LONDON — A phase-two clinical trial led by the Institute of Cancer Research, London, found that adding the immunotherapy drug durvalumab to standard chemotherapy and radiotherapy prevented bladder cancer recurrence in 85% of patients and eliminated the need for bladder-removal surgery. The treatment combination allowed 46 of 54 patients in the trial to avoid radical cystectomy—the surgical removal of the bladder—while maintaining cancer-free status after one year.
The results, presented at the American Society of Clinical Oncology’s annual meeting in Chicago, represent a potential shift in treatment for aggressive bladder cancer. Previously, chemotherapy and radiotherapy alone prevented recurrence in about 60% of patients. Durvalumab, a PD-L1 inhibitor that helps the immune system detect and destroy hidden cancer cells, appears to improve those outcomes.
“Now, we’ve shown that with the addition of immunotherapy, the combination of treatments has an even bigger improvement in outcomes – fewer cancers come back,” said Nick James, professor of prostate and bladder cancer research at the Institute of Cancer Research, London. He added, “Importantly, we’ve shown that it’s possible to achieve these outcomes without surgically removing the bladder. Keeping the bladder means people can avoid major, life-changing surgery and maintain more of their normal daily function and independence.”
Kristian Helin, chief executive of the Institute of Cancer Research, said: “By adding immunotherapy to chemotherapy and radiotherapy, we may be able to spare patients the physical and psychological burden of having their bladder removed entirely – and after one year, we’re already seeing a meaningful reduction in the risk of the cancer returning.” He called the findings “a step forward for people with aggressive bladder cancer.”
Michelle Mitchell, chief executive of Cancer Research UK, welcomed the results but emphasized the need for larger studies. “Further research will be needed at a larger scale to know for sure, but these results have the potential to be life-changing for some bladder cancer patients. Breakthroughs just like this are essential to ensure people affected by cancer can live not just longer lives, but better lives,” she said. “Radical surgery can cause serious side effects for bladder cancer patients. Finding kinder ways to treat the disease is incredibly important, and this trial has done exactly that.”
The trial was funded by AstraZeneca and the University of Birmingham. Bladder cancer is the ninth most common cancer worldwide, and advanced cases often require bladder removal, which necessitates lifelong use of a urostomy bag for urine collection—a condition that can profoundly affect quality of life.