Barts Health researchers find new class of drug leads to 30% reduced risk of death for bladder cancer patients
A new type of drug that helps target chemotherapy directly to cancer cells has been found to significantly increase survival of patients with the most common form of bladder cancer, according to results from a phase III clinical trial led in the UK by Barts Health NHS Trust and Queen Mary University of London.
The results are published in the New England Journal of Medicine and were presented at the 2021 American Society of Clinical Oncology’s Genitourinary Cancers Symposium.
Urothelial cancer is the most common type of bladder cancer, affecting 90% of cases, and can also be found in the renal pelvis – where urine collects inside the kidney, ureter – the tube that connects the kidneys to the bladder, and urethra.
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.
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.
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 who were previously treated with platinum-based chemotherapy and an immunotherapy drug called a PD-1/L1 inhibitor.
Lead UK researcher Tom Powles, director of our Barts Cancer Centre and professor of genitourinary oncology at Queen Mary University of London, 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 per cent and beat chemotherapy in every setting, so this really is a big deal.”
Enfortumab vedotin was also found to have a tolerable safety profile. Side effects included pins and needles and a skin rash, which the research team say require careful management.
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).
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