Doctors are celebrating a breakthrough immunotherapy drug that may spare bladder cancer patients from life-changing surgery and prevent tumors from recurring. Bladder cancer ranks as the ninth most common cancer globally, with advanced cases often requiring the complete removal of the bladder, forcing patients to adapt to alternative methods of urination for the rest of their lives.
Promising Trial Results
A new study led by the Institute of Cancer Research, London (ICR), has found that the immunotherapy drug durvalumab, when added to standard chemotherapy and radiotherapy, significantly reduces the risk of cancer returning while eliminating the need for surgical removal of the bladder. The phase-two trial, funded by AstraZeneca and the University of Birmingham, involved 54 patients and showed that cancer did not recur in 46 patients (85%) after one year. In comparison, previous trials using only chemotherapy and radiotherapy without immunotherapy prevented recurrence in 60% of patients.
Expert Opinions
Nick James, professor of prostate and bladder cancer research at the ICR, stated: “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.”
Patient Perspective
The artist Tracey Emin, who was diagnosed with an aggressive form of bladder cancer in 2020 and underwent bladder removal surgery, shared her experience. 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.”
How Durvalumab Works
Durvalumab is a PD-L1 inhibitor that helps the immune system recognize cancer cells that are hiding, enabling the body to target and destroy them. The ICR’s chief executive, Prof Kristian Helin, emphasized the importance of identifying smarter, kinder treatments: “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.”
Future Implications
Michelle Mitchell, chief executive of Cancer Research UK, who was not involved in the study, commented: “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.”
