A bladder cancer treatment trial has pointed to a way some patients could avoid having their bladder removed.
Researchers found that adding the immunotherapy drug durvalumab to chemotherapy and radiotherapy reduced the risk of aggressive bladder cancer returning, while sparing patients surgery.
The phase-two trial, led by the Institute of Cancer Research, London, tested the drug in 54 patients and was funded by AstraZeneca and the University of Birmingham.
Results presented in Chicago at the American Society of Clinical Oncology’s annual meeting showed cancer did not come back in 46 patients, or 85 percent.
In previous trials, chemotherapy and radiotherapy without immunotherapy prevented the cancer returning in 60 percent of patients.
Bladder cancer is the ninth most common cancer in the world. Advanced or aggressive forms are often treated with surgery to remove the entire bladder, leaving patients to find alternative ways to pass urine for the rest of their life.
Durvalumab is a PD-L1 inhibitor, which helps the body spot cancer cells hiding from the immune system, allowing it to target and destroy them.
Nick James, professor of prostate and bladder cancer research at the ICR, said: “In 2012, my team showed that adding a low-cost chemotherapy drug to radiation provides good long-term benefit to bladder cancer patients.
“Now, we’ve shown that with the addition of immunotherapy, the combination of treatments has an even bigger improvement in outcomes – fewer cancers come back.
“Importantly, we’ve shown that it’s possible to achieve these outcomes without surgically removing the bladder. Keeping the bladder means people can avoid major, life-changing surgery and maintain more of their normal daily function and independence.
“I expect this approach to be practice-changing – offering bladder cancer patients improved outcomes whilst preserving their quality of life.”
In 2020, artist Tracey Emin said she had been diagnosed with a “really aggressive” form of bladder cancer and had undergone surgery to remove her bladder.
In 2021, she said: “Having a urostomy bag is quite a disadvantage for lots of reasons and it’s something that most people would want to keep a secret.
“It’s a very private thing because, basically, you’ve got part of your bodily function happening on the outside of your body. It leaks and things happen. I could be out somewhere public and it could happen – and people’d just think I’ve pissed myself or think I’ve been drinking.”
The ICR’s chief executive, Prof Kristian Helin, said identifying smarter, kinder treatments was a priority in cancer research.
“These results are a significant step forward for people with aggressive bladder cancer. By adding immunotherapy to chemotherapy and radiotherapy, we may be able to spare patients the physical and psychological burden of having their bladder removed entirely – and after one year, we’re already seeing a meaningful reduction in the risk of the cancer returning.”
Michelle Mitchell, chief executive of Cancer Research UK, who was not involved in the study, said: “Radical surgery can cause serious side effects for bladder cancer patients. Finding kinder ways to treat the disease is incredibly important, and this trial has done exactly that.
“Further research will be needed at a larger scale to know for sure, but these results have the potential to be life-changing for some bladder cancer patients. Breakthroughs just like this are essential to ensure people affected by cancer can live not just longer lives, but better lives.”
Read more from The Guardian.
