An immunotherapeutic drug can reduce recurrence when bladder cancer spreads

An immunotherapeutic drug can reduce recurrence when bladder cancer spreads

Steven Reinberg

A new clinical study found that immunotherapy with nivolumab (Opdivo) after surgery for metastatic bladder cancer significantly reduces the likelihood of tumor recurrence.

Among the 700 patients with urothelial bladder or other parts of the urinary tract who had spread to muscle, patients treated with Opdivo had a 30% lower chance of recurrence within 11 months compared with those receiving placebo, a clinical phase 3 trial was found.

“This is the first immunotherapy to show a significant improvement in disease-free survival in patients with urothelial cancer – bladder cancer or urothelial cancer elsewhere in the urinary tract,” said researcher Dr. Matthew Galsky. He is the director of urogenital medical oncology at the Mount Sinai Tisch Cancer Center in New York City.

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Urothelial carcinomas begin in the cells lining different parts of the urinary system. The US Food and Drug Administration has approved nivolumab as an adjunct or adjuvant treatment for urothelial cancer.

“Demonstrating consistent results with longer follow-up is quite important to strengthen the role of this therapy,” Galsky said.

It’s hardly expensive, but because it’s approved by the FDA, most insurers cover it, he said.

Surgery to remove the bladder or kidneys and ureter has been the standard treatment for patients whose urothelial cancer has spread to the muscles or lymph nodes. The researchers reported that about 50% of these patients had a recurrence of fatal metastatic cancer.

Galsky said Opdivo was even more effective in patients whose tumors had the PD-L1 gene, and those patients were even less likely to have cancer. The court funded drug maker Bristol Myers Squibb.

The results of the study were presented on Friday at a meeting of the American Urological Association in New Orleans. Survival data researchers presented at the meeting are based on initial data published by Galsky and his colleagues last year New England Journal of Medicine.

The immunotherapeutic drug is administered intravenously and acts to bind to the PD-1 receptor, thereby blocking the tumor’s ability to grow. The treatment is usually given several times a week for one year.

Dr. Xinhua Zhu, a medical oncologist and hematologist at the Northwell Health Cancer Institute in New York, said patients tolerated the treatment well. Side effects – which may include nausea, constipation and anemia – are generally mild and easy to manage.

“I can tell you that based on my experience, immunotherapy is much, much more tolerable than conventional chemotherapy,” Zhu said of the new findings.

He noted that Opdivo has been the standard treatment for metastatic bladder cancer for over a year.

This study is the first to show the long-term benefits of the drug, Zhu added.

Although this study has only shown a benefit for 11 months, it is expected to have significant benefits for survival.

“You know, half the patients will recur, that’s a lot. It’s a really aggressive type of cancer,” Zhu said. “If we manage to get rid of cancer or significantly delay its recurrence, then the patient will get a huge benefit.

To learn more about bladder cancer, visit the American Cancer Society.

SOURCES: Matthew Galsky, MD, Director of Genitourinary Medical Oncology and Associate Director of Translational Research, Mount Sinai Tisch Cancer Center, New York City; Xinhua Zhu, MD, PhD, Medical Oncologist and Hematologist, Northwell Health Cancer Institute, Queens, NY; presentation, meeting of the American Urological Association, New Orleans, May 13, 2022

Originally published on, part of the TownNews Content Exchange.


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