There are currently groundbreaking developments in the treatment of metastatic bladder cancer. A new therapeutic approach has been developed that enables a statistically significant and clinically meaningful improvement in overall survival and progression-free survival, which is considered a milestone.
A new study involving experts from the Netherlands Cancer Institute (NKI) examined how a combination of nivolumab with gemcitabine-cisplatin affects the treatment of unresectable or metastatic bladder cancer. The results can be read in the “New England Journal of Medicine” (NEJM).
How is metastatic bladder cancer treated?
Metastatic bladder cancer has been treated primarily with chemotherapy for the past 40 years. This is done on a cisplatin basis if affected people can tolerate the drug, the researchers explain. However, the treatment successes remained limited.
Experts are currently pursuing a new approach that uses immunotherapy combinations. Most recently, two phase 3 clinical trials examined the effects of combining immunotherapies with chemotherapy or with the new drug enfortumab vedotin, the team reports.
Combination of nivolumab and chemotherapy
The study published in the “NEJM” analyzed the effect of nivolumab and gemcitabine-cisplatin against bladder cancer (urothelial carcinoma) and compared the effect with treatment based on chemotherapy alone.
It showed that people treated with both drugs had a 22 percent reduced risk of death compared to people who underwent chemotherapy, the researchers report. In addition, the combination of nivolumab and chemotherapy led to a significant improvement in progression-free survival.
The other study examined the combination of an antibody-drug conjugate with immune checkpoint inhibition using enfortumab vedotin and pembrolizumab. This treatment also achieved a statistically significant and clinically meaningful improvement in overall survival and progression-free survival, the team said.
The researchers add that the results of the second study will only be published in a medical journal at a later date.
Improved survival through novel treatment
The studies showed a significant increase in overall survival and progression-free survival through the combined treatments and the results represent a “milestone in bladder cancer research as they provide the first evidence of a survival advantage of combination therapy with immune checkpoint inhibitors over chemotherapy “, explains study author Michiel van der Heijden in a current press release.
In the future, there will be a true revolution in the effectiveness of the treatment of bladder cancer, so that many more people affected will overcome this life-threatening disease and survive in the long term without bladder cancer progression, the experts conclude. (as)
