A groundbreaking study has revealed that bladder cancer patients may no longer need life-changing surgery to remove the organ, thanks to a new drug combination. The research offers hope to thousands diagnosed each year with an aggressive form of the disease.
Study details and findings
Around 11,000 cases of bladder cancer are diagnosed annually in the UK. One in four patients have a form where the tumour has invaded the muscle wall. Only half survive for five years, and standard treatment often involves radical cystectomy – complete removal of the bladder. This surgery and its aftermath are notoriously difficult.
Artist Tracey Emin underwent such surgery in 2020 for severe squamous bladder cancer and subsequently required a urostomy bag. She described the experience as “hardcore,” noting the challenges of having a bag attached for life and the risk of leaks in public.
Previous research showed that combining chemotherapy with radiotherapy can reduce cancer recurrence risk. However, about 40% of patients still see their cancer return within a year.
The new trial, involving 54 patients, tested the addition of the immunotherapy drug durvalumab to chemoradiation. Results presented at the American Society of Clinical Oncology meeting in Chicago showed that 46 patients (85%) remained cancer-free after one year.
Expert commentary
Study leader Professor Nick James, an expert in prostate and bladder cancer at The Institute of Cancer Research in London, said: “We’ve shown that with the addition of immunotherapy, the combination of treatments has an even bigger improvement in outcomes — fewer cancers come back. Importantly, it’s possible to achieve these outcomes without surgically removing the bladder. Keeping the bladder means people can avoid major, life-changing surgery and maintain more of their normal daily function and independence.”
Durvalumab works by blocking a protein that cancer cells use to hide from the immune system. It was recently approved on the NHS for bladder cancer when used alongside surgery and chemotherapy.
Professor James, also a consultant clinical oncologist at the Royal Marsden NHS Foundation Trust, added: “I expect this approach to be practice-changing — offering bladder cancer patients improved outcomes whilst preserving their quality of life.”
Broader implications
ICR chief executive Professor Kristian Helin said: “Identifying smarter, kinder treatments is a key priority in cancer research — approaches that not only control the disease effectively, but that also reduce the life-changing impact of treatment on patients. These results are a significant step forward for people with aggressive bladder cancer. By adding immunotherapy to chemotherapy and radiotherapy, we may be able to spare patients the physical and psychological burden of having their bladder removed entirely and after one year, we're already seeing a meaningful reduction in the risk of the cancer returning.”
Michelle Mitchell, chief executive of Cancer Research UK, commented: “Radical surgery can cause serious side effects for bladder cancer patients. Finding kinder ways to treat the disease is incredibly important, and this trial has done exactly that. Further research will be needed at a larger scale to know for sure, but these results have the potential to be life changing for some bladder cancer patients. Breakthroughs just like this are essential to ensure people affected by cancer can live not just longer lives, but better lives.”
