A new drug combination can double the overall survival for patients with bladder cancer that has spread, a study has found.
Researchers at Barts Health NHS Trust and Queen Mary University found that giving patients enfortumab vedotin and pembrolizum can stop their disease from getting worse and help them live twice as long as those given chemotherapy.
Bladder cancer kills around 5,500 Britons every year and the average life expectancy after diagnosis is just one year. Once it has spread, chemotherapy is the only available treatment.
The new trial, called EV302, involved nearly 900 participants with metastatic bladder cancer. Half were given the combination of enfortumab vedotin and pembrolizumab, while the other half received chemotherapy.
Those given the new drug combination lived for 31.5 months, compared to 16 months for those who were given chemotherapy.
The research also found that the risk of death was 53 per cent lower in those given the combination, which was also associated with better disease control rates.
Side effects from the drug combination were very similar to those experienced by people given chemotherapy. This includes nausea, tiredness and weak muscles.
Tom Powles, a professor of urology cancer at Queen Mary University of London who led the trial at Barts, said: “We’ve long known that we need to improve people’s chances of surviving bladder. This study has achieved that in a dramatic manner.
“We’ve shown that combining these two drugs helped people live twice as long compared to those given standard chemotherapy, with unprecedented responses. There is new hope in bladder cancer, and I can’t thank those who took part in the trial enough for doing so.”
'These drugs are incredible'
Paul Goodfellow was diagnosed with invasive bladder cancer in December 2019, just three months after retiring. His initial treatment was 3 cycles of chemotherapy followed by major surgery to remove the cancer, which included removing his bladder.
“It was a big operation”, he said. “For about a year after, all my scans came back clear."
In late 2021, he was told that his cancer had spread.
“I was devastated, my whole family was. I was offered a limited amount of chemotherapy cycles which would hopefully halt the spread but would have a short-term effect. It appeared to be the only option for me, so I was prepared to start the treatment."
Mr Goodfellow joined the trial at Barts after being informed about it by a specialist MacMillan nurse who had been supporting him.
"I’ve been having the new combination of drugs for 22 months. I am over the moon to say I had an 80 per cent response rate after just three cycles. My cancer hasn’t gone away, but it’s not getting worse.
“Thanks to this trial, I feel really well. I’m getting to spend time with my wife, family and dog that I didn’t think I’d have. I’m still walking around three miles a day and going on campervan trips with my wife and sometimes our children and grandchildren join us."
He added: “I could not have envisaged the things we are doing and have done since the awful news we received in 2021. These drugs are absolutely incredible, and I hope more people can benefit from these treatments in the future.”
The findings of the EV302 trial will be presented at the European Society of Medical Oncology (ESMO) conference on Sunday.
