Treatment advances and predictive biomarkers stand to improve bladder cancer care
Recent advances in bladder cancer treatments may offer hope of curative care to more patients, including those with high-risk localized, muscle-invasive disease,
Recent advances in bladder cancer treatments may offer hope of curative care to more patients, including those with high-risk localized, muscle-invasive disease, according to an editorial published in the New England Journal of Medicine.
Matthew Milowsky, MD, FASCO, a bladder cancer expert at UNC School of Medicine and UNC Lineberger Comprehensive Cancer Center, wrote that the promise of incorporating new treatments and predictive biomarkers to select the right patient for the right treatment every time offers a bright future for bladder cancer patients.
Platinum-based chemotherapy has long been the standard treatment for metastatic bladder cancer and for muscle-invasive bladder cancer where neoadjuvant chemotherapy is delivered prior to surgery. However, the landscape began to shift with the development of immune checkpoint inhibitors, which release "the brakes" on immune cells, freeing them to attack cancer cells.
When combined with chemotherapy and new drug formulations, like the antibody-drug conjugate enfortumab vedotin, which the FDA approved in 2019 for the treatment of advanced bladder cancer, these treatments are notably more effective than chemotherapy alone.
Now, these combination therapies are being explored to fight bladder cancer in earlier stages, with the potential to save lives and reduce the likelihood of recurrence.
Recent results from the NIAGARA trial, which evaluated using the immune checkpoint inhibitor durvalumab in combination with chemotherapy before and after surgery to remove the bladder, showed that patients treated with the combination therapy experienced a significantly higher two-year survival rate than those who received chemotherapy alone
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