‘A big deal’: New drug significantly cuts death rate in most common bladder cancer, study finds

New treatment could be available on NHS within months, writes Conrad Duncan

A study has found antibody-drug conjugates can help to target chemotherapy at cancer cells while ignoring healthy cells (Getty Images)

A new type of drug that helps target chemotherapy directly to cancer cells significantly increases survival for patients with the most common form of bladder cancer, according to new research.

The class of drugs, known as antibody-drug conjugates (ADC), work by having an antibody attached to a chemotherapy-like drug, allowing the treatment to only target cancer cells while ignoring normal cells.

A study, published in the New England Journal of Medicine, found that the risk of death was 30 per cent lower with the new drug compared to standard chemotherapy, with an average survival of approximately 13 months for the new drug.

Urothelial cancer is the most common type of bladder cancer, accounting for about 90 per cent of cases, and can also be found in the renal pelvis, ureter and urethra.

Tom Powles, lead UK researcher for the study and professor of genitourinary oncology at Queen Mary University of London, described the results as “a big deal”.

“This new type of drug has led to a survival advantage in bladder cancer which has been difficult to achieve in this difficult disease,” Mr Powles, who is also the director of Barts Cancer Centre, Barts Health NHS Trust, said.

“It reduced the death rate by 30 per cent and beat chemotherapy in every setting, so this really is a big deal.”

The researchers added that if the drug goes through the Early Access Medicine Scheme (EAMS), it could be available to NHS patients in a few months.

There are approximately 549,000 new cases of bladder cancer and 200,000 deaths reported each year globally.

Chemotherapy, which is one of the most widely-used treatments for this type of cancer, works by targeting all the cells in the body, successfully acting upon cancer cells but also affecting non-cancer cells.

The trial involved 608 patients in 19 countries and tested a new ADC drug enfortumab vedotin, developed by Astellas Pharma and Seagen, in adult patients with locally advanced or metastatic urothelial cancer.

Patients were previously treated with platinum-based chemotherapy and an immunotherapy drug called a PD-1/L1 inhibitor.

The phrase three study results, presented at the 2021 American Society of Clinical Oncology's Genitourinary Cancers Symposium, showed the median progression-free survival – the time without progression of cancer – was 5.6 months for the new drug against 3.7 months for chemotherapy.

The overall response rate, the percentage of patients with either complete or partial response, was 40.6 per cent versus 17.9 per cent of patients in the chemotherapy arm.

Side effects of the drug, such as pins and needles and a skin rash, were manageable and overall similar to chemotherapy, the study found.

Enfortumab vedotin is already available in the US after the Food and Drug Administration gave it accelerated approval and it is currently awaiting regulatory approval in the UK.

The trial was led in the UK by Queen Mary University of London and Barts Health NHS Trust.

Additional reporting by PA