More focussed clinical trials needed for improved bladder cancer survival

Better integration of chemotherapy and surgery could lead to a long-awaited improvement in bladder cancer survival, according to new research presented in Sydney by a visiting US expert in urogenital cancers.

Speaking at the ANZUP annual scientific meeting, New York-based urologist and oncologist Professor Shahrokh F. Shariat said that while removal of affected tissue was the traditional way to treat bladder cancer, the model was being challenged by new clinical trials data.

“Bladder cancer is a biologically aggressive disease with a high propensity to spread to other organs. Removing the visible cancer alone is often insufficient.” Professor Shariat said.

“A growing body of evidence shows that perioperative chemotherapy – administered immediately before and after surgery – can slow the advance of bladder cancer.”

“At present, this only occurs in individual clinical trials. We need more trials and more data if we are to change practice and ultimately improve outcomes for a wider range of patients – not just those participating in trials.”

“Most current clinical trials continue to use extensive patient populations that include many patients who are unlikely to respond to a targeted treatment, because their cancer does not have the relevant molecular defects, and thereby unnecessarily endure its side effects. To ensure higher chances of benefit, we have to design trials that will include smaller patient populations who harbor relevant genetic and epigenetic defects measured by validated biomarker signatures.”

ANZUP Chair, Melbourne-based medical oncologist and researcher Professor Ian Davis, said Professor Shariat’s work showed the importance of clinical trials to improving cancer survival.

“The potential for the research to improve bladder cancer survival – which is the least-improved in Australia – is a compelling case for funding independent clinical trials,” Professor Davis said.

“Clinical trials are the only way to clearly show that innovations in medical practice work.”

The meeting, opened by federal Minister for Health Tanya Plibersek, brings together 130 of the world’s leading authorities on urogenital and prostate cancer research.

“Urogenital and prostate cancers are among the most challenging to treat in relation to clinical practice and quality of life,” Professor Davis said. “Our annual scientific meeting explores the latest research and how we can do more in clinical trials to help reduce overall cancer burden.”

(Source: ANZUP)