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Progress for new bladder cancer treatment

Clinical trial hints at new treatment option for bladder cancer

14th October 2020

Thanks to supporters like you, scientists in the Netherlands have made progress towards a new treatment option for patients with bladder cancer. Results from an early stage clinical trial, called NABUCCO, show that combining two types of immunotherapy prior to surgery in bladder cancer patients could be an effective way to stop the cancer coming back.

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 Maries van den Broek, a Worldwide Cancer Research scientist who worked on the study, analysed the tissue removed from the patients during surgery to look for markers that could be used to explain why some patients responded better than others to immunotherapy. Her team were particularly interested in something called tertiary lymphoid structures, special sites in the body that help to activate immune cells in their fight against cancer.

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 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.”