Bladder cancer begins in the lining of the bladder, the organ that stores urine before it leaves the body.
Some bladder cancers grow slowly, while others are much more aggressive and are more likely to come back after treatment.
One of the standard treatments for high-risk bladder cancer that has not spread into the bladder muscle is bacillus Calmette-Guérin, commonly called BCG. This treatment has helped many people, but it does not work for everyone.
When cancer returns after BCG treatment, doctors usually recommend removing the bladder.
This operation can save lives, but it also changes daily life in major ways because patients need a new way for urine to leave the body. Many people hope for an effective treatment that controls the cancer while allowing them to keep their bladder.
A large international study led by Mayo Clinic has now offered encouraging news. The phase 3 clinical trial tested a new immunotherapy called cretostimogene grenadenorepvec in people whose high-risk bladder cancer returned despite BCG treatment. The findings were published in The Lancet Oncology.
Immunotherapy works by helping the body’s own immune system recognize and attack cancer cells. Instead of directly killing the cancer like chemotherapy, it encourages the body’s natural defenses to fight the disease. Researchers hoped this approach would control the cancer without the need for major surgery.
The study involved 115 patients treated at 41 medical centers across North America, Asia, and Australia. Researchers followed participants closely to see whether the cancer disappeared, how long the response lasted, whether patients needed bladder removal, and what side effects occurred.
The results were very promising. About 75 percent of patients had a complete response, meaning doctors could no longer detect signs of cancer after treatment. Among those patients, around 60 percent remained cancer-free two years later. One participant has remained free of cancer for more than four years after finishing treatment.
Two years after treatment began, researchers estimated that 81 percent of participants had still avoided surgery to remove the bladder. This is important because preserving the bladder can greatly improve comfort, independence, and overall quality of life.
Lead researcher Dr. Mark Tyson II said patients have had very few effective choices after BCG stopped working. These findings suggest that many people may now have another option that can control the disease while helping them avoid bladder removal.
The treatment also appeared to have a favorable safety profile. Most side effects were mild bladder symptoms that were temporary. Researchers did not report any severe treatment-related side effects during the study.
The researchers noted that this treatment has not yet been directly compared with other bladder-preserving treatments, so more studies will be useful. Even so, the results suggest that cretostimogene grenadenorepvec could become an important new option for patients with high-risk bladder cancer that returns after BCG therapy. The publication of the research in The Lancet Oncology highlights the importance of these findings.
The study is encouraging because it focuses not only on helping people live longer but also on helping them maintain their quality of life.
The results are strong for a phase 3 trial, although longer follow-up and direct comparisons with other treatments will help doctors understand exactly where this therapy fits into future care. If confirmed by further research and wider clinical use, this immunotherapy could change the standard treatment for many patients.
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Source: Mayo Clinic.
