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Patients with advanced bladder cancer treated with an immunosuppressant are a third less likely to have the disease return and more likely to survive longer than patients who received standard treatments, new research shows.
The expert who led the study said more patients could be cured if new treatments from the “game-changing” study become the new standard of care.
The study showed that patients with invasive muscle bladder cancer had a significantly lower risk of cancer progress or relapse when treated with the immunosuppressive drug durvalumab, and are more likely to 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 advance” in the treatment of bladder cancer.
“For many years, survival rates for advanced bladder cancer have stagnated, but our findings offer hope to thousands of patients facing this devastating diagnosis,” he said.
Experts from the University of Sheffield and Barts Cancer Institute at Queen Mary University of London included 1063 patients with operable bladder cancer in their study.
The research was funded by AstraZenecawho developed durvalumab, and the results were published in the New England Journal of Medicine.
Patients with muscle-invasive bladder cancer received either standard chemotherapy (cisplatin and gemcitabine) and surgery (530 subjects), or chemotherapy plus durvalumab before surgery and eight cycles of durvalumab after surgery (533).
A late-stage Phase 3 clinical trial found that patients were 32 percent less likely to experience cancer recurrence or progression if they had the immunotherapy, and were more likely to still be alive after two years.
Overall survival at two years was 82.2 percent in the durvalumab group and 75.2 percent in the comparator group.
Durvalumab (brand name Imfinzi) is a drug for non-small cell lung cancer, but it is also being tested in other cancers.
Professor Catto said the findings were important for patients undergoing chemotherapy and suffering from “its many and often debilitating side effects”.
“We hope this treatment will be available NHS patients as soon as possible after regulatory approval from the Medicines and Healthcare products Regulatory Agency, and for it to become the new standard of care,” he said.
“Recent research suggests that the number of bladder cancer cases will increase by 50 per cent over the next two decades, yet the level of awareness of bladder cancer in the UK remains low.”
Currently, about half of patients with muscle-invasive bladder cancer experience a recurrence within three years.
Syed Hussain, professor and honorary consultant in medical oncology at the University of Sheffield and Sheffield Hospitals NHS Foundation Trust and principal investigator of the trial, said “the magnitude of the survival benefit seen will certainly be a game-changer”.
He added: “These are exciting times in the treatment of muscle-invasive bladder cancer.
“We have seen no additional survival benefit in previous trials investigating additional treatments in combination with standard care cisplatin-based chemotherapy before surgery.
“By introducing these exciting new treatments earlier in the course of the disease, we will continue to see more patients 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 to other patients.
“I was happy to be able to help with the trial, not only for myself, but in the hope that it would help other patients,” he said.