A recently approved immunotherapy drug from Roche appeared effective as an initial treatment some patients of advanced bladder cancer, new data presented on Sunday have shown.
Results of the mid-stage trial could lead atezolizumab — sold under the brand name Tecentriq — to be a first-option treatment for those with metastatic bladder cancer, according to one of the researchers heading the study.
Tecentriq was approved in the United States last month for patients with urothelial carcinoma who have gotten worse while undergoing or after chemotherapy. It became the first new medication for the disease in three decades.
The study tested the drug on 119 patients via injections given every three weeks. It was found to shrink tumors by at least 30 percent in 24 percent or 28 of the participants — including 7 percent who demonstrated no sign of cancer.
Lead investigator Dr. Arjun Balar from NYU Langone Medical Center dubbed atezolizumab a “major advance” in treating the condition.
“Indeed, it may be the only therapy some patients need,” he said, adding that the drug was well-tolerated by everyone in the current study conducted in U.S., Canadian, and European medical centers.
Patients reported relatively mild cases of itchy skin, fatigue, and diarrhea, Balar went further.
Cisplatin, a drug-killing tumor cells through blocking them from repairing their DNA damage, is currently the first-line treatment in bladder cancer. It lengthens survival to a little over a year, but almost half of patients cannot take it because of toxic nerve and kidney function side effects.
Many of them also develop drug resistance and similar chemotherapy treatments eventually, Balar explained.
Tecentriq, on the other hand, is the first in the class of medications known as PD-1/PD-L1 inhibitors, which target the pathway that cancer uses in order to evade detection. It works similarly to PD-1 inhibitor drugs from Merck & Co and Bristol-Myers Squibb, which have extended advanced melanoma and lung cancer survival.
After follow-up of about 15 months into therapy, 3/4 of patients responding to the therapy had not experienced cancer growth. All of them still in cancer remission are still being monitored, with some receiving atezolizumab since May 2014.
"It's extremely exciting for that group of patients to see these durable remissions," said Dr. David Nanus, hematology and oncology chief at Weill Cornell Medicine and New York-Presbyterian Hospital. He was not involved in the study.
Advanced bladder cancer patients who cannot be on cisplatin are typically expected to survive 9 to 10 months.
In America, about 77,000 people will be diagnosed with bladder cancer this year, with less than 15 percent surviving beyond five years if the disease is detected in its advanced phases.
Tecentriq has a list price of $12,500 a month, costing roughly the same as Keytruda and Bristol's rival drug Opdivo. This drug belongs to a new breed of injectable cancer therapies working with the patient’s immune system, leading it to scour and kill tumor cells that would otherwise spread in the body through mechanisms allowing them to hide from immunity.
The findings were presented June 5 at the American Society for Clinical Oncology’s annual meeting in Chicago.