Immunotherapy after bladder cancer surgery may reduce recurrence, according to study


Killer T cells surround a cancer cell. Credit: NIH

New research from Memorial Sloan Kettering Cancer Center (MSK) medical oncologist Dean Bajorin, MD, and colleagues found that patients who received nivolumab (Opdivo) after bladder cancer surgery reduced their overall risk of recurrence of high-grade bladder cancer. This research was published in New England Journal of Medicine.

In this randomized phase III study, Dr. Bajorin and a team of researchers evaluated 709 who had a high risk of recurrence of urothelial cancer after removal of the bladder, ureter, or kidney for high-grade cancer. To assess benefit, patients were randomized to receive nivolumab or a placebo every two weeks for one year. Patients and doctors were left blind to treatment. Both safety and quality of life were assessed.

Dr. Bajorin and researchers found that in high-risk patients, nivolumab reduced recurrence after surgery compared with patients receiving placebo. The current standard of care after surgery to remove the bladder or kidney and ureter has been an observation without —Even in patients at high risk of recurrence and death. This is because no chemotherapy or immunotherapy has previously been shown to be beneficial. Participants who received nivolumab had of 21 months compared with 10.9 months of people receiving placebo.

“We are very encouraged by the data and results of the study,” said Dr. Bajorin, first and corresponding author of the study. “Despite the therapies available for advanced metastases , new options are needed to improve long-term disease control and patient survival. These findings may change the standard of care for bladder cancer. “

Urothelial cancers are tumors that begin in the lining of the urine collection system that carries urine from the kidneys to the outside of our body. These cancers are often called “bladder cancer” because most start in the bladder.

Dr. Bajorin and colleagues concluded that survival data are not yet mature and will need additional research and follow-up. The primary criteria of disease-free survival in the study population and disease-free survival in the subgroup of patients with PD-L1-positive tumors were met, and these results are highly statistically and clinically relevant for a population. of patients with unmet medical need.

“The trial shows that new therapies can be identified as beneficial to patients when studies are carried out very rigorously. We hope that this treatment will gain approval for all patients at high risk of recurrence after the U.S. Food and Drug Administration has done a detailed review of all the data, ”Dr. Bajorin said.

Making pioneering advances in patients with bladder cancer

Cancer immunotherapy was born in MSK just over a century ago. Since then, MSK scientists have led the effort to develop immunity-based treatments for different types of cancer. MSK has been at the epicenter of discoveries in the field and the work of the institution brings new and interesting treatment options to people around the world. MSK physicians have extensive experience in using immunotherapy to treat people with melanoma, kidney cancer, lung cancer, and other cancers, as well as in handling immunity-related side effects.

Without treatment, bladder cancer can be an aggressive disease. In 2021, is loved that there will be about 17,000 deaths due in the United States, and the numbers are expected to increase significantly in the next decade.

“As physicians, we constantly strive to provide our patients with the most effective therapies and offer more options to those with advanced diseases,” Dr. Bajorin said.

Immunotherapy after surgery reduces the risk of fatal relapse in advanced bladder cancer

Citation: Immunotherapy after bladder cancer surgery may reduce recurrence, according to study (2021, June 4), recovered on June 4, 2021 at immunotherapy-bladder-cancer-surgery-recurrence.html

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