Looking ahead: Novel drug treatments to combat bladder cancer

Prof. Thomas Powles, from the Barts Cancer Institute, London, UK, discusses a novel group of drugs known in broad terms as immune checkpoint inhibitors, to treat urethral bladder cancer. These drugs are immune therapies that boost the immune system and work differently from chemotherapies. The drugs used widely in bladder cancer includes: Tocilizumab, pembrolizumab, durvalumab, nivolumab and avelumab, all of which are at different stages of approval. The way they work differs from chemotherapy, because the cancers have developed a way of evading immune recognition and these drugs remove that process of evasion, to allow one’s natural immune system to attack the cancer. In bladder cancer, subsets of patients respond to therapy and go into long-term durable remissions. We have also shown, that in some settings, immune therapy can outperform what was previously the standard of care, chemotherapy. The future focuses on trying to implement the drugs earlier in the disease setting, maybe even to prevent the cancer spreading, and the need for chemotherapy, radiotherapy and cystectomy altogether, ultimately working towards a cure for more patients. Recorded at the European Association of Urology (EAU) conference 2017 in London, UK.