Drug trial success could reduce risk of bladder cancer recurring by a third

A major bladder cancer trial, funded by Cancer Research UK, has shown that adding two commonly used chemotherapy drugs to traditional radiotherapy can reduce the chance of a patient’s tumour coming back by a third.

The trial – led by scientists at the University of Birmingham, and the Institute of Cancer Research (ICR) – is the largest of its kind in bladder cancer in the world. Its success could mean fewer patients with invasive bladder cancer will need radical surgery to completely remove their bladder.

The results will be presented at the American Society for Radiation Oncology (ASTRO) annual conference next Monday (1st November 2010)*.

Professor Nick James, from the University of Birmingham, who led the study with Dr Robert Huddart from the ICR, said: “These trial results are hugely promising, with a significant reduction in the risk of the cancer returning when compared to radiotherapy alone. When we looked at the risk of potentially lethal invasive disease returning, the improvement was even more marked.”

After two years of follow up the results showed a tumour relapse rate of 33 per cent for patients receiving chemotherapy in addition to radiotherapy – known as chemoradiotherapy – compared to 46 per cent for radiotherapy alone. The reduction in relapse of the most severe type of tumour was even more marked at 18 per cent versus 32 per cent percent.

Professor James added: “Importantly, both chemotherapies used in this trial are cheap widely available drugs that are commonly used in cancer treatment already. This makes their use much more practical.

“Having surgery to remove the bladder is a major operation that can seriously impact a patient’s quality of life. We have shown that adding chemotherapy to radiotherapy reduces the risk of the most severe type of tumour recurring by nearly half. Hopefully these trial results will mean more bladder cancer patients are given the opportunity to avoid surgery and preserve their bladder function.”

Patients diagnosed with invasive bladder cancer are usually offered either radiotherapy alone – which carries a 40 to 50 per cent chance of the cancer coming back – or surgery to completely remove the bladder.

But giving the two chemotherapy drugs – 5FU and Mitomycin C – at the same time as the radiotherapy helped make the cancer cells more sensitive to it, boosting the effectiveness of the treatment.

The new approach could lead to fewer invasive bladder cancer patients being referred for surgery and may provide a lifeline for those too old or weak to survive the operation.

Each year in the UK around 10,300 people are diagnosed with bladder cancer. It is responsible for more than 4,900 deaths per year, primarily in older people, and is the fourth most common cancer in men.

Kate Law, director of clinical research at Cancer Research UK, said: “The results of this promising trial offer patients a potentially effective option for those who want to avoid having their bladder removed.

“This is particularly important since eight out of ten cases of bladder cancer occur in patients over 65, meaning many patients are unsuitable for surgery due to their age or other pre-existing health conditions.

“This trial demonstrates that efforts to maximise the effectiveness of radiotherapy and chemotherapies are vital. These treatments remain a crucial part of the fight against the disease.”

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