Harnessing Your Immune System to Treat Advanced Bladder Cancer


Drug approval provides another tool if chemotherapy fails

Your immune system helps you to fight off all kinds of ailments, including the common cold and the flu. But in recent years, immunotherapy — drugs that use your body’s immune system to kill diseases — has become an important tool for treating some types of cancer. And now, people with advanced bladder cancer have an immunotherapy option.

Earlier this year, the Food and Drug Administration (FDA) approved a drug called atezolizumab, which is sold under the brand name Tecentriq, to treat the most common type of bladder cancer, called urothelial carcinoma. Atezolizumab is the first product in its class to receive FDA approval to treat this type of cancer, the FDA says.

The drug targets a protein found on the body’s immune cells and some cancer cells. By blocking interactions between this and another protein, the drug may help the body’s immune system fight cancer cells.

A study of the drug showed that up to 28 percent of patients who received atezolizumab experienced complete or partial shrinking of their tumor. Response rates were greater in those who had a certain protein on their immune cells called PD-L1.

New paradigm

Urothelial carcinoma is the most common type of bladder cancer and occurs in the urinary tract system, and involves the bladder and related organs. Urothelial carcinoma can spread during or after certain chemotherapy treatments.

Bladder cancer is the fourth most common cancer in men, and fifth most common overall. The National Cancer Institute (NCI) estimates 77,000 new cases of bladder cancer and 16,000 deaths from the disease in 2016.

“This is definitely a breakthrough and it’s a new paradigm of treatment, particularly in the area of urothelial cancer,” says oncologist Petros Grivas, MD, PhD. Dr. Grivas is a paid consultant for the parent company of the drug.

A new tool

Until recently, there had been no treatment options for people with advanced bladder cancer if standard chemotherapy fails.

The drug, which is given through an intravenous infusion every three weeks, gives doctors another tool and is changing the way advanced bladder cancer is treated, the FDA says.

Doctors hope that the drug will help prolong life, delay cancer growth and contribute to an overall better quality of life.

“This is not a cure or a panacea for bladder cancer, but it definitely adds significantly to the therapeutic medicines, techniques and equipment to treat the disease,” Dr. Grivas says.

Other immunotherapy drugs such as pembrolizumab, nivolumab, durvalumab and avelumab are being tested in clinical trials, Dr. Grivas says, who is a paid consultant for most of the companies that produce these drugs.

“These drugs work in a similar way with what seems to be so far comparable effectiveness and tolerability that also may contribute to our treatment armamentarium for this challenging cancer,” Dr. Grivas says.

For example, a clinical trial showed that pembrolizumab prolonged the lives of patients with advanced urothelial cancer when compared to second-line chemotherapy after disease progression on prior chemotherapy.

Additional research is necessary to identify who will benefit most from the new treatments and to see if they work in earlier disease settings, Dr. Grivas says.

-By Cancer Care Team, Courtesy of Cleveland Clinic HealthEssentials