- New ‘double attack’ treatment is three times better than earlier regimens
- Experts call it ‘most effective yet’ against bladder cancer
- More than 10,000 Britons are diagnosed with bladder cancer each year
- Around 5,000 Britons die from this deadly disease every 12 months
Professor Thomas Powells, oncologist and director of the Barts Cancer Centre, where the trial took place, said people who have been given the two-pronged treatment will ‘undoubtedly live longer’
A new ‘double attack’ treatment for deadly bladder cancer that keeps the disease at bay for three times longer than current approaches is offering new hope to the sickest patients.
Top cancer experts have described the drug combination as the ‘most effective yet’, after a landmark trial showed it stopped cancer in its tracks for at least 18 months in three quarters, depending on treatment options. were out.
Professor Thomas Powells, oncologist and director of the Barts Cancer Centre, where the trial took place, said people who have been given the two-pronged treatment will ‘undoubtedly live longer’.
He cautioned that this is not a cure, but added: ‘It may lead to prolonged remission.’
Every year, more than 10,000 Britons are diagnosed with bladder cancer. While survival rates for the disease have increased in recent years, due to medical advances and earlier diagnosis, it still kills about 5,000 people each year.
Most of these patients – about a quarter of all bladder cancer sufferers – will be diagnosed at a late stage when the disease has spread to nearby organs.
According to Cancer Research UK, more than two thirds of people diagnosed at this stage do not live a full year. Radical surgery is usually performed to remove the bladder and surrounding organs, which often leaves patients with life-changing disabilities.
Last year artist Tracy Emin revealed that she had extensive surgery to remove a tumor in her bladder, which also included removing part of her bowel and her vagina to stop the disease from spreading.
Last year artist Tracy Emin showed she had extensive surgery to remove a tumor in her bladder, which also included removing part of her intestine and her vagina to stop the disease from spreading.
Patients usually follow such a procedure with a course of chemotherapy to kill the remaining cancer cells. But in 60% of them, chemotherapy only works to stop the cancer from growing for a few months. Doctors may then try a course of a new generation of drugs called immunotherapy — which train the immune system to find and destroy cancer cells.
But even these can stop working within six to nine months.
Now doctors have found that adding another drug called erdafitinib can dramatically increase the time tumors remain under control. The drug is a targeted therapy, which means it is designed to attack a specific gene within a cancer cell called FGFR – present in a quarter of bladder cancers.
Targeted therapies usually have fewer side effects than conventional treatments because they act on diseased cells, and do not cause collateral damage by affecting healthy ones as well.
While the drug alone — taken as two daily pills — can keep cancer at bay for a few months, doctors found combining it with immunotherapy to be particularly potent. In a trial of 40 patients at Barts NHS Trust, 20 were given only the immunotherapy drug cetrelimab, while the other half were given a combination of cetrelimab and erdafitinib.
The findings, presented last week at the European Society for Medical Oncology Congress, showed that combination therapy benefited twice as many patients than immunotherapy alone. And even after 18 months of treatment, three quarters of patients still see their tumors shrink. Doctors aren’t sure why the combination is so powerful. Professor Powells says this may be because the effect of erdafitinib means ‘there is less cancer for immunotherapy to fight’.
Professor Powells says the combination therapy could eventually replace chemotherapy for people with tumors that contain the FGFR gene.
One patient to benefit from treatment is Katherine Kersey, 85, of Stratford, east London. The former local council worker was diagnosed with the condition in March 2020 after he noticed blood in his urine. “The doctor thought it was a urine infection at first, so it took a while to get diagnosed,” she says. ‘And by then the cancer had spread.’
In April last year, a biopsy found that the tumor contained the FGFR gene. It had spread to hard-to-reach areas that were out of surgery, so Katherine enrolled in the trial and began treatment in October 2020.
‘The side effects were difficult,’ she says. ‘My toe nails were so brittle and sore, they actually fell off at one point and I developed an angry rash on my foot.’
But the treatment proved successful in controlling his bladder cancer. In July, scans showed the tumor had shrunk to less than a third of its original size, half the diameter of a five pence piece.
“It was really unbelievable to watch, and I feel so lucky,” she says.