‘Game changer’ immunotherapy drug could lead to increased survival rates for bladder cancer patients
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Patients with advanced bladder cancer treated with an immunosuppressant drug were a third less likely to see the disease return and more likely to survive for longer than patients who were given standard treatments, new research shows.
An expert who led the study said more patients could be cured if new treatments from the “game-changer” study become the new standard of care.
The study found that patients with muscle-invasive bladder cancer had significantly less risk of cancer progressing or returning when treated with immunosurpressant drug durvalumab, and were more likely to still be alive two years after treatment.
James Catto, professor of urology at the University of Sheffield and honorary consultant urological surgeon, who co-led the study, said it was a “major breakthrough” in the treatment of bladder cancer.
“For many years, survival rates for advanced bladder cancer have remained stagnant, but our findings offer hope to thousands of patients who face this devastating diagnosis,” he said.
Experts from the University of Sheffield and Barts Cancer Institute at Queen Mary University of London included 1,063 patients with operable bladder cancer in their study.
The research was funded by AstraZeneca, which developed durvalumab, and the results were published in the New England Journal of Medicine.
Patients with muscle-invasive bladder cancer were given either standard chemotherapy (cisplatin and gemcitabine) and surgery (530 people), or chemotherapy plus durvalumab before surgery and eight cycles of durvalumab after surgery (533).
The final-stage phase 3 clinical trial found patients were 32 per cent less likely to experience cancer recurrence or progression if they had immunotherapy, and were more likely to still be alive after two years.
Overall survival at two years was 82.2 per cent in the durvalumab group and 75.2 per cent in the comparator group.
Durvalumab (brand name Imfinzi) is a treatment for non small cell lung cancer but is also being trialled in other cancers.
Prof Catto said the findings were important for patients going through chemotherapy and suffering “its numerous and often debilitating side effects”.
“Our hope is that this treatment can be made available for NHS patients as soon as possible following regulatory approval by the Medicines and Healthcare products Regulatory Agency, and that it becomes the new standard of care,” he said.
“Recent research suggests that cases of bladder cancer will increase by 50 per cent over the next two decades, but yet the level of awareness about bladder cancer in the UK remains low.”
At the moment, around half of patients with muscle-invasive bladder cancer experience recurrence within three years.
Syed Hussain, professor and honorary consultant of medical oncology at the University of Sheffield and Sheffield Hospitals NHS Foundation Trust and principal investigator of the trial, said the “magnitude of survival benefit seen will certainly be a game changer”.
He added: “These are exciting times in the management of muscle-invasive bladder cancer.
“We had not seen any additional survival benefit in previous trials investigating additional treatments in combination with standard of care cisplatin-based chemotherapy before surgery.
“By bringing these exciting new treatments earlier in the disease pathway we will continue to see more patients being cured of muscle-invasive bladder cancer.”
Ian Flower, 63, from Sheffield, took part in the trial, and said he hoped the treatment could become available for other patients.
“I was happy to help with the trial, not just for myself but in the hope that it could help other patients,” he said.
