Clinical trial hints at new treatment option for bladder cancer

The NABUCCO trial involved 24 patients with advanced bladder cancer who received two immunotherapy drugs prior to their surgery. Following surgery, it was discovered that nearly all the removed tumours had shrunk after treatment with immunotherapy. Remarkably, 11 of the 24 patients had no remaining tumour after treatment.

Professor Broek found that these tertiary lymphoid structures were induced in the tumours following treatment with immunotherapy, suggesting that these structures could be playing a vital role in making immunotherapy work better. However, the presence of these structures prior to treatment did not help predict who would respond well to the drugs.

Professor Broek said, “Our observation that pre-treatment tertiary lymphoid structures did not predict response to immunotherapy was rather unexpected because it contrasts with findings in other cancer types. We now need to examine whether tertiary lymphoid structures are different between cancer types or tissues that could explain this discrepancy”.

Although this is an early stage trial, the results are promising. The researchers say that combining the two immunotherapy drugs prior to surgery could be an effective approach to treating this group of bladder cancer patients who often have a poor prognosis. Over 10,000 people are diagnosed with bladder cancer each year in the UK and only around four out of ten people with advanced bladder cancer are likely to survive 5 years after their diagnosis.

Professor Broek said, “Our study contributes to better understanding the interactions between cancer and the immune system. Such knowledge is essential for developing novel treatments. Our approach needs to be investigated in larger trials, which may lead to better treatments for bladder cancer.”