The anti-PD-L1 immunotherapy atezolizumab, which was recently approved for use in treating bladder cancer, has been found to help stop the spread of tumors in patients with advanced, previously untreated bladder cancer. All the patients were not eligible for standard cancer treatments.
The drug, sold under the brand name Tecentriq, works similarly to Keytruda, the drug that is said to have cured former president Jimmy Carter’s advanced melanoma. In the research conducted, the treatment stalled tumor growth in 24% of advanced bladder cancer patients and shrank said tumors by 30%.
Dr. Arjun Balar, an assistant professor at NYU Langone Medical Center, helped treat some of the patients, some of whom were too old or unhealthy to undergo standard chemotherapy. “Immunotherapy really treats your body’s immune system so your immune system can fight the cancer for you,” he says in an NBC News report.
Previous immune therapy methods involved putting the immune system on hyperdrive, which did not always work and caused unpleasant side effects. More successful approaches have included training immune cells to recognize specific tumors, or finding and broadening tumor-specific immune cells.
This new drug goes directly to the immune cells that are supposed to destroy cancerous tumors, stopping a genetic interaction that will let cancer cells avoid immune cells. These are called checkpoint inhibitors.
The American Cancer Society reports that 76,960 new cases of bladder cancer will be diagnosed this year, mostly in men. Bladder cancer will kill more than 16,000 Americans this year. “Bladder cancer accounts for about 5 percent of all new cancers in the US. It is the fourth most common cancer in men,” the organization says. Almost all patients diagnosed at the earliest stage 0 survive, but stage IV bladder cancer kills 85% of patients within five years.
Tecentriq got their Food and Drug Administration approval, but the drug is not cheap: it’s priced at $12,500 a month. Researchers say this is fair, given its level of effectivity and the costs for its development. “Our new study results argue that atezolizumab represents a major advance in the treatment of bladder cancer,” Balar says.
Atezolizumab is the first therapy to be approved in more three decades for this disease, and it is the new standard of care for patients whose initial therapy with platinum-based chemotherapy drugs has failed,
Balar adds. “Indeed, it may be the only therapy some patients need.”
The patients who were in the study had tried to get the best available treatment for bladder cancer, to no avail. This was the first drug they had received to treat the disease.
“Most patients who received atezolizumab really had no side effects whatsoever,” Balar says, although there are mild side effects to the drug, including fatigue, itchy skin and diarrhea.
Other research on checkpoint inhibitors, however, suggests that they might set off attacks on healthy organs, so more research is needed. Balar has wondered about the drug can be used in patients with early-stage diagnosis of bladder cancer. “Can we use this treatment earlier in the course of the disease?” he asks.
Studies on similar drugs are currently underway to check if genetic tests can predict which patients these checkpoint inhibitors are most likely to help.
The study was presented at the American Society for Clinical Oncology in Chicago.
