Safe and effective for intermediate and high-risk Non Muscle Invasive Bladder Cancer patients, including patients who failed BCG instillations [1-26].
Reduced rates of tumour recurrence (adjuvant therapy).
High complete response rates in tumour eradication (neo-adjuvant therapy) in CIS patients and/or inoperable patients.
High Bladder preservation rates.
Administered in an outpatient setting, allowing patients to continue their daily activities following treatment.
Local RF enhances mitomycin C diffusion into the tissue and higher tumour-specific delivery of the drug, achieving higher accumulation in tumour tissue compared with standard bladder instillations.

Request clinical evidence, implementation information, or a discussion with our team.

RF in combination with Chemotherapy for the treatment of non-muscle-invasive bladder cancer (NMIBC)

Improve NMIBC Treatment Outcomes with Synergo®

Lammers RJ, Witjes JA, Inman BA, Leibovitch I, Laufer M, Nativ O, Colombo R. (2011) 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(1):81-93
Arends TJ, Nativ O, Maffezzini M, de Cobelli O, Canepa G, Verweij F, Moskovitz B, van der Heijden AG, Witjes JA. (2016) Results of a Randomised Controlled Trial Comparing Intravesical Chemohyperthermia with Mitomycin C Versus Bacillus Calmette-Guérin for Adjuvant Treatment of Patients with Intermediate- and High-risk Non-Muscle-invasive Bladder Cancer. Eur Urol. 69(6):1046-52
Colombo R, Da Pozzo LF, Salonia A, Rigatti P, Leib Z, Baniel J, Caldarera E, Pavone-Macaluso M. (2003) Multicentric study comparing intravesical chemotherapy alone and with local micro-wave hyperthermia for prophylaxis of recurrence of superficial transitional cell carcinoma. J Clin Oncol. 21(23):4270-6
van der Heijden AG, Kiemeney LA, Gofrit ON, Nativ O, Sidi A, Leib Z, Colombo R, Naspro R, Pavone M, Baniel J, Hasner F, Witjes JA. (2004) Preliminary European results of local microwave hyperthermia and chemotherapy treatment in intermediate or high risk superficial transitional cell carcinoma of the bladder. Eur Urol. 46(1):65-71
Gerson Lüdecke, Larissa Schäfer, Ofer Nativ, Ulrich Witzsch, Herbert Hanitzsch, Florian Hasner, Rami Issa, Alfred Witjes, Wolfgang Weidner (2015) Therapeutic power of radiofrequency induced intravesical hyperthermia-chemotherapy (RIHTC) in high-risk non-muscle-invasive bladder cancer NMIBC in respect of recurrence rate over 2 years: International, multi-institutional cohort study. Journal of Clinical Oncology 33:15_suppl, e15513-e15513
Gerson Lüdecke, Florian Hasner, Herbert Hanitzsch, Matthias Schmidt (2013) The German study group of intravesical hyperthermia-chemotherapy in non-muscle-invasive bladder cancer presents their long-term results in efficacy and tolerability for optimized adjuvant therapy and bladder preservation. J Clin Oncol 31, 2013 (suppl 6; abstr 268)
Colombo R, Salonia A, Leib Z, Pavone-Macaluso M, Engelstein D. (2011) 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(6):912-8
Brummelhuis ISG, Wimper Y, Witjes-van Os HGJM, Arends TJH, van der Heijden AG, Witjes JA. (2021) Long-Term Experience with Radiofrequency-Induced Hyperthermia Combined with Intravesical Chemotherapy for Non-Muscle Invasive Bladder Cancer. Cancers 2021, 13, 377
Benjamin Ayres, Chris Backhouse, Domagoj Tomic, Babbin John, Matthew Perry, Mike Bailey, Rami Issa (2018) 10-Year Experience of RITE Thermochemotherapy for High Risk Non Muscle Invasive Bladder Cancer that has failed BCG J Urology April 2018 Volume 199, Issue 4, Supplement, Page e96
Giorgio Canepa, Fabio Campodonico, Stefania Tamagno, Carlo Introini, Matteo Puntoni (2016) Ten years’ experience with intravesical thermo-chemotherapy MMC 40mg for Non Muscle Invasive Bladder Cancer high/intermediate risk. XXIII Congresso Nazionale Auro Link to abstract
Jill-Isabel Kilb, Arne Hauptmann, Florian Wagenlehner, and Gerson Luedecke (2018) Long-term results of organ preservation rate and progression risk in high-risk non-muscle-invasive bladder cancer (NMIBC) patients treated with radiofrequency-induced thermochemotherapy effect (RITE) with the Synergo system. Journal of Clinical Oncology 2018 36:6_suppl, 456-456
Miriam Hiebeler (2020) Dissertation study: Kombinierte intravesikale Chemotherapie und intrakavitäre Hyperthermie zur Behandlung nichtmuskelinvasiver Blasentumore – Retrospektive Ergebnisanalyse des Patientenkollektivs der Urologie des Klinikum Harlachings (2009-2015). Retrospective analysis from Harlaching Hospital (2009-2015) Link to study
Moskovitz B, Halachmi S, Moskovitz M, Nativ O. (2012) 10-year single-center experience of combined intravesical chemohyperthermia for nonmuscle invasive bladder cancer. Future Oncol. 8(8):1041-9
Arends TJ, van der Heijden AG, Witjes JA. (2014) Combined chemohyperthermia: 10-year single center experience in 160 patients with nonmuscle invasive bladder cancer. J Urol. 192(3):708-13
