. Colombo, R., Salonia, A., Leib, Z., Pavone-Macaluso, M. & Engelstein, D. Long-term outcomes of a randomized controlled trial comparing thermochemotherapy with mitomycin-C alone as adjuvant treatment for non-muscle-invasive bladder cancer (NMIBC). BJU Int. 107, 912–8 (2011).
3. Sousa-Escando, A., Piñerio, A. & Uribarri, C. MP–04.22: Neoadjuvant Chemohyperthermia for the Treatment of High Risk Non Muscle Invasive Bladder Cancer (NMIBC): A Phase I Study. Urology 78, Supp 3A, S57 (2011).
4. SC Brousell, BA Inman. Heat Targeted Drug Delivery Using The COMBAT BRS Device For Treating Bladder Cancer. Data Presented at AUA Boston 14/05/17.
5. Song, C. W. Effect of Local Hyperthermia on Blood Flow and Microenvironment : A Review. Cancer Res. 44, 4721s – 4730s (1984).
6. Teicher, B. A., Kowal, C. D., Kennedy, K. A. & Sartorelli, A. C. Enhancement by Hyperthermia of the in Vitro Cytotoxicity of Mitomycin C toward Hypoxic Tumor Cells. Cancer Res. 41, 1096–1099 (1981).

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