A new type of drug that helps target chemotherapy directly to cancer cells significantly increases survival of patients with the most common form of bladder cancer, new research suggests.
The risk of death was 30% lower with the new drug than with chemotherapy, with an average survival of approximately 13 months for the new drug, according to the new study.
Urothelial cancer is the most common type of bladder cancer and accounts for around 90% of cases.
It can also be found in the renal pelvis (where urine collects inside the kidney), ureter (tube that connects the kidneys to the bladder) and urethra.
A new class of drugs known as antibody-drug conjugates (ADC) work by having an antibody attached to a chemotherapy-like drug.
The antibody specifically targets and attaches to the cancer cells, bringing with it the chemotherapy-like drug, allowing it to only act upon those cancer cells and ignore normal cells in the body.
Lead UK researcher, Tom Powles, professor of genitourinary oncology at Queen Mary University of London, and director of Barts Cancer Centre, Barts Health NHS Trust, said: “This new type of drug has led to a survival advantage in bladder cancer which has been difficult to achieve in this difficult disease.
“It reduced the death rate by 30% and beat chemotherapy in every setting, so this really is a big deal.”
Globally, approximately 549,000 new cases of bladder cancer and 200,000 deaths are reported annually.
One of the most widely used treatments for this type of cancer is chemotherapy which works by targeting all the cells in the body, successfully acting upon cancer cells, but also affecting non-cancer cells, causing side effects.
Published in the New England Journal of Medicine, the phase three study results were presented at the 2021 American Society of Clinical Oncology’s Genitourinary Cancers Symposium.
The trial involved 608 patients in 19 countries and tested a new ADC drug enfortumab vedotin, developed by Astellas Pharma Inc and Seagen Inc in adult patients with locally advanced or metastatic urothelial cancer.
They were previously treated with platinum-based chemotherapy and an immunotherapy drug called a PD-1/L1 inhibitor.
The median progression-free survival, which is the time without progression of cancer, was 5.6 months for the new drug vs. 3.7 months for chemotherapy.
The overall response rate, the percentage of patients with either complete or partial response, was 40.6%vs. 17.9% of patients in the chemotherapy arm.
Side effects of the drug were manageable and overall similar to chemotherapy, the study found.
They included pins and needles and a skin rash, which the researchers say require careful management.
Enfortumab vedotin was also found to have a tolerable safety profile.
The drug is already available in the US after the Food and Drug Administration gave it accelerated approval and is currently awaiting regulatory approval in the UK.
Researchers say it could be available to NHS patients in a few months if it goes through the Early Access Medicine Scheme (EAMS).
The trial was led in the UK by Queen Mary University of London and Barts Health NHS Trust.