An immunotherapy helps bladder cancer patients remain cancer free and enables them to avoid surgery, a phase 2 trial has found.
Adding durvalumab to chemotherapy and radiotherapy – without surgically removing the bladder – kept cancer at bay, according to the 12-month results of the trial presented at the American Society of Clinical Oncology annual meeting.
Muscle-invasive bladder cancer is an advanced form of the disease, where the tumour has grown into the muscle wall of the bladder. It affects around 25% of bladder cancer patients and is most often treated with surgery to remove the bladder.
Surgical removal of the bladder is a big operation, and patients will need an alternative way to pass urine for the rest of their life, such as a bag outside the body.
The RAD-IO trial tested the addition of the immunotherapy durvalumab to the chemoradiation, without the use of surgery.
The trial, led by Professor Nick James at The Institute of Cancer Research, London and Royal Marsden NHS Foundation Trust, tested the treatment in 54 patients.
Of the 54 patients, 46 – 85% – had no return of cancer after one year. In previous trials, chemoradiation, without immunotherapy, prevented cancer returning after one year in 60% of patients.
Professor Nick James said: “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.”
Professor Kristian Helin said: “These results are a significant step forward for people with aggressive bladder cancer.
“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.”
