Bladder cancer research highlights from EAU24

The European Association of Urology 2024 (EAU24) is Europe’s largest Annual Urology Congress which took place on April 5-8, in Paris, France.  

We have selected three bladder cancer research studies presented at EAU24, with lay summaries of each study provided below. 

Localised chemotherapy for people with high-risk, non-muscle-invasive bladder cancer

The SunRISe-1 study is evaluating the effectiveness and safety of TAR-200, a new treatment for people with high-risk non-muscle-invasive bladder cancer who found that standard BCG treatment didn’t work for them and who are unable to have surgery (cystectomy). TAR-200 is a drug delivery system that releases the chemotherapy drug gemcitabine directly into the bladder, aiming to treat cancer locally. 

After 11 months, 77% of people who received TAR-200 showed no signs of cancer. Most side effects were low-grade and related to the urinary tract, but they were manageable with symptomatic treatment. Serious side effects were rare, and very few people discontinued treatment due to side effects.  

Circulating tumour DNA, cystectomy, and immunotherapy in people with muscle-invasive bladder cancer

The IMvigor011 study is currently exploring the significance of monitoring circulating tumour DNA (ctDNA) in people with muscle invasive bladder cancer who have undergone surgery (cystectomy) to remove their bladder. One part of the study focused on those who do not show ctDNA after their surgery—a sign which might indicate they are free from cancer. 

ctDNA are small fragments of DNA that are shed from cancer cells into the bloodstream. Because ctDNA originates from cancer cells, it can provide specific information about the mutations or changes in these cells. Collecting involves a simple blood draw, much like any standard blood test. ctDNA tests often need to be personalised for each person because the genetic alterations in the tumour DNA can vary widely. 

Previously, ctDNA has been used to identify people at high risk of their cancer returning after surgery. The current study, IMvigor011, is testing the effectiveness of giving the drug atezolizumab compared to a placebo to these high-risk people who have ctDNA in their blood. Atezolizumab is known for blocking a protein (PD-L1) that cancer cells use to avoid being attacked by the immune system. 

The research presented here specifically looked at people who remained ctDNA-negative through multiple tests after surgery. This group was closely monitored using blood tests and scans for up to a year. The results are promising: many of these people did not experience cancer recurrence during this period, suggesting that ongoing ctDNA negativity might be a good indicator of disease-free survival. This might help doctors decide which people could safely skip further treatment after surgery, potentially sparing them from unnecessary side effects. 

This study is part of ongoing research and highlights the potential of ctDNA as a valuable tool for guiding cancer treatment decisions. However, it focuses only on people who consistently tested negative for ctDNA.  

Immunotherapy after radical cystectomy in people with muscle-invasive bladder cancer  

The CheckMate 274 study is a research project that examines the effectiveness of an immunotherapy drug called nivolumab in people with muscle-invasive bladder cancer who have undergone surgery (cystectomy)  to remove their cancer. This drug is known for blocking a protein (PD-L1) that cancer cells use to avoid being attacked by the immune system. 

The study found that nivolumab, when given after surgery, improved the time people remained free of cancer compared to those who didn’t receive nivolumab. People treated with nivolumab generally lived longer than those who received the placebo. The average overall survival was longer with nivolumab — over 69 months, compared to just over 50 months without nivolumab. The benefits of nivolumab continue over time, including reducing the chances of the cancer returning anywhere in the body or spreading to distant organs.  

Read more about the non-scientific programme highlights in this blog post from Melanie Costin at Fight Bladder Cancer in the United Kingdom. 

Learn more about the European Association of Urology Congress 2024. 

Disclaimer: The information contained in this article is intended for informational purposes only and should in no way be taken as a substitute for medical care. For medical care and advice, please contact your doctor. Any company mention in this article does not imply WBCPC’s endorsement of any particular form or forms of therapy, treatment regimen or behaviour.