Gerson Lüdecke, Larissa Schäfer, Wolfgang Weidner, Matthias Schmidt, Herbert Hanitzsch, and Florian Hasner (2013) 1702 radiofrequency hyperthermia chemotherapy (htc) in high- and extreme high-risk non-muscle-invasive bladder cancer (nmibc) performed by the german htc study group: impressive high chance of organ preservation documented in a cohort study with long-time follow-up. Journal of Urology Vol. 189 Issue 4S e700-e700
Nativ O, Witjes JA, Hendricksen K, Cohen M, Kedar D, Sidi A, Colombo R, Leibovitch I. (2009) Combined thermo-chemotherapy for recurrent bladder cancer after bacillus Calmette-Guerin. J Urol. 182(4):1313-7
Volpe A, Racioppi M, Bongiovanni L, D'Agostino D, Totaro A, D'Addessi A, Marangi F, Palermo G, Pinto F, Sacco E, Bassi PF. (2012) Thermochemotherapy for non-muscle-invasive bladder cancer: is there a chance to avoid early cystectomy? Urol Int. 89(3):311-8
Halachmi S, Moskovitz B, Maffezzini M, Conti G, Verweij F, Kedar D, Sandri SD, Nativ O, Colombo R. (2011) Intravesical mitomycin C combined with hyperthermia for patients with T1G3 transitional cell carcinoma of the bladder. Urol Oncol. 29(3):259-64
Ayres B, Sri D., Perry M., Issa R. (2017) 5-year outcomes of RITE thermochemotherapy for BCG unresponsive high risk non muscle invasive bladder cancer. Eur Urol Suppl 2017; 16(3);e1158
Sooriakumaran P, Chiocchia V, Dutton S, Pai A, Ayres BE, Le Roux P, Swinn M, Bailey M, Perry MJ, Issa R. (2016) Predictive Factors for Time to Progression after Hyperthermic Mitomycin C Treatment for High-Risk Non-Muscle Invasive Urothelial Carcinoma of the Bladder: An Observational Cohort Study of 97 Patients. Urol Int. 96(1):83-90
Gofrit ON, Shapiro A, Pode D, Sidi A, Nativ O, Leib Z, Witjes JA, van der Heijden AG, Naspro R, Colombo R. (2004) Combined local bladder hyperthermia and intravesical chemotherapy for the treatment of high-grade superficial bladder cancer. Urology 63(3):466-71
Nair R, Pai A, Kaul A, Ayres B, Bailey M, Perry M, Issa R (2014) Challenging the gold standard: A comparison of long-term disease specific outcomes for high-risk non-muscle invasive bladder cancer treated with mitomycin hyperthermia and radical cystectomy. European Urology Supplements 13(1):e1109
Colombo R, Lev A, Da Pozzo LF, Freschi M, Gallus G, Rigatti P. (1995) A new approach using local combined microwave hyperthermia and chemotherapy in superficial transitional bladder carcinoma treatment. J Urol. 153(3 Pt 2):959-63
Colombo R, Da Pozzo LF, Lev A, Freschi M, Gallus G, Rigatti P. (1996) Neoadjuvant combined microwave induced local hyperthermia and topical chemotherapy versus chemotherapy alone for superficial bladder cancer. J Urol. 155(4):1227-32
van Valenberg FJP, Kajtazovic A, Canepa G, et al. (2018) Intravesical Radiofrequency-Induced Chemohyperthermia for Carcinoma in Situ of the Urinary Bladder: A Retrospective Multicentre Study. Bladder Cancer. 4(4):365-376
Moskovitz B, Meyer G, Kravtzov A, Gross M, Kastin A, Biton K, Nativ O. (2005) Thermo-chemotherapy for intermediate or high-risk recurrent superficial bladder cancer patients. Ann Oncol. 16(4):585-9
Alfred Witjes J, Hendricksen K, Gofrit O, Risi O, Nativ O. (2009) Intravesical hyperthermia and mitomycin-C for carcinoma in situ of the urinary bladder: experience of the European Synergo working party. World J Urol. 27(3):319-24
Maffezzini M, Campodonico F, Canepa G, Manuputty EE, Tamagno S, Puntoni M. (2014) Intravesical mitomycin C combined with local microwave hyperthermia in non-muscle-invasive bladder cancer with increased European Organization for Research and Treatment of Cancer (EORTC) score risk of recurrence and progression. Cancer Chemother Pharmacol. 73(5):925-30
Mero S, Oberneder K, Weiss J, Grobet-Jeandin E, Grégoris A, Sèbe P, Shariat S, D'Andrea D. (2025) Radiofrequency induced hyperthermia in non-muscle invasive bladder cancer: Oncologic outcomes in a real-world scenario. Actas Urol Esp (Engl Ed). 49(5):501746. doi:10.1016/j.acuroe.2025.501746. Epub 2025 Mar 17. PMID: 40107614.

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www.synergo-medical.com

If you would like to integrate Synergo into your clinic practice, refer patients, or discuss indications / contraindications, please feel free to contact us. Our team is available to provide further information and support.

Synergo in NMIBC pathway

In spite of the variety of treatments available, the rate of tumour recurrence and disease progression have been high among bladder cancer patients at intermediate and high risk of tumour recurrence. Synergo combines local intravesical chemotherapy with radiofrequency to enhance cancer cell destruction.

Bladder-preservation focus

Treatment with
MMC using Synergo
is associated with fewer
cystectomies and an increase in
life years gained and QALYs.

Integration into existing NMIBC pathways

Synergo is positioned within existing NMIBC management as device-assisted intravesical therapy.

Long-term follow-up efficacy

Durable cancer control approach that protects quality
of life