Keeping the bladder has long been one of the biggest challenges for people whose high-risk bladder cancer returns after standard treatment.
For many years, removing the bladder has been the safest option because it greatly reduces the chance of the cancer spreading.
However, the surgery can permanently affect daily living, making the search for effective bladder-preserving treatments a major goal of cancer research.
Scientists from Mayo Clinic and many international medical centers have reported encouraging progress.
Their phase 3 study examined an immunotherapy called cretostimogene grenadenorepvec in patients whose cancer returned after BCG treatment. The research was published in The Lancet Oncology.
BCG has been the main treatment for high-risk bladder cancer that has not grown into the bladder muscle. Although it works well for many people, some cancers return despite treatment. Until recently, these patients had very few choices besides surgery.
The new treatment is designed to stimulate the immune system so it can recognize and destroy cancer cells more effectively. Because the immune system continues working after treatment, researchers hoped the benefits would last for a long time.
The international study enrolled 115 patients from 41 hospitals and cancer centers across North America, Asia, and Australia. Every participant had cancer that had returned after BCG treatment, placing them at high risk of disease progression.
Researchers found that three out of every four patients achieved a complete response, with no detectable signs of cancer after treatment. Even more encouraging, many of these responses continued for more than two years. Around 60 percent of those who achieved a complete response were still cancer-free after two years, and one patient has remained free of cancer for more than four years.
The treatment also reduced the need for bladder removal. About 81 percent of patients had still avoided surgery two years after starting treatment. For many people, keeping their bladder means maintaining a more normal lifestyle, avoiding major surgery, and reducing the emotional burden that often follows bladder removal.
Safety is another important part of any cancer treatment. Most patients experienced only mild and temporary bladder-related side effects, and no severe treatment-related side effects were reported. This balance between effectiveness and safety makes the therapy particularly attractive.
Lead author Dr. Mark Tyson II said these findings may provide patients with a valuable new option when BCG no longer works. Rather than immediately moving to bladder removal, some patients may be able to receive immunotherapy while still achieving long-lasting cancer control.
The study has important strengths because it involved many hospitals and followed patients for several years.
However, the researchers also explained that the treatment has not yet been directly compared with other bladder-sparing therapies. Future studies will help clarify which patients benefit most and how it compares with other available options. Overall, the publication in The Lancet Oncology represents a major step toward more personalized and less invasive bladder cancer care.
The findings are significant because they address both survival and quality of life. While additional research is still needed, the high response rate, durable cancer control, and low rate of serious side effects suggest this immunotherapy has the potential to become a new standard option for selected patients who wish to avoid bladder removal.
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Source: Mayo Clinic.
