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CURE’s bladder cancer page is a go-to resource for oncology news and updates in the world of bladder cancer. Here, readers will find cancer articles, videos, podcasts, and more with expert insight into the latest treatments and research in bladder cancer.

It’s been a busy few weeks here at CURE® and in the oncology space as a whole, as the last two weekends had back-to-back meetings: the American Society of Clinical Oncology’s 

Here are some highlights from the conference, but as always, you can find all of our coverage at curetoday.com.

Imfinzi, Avastin, TACE May ‘Set a New Standard of Care’ in Liver Cancer

For patients with liver cancer whose disease is not eligible to be removed via surgery, adding Imfinzi and Avastin to transarterial chemoembolization — also known as TACE — tended to lengthen the time patients lived before their disease got worse, according to findings from the EMRALD-1 trial. These improvements in progression-free survival over TACE alone could lead to a new standard of care for this patient population, according to the lead study author, Dr. Riccardo Lencioni.

More specifically, patients who received Imfinzi and Avastin plus TACE lived for a median of 15 months before death or disease worsening, compared to 8.2 months for patients who received TACE alone. This correlates to a 23% reduction in the risk of disease progression or death, and benefits were seen across different patient subgroups.

Notably, the researchers on EMRALD-1 are still monitoring how the addition of the two drugs impacts overall survival. Once those data become more clear, it is possible that the drug manufacturers could submit this regimen to the FDA for approval, thereby officially shaking up the standard of care of TACE, which has remained the main treatment in this setting for about two decades.

Cancer in Bloodstream May Predict CRC Outcomes

Circulating tumor DNA — also known as ctDNA — was another hot topic at the Gastrointestinal Cancers Symposium. So ctDNA measures little fragments of cancer that are found in the bloodstream after cancer treatment.

Now, findings from the BESPOKE trial highlight the fact that ctDNA may offer insight into the recurrence risk in patients with stage 2/3 colorectal cancer who underwent surgery and then chemotherapy. The researchers used ctDNA to help determine minimal residual disease, or MRD, status. Essentially, patients with disease still detected in the blood stream were MRD positive, while those without detectable cancer were MRD negative. Findings showed that those with MRD negativity tended to live longer without experiencing relapse or death compared to patients with MRD positivity.

Survival Benefits with Keytruda and Padcev in Advanced Urothelial Cancer

Back in December, the Food and Drug Administration approved Padcev plus Keytruda for patients with previously treated locally advanced or metastatic bladder cancer. The approval was based on primary findings from the EV-302 trial. Now, updated findings from that trial are showing that the drug duo continues to outperform chemotherapy when it comes to progression-free survival — that’s the time patients live before their disease gets worse — as well as overall survival, which is the time patients live before death of any cause.

Notably, these survival benefits were seen across patient subgroups, such as those with visceral metastases and lymph node-only disease. According to the lead study author, Dr. Michiel S. Van Der Heijden, this could result in a new standard of care in patients with locally advanced or metastatic urothelial carcinoma.

Many Patients Miss Out on Testing to Guide Prostate Cancer Treatment

On the prostate cancer front, a study found that many people with metastatic castration-resistant prostate cancer are not undergoing germline or somatic testing. Now this is really important because back in 2020, two PARP inhibitors were approved in this setting. These are targeted drugs approved for patients whose cancers have certain characteristics, which can be determined by these types of tests.

Rates of germline and somatic testing have increased since the FDA approvals, but according to the study — which looked at real-world evidence of patients being treated in community cancer and urology centers — about 40% of patients did not undergo standard-of-care testing.

Study author, Dr. Neal Shore, said that this indicates the need for improved education on the importance of germline and somatic testing.

For more news on cancer updates, research and education, don’t forget to 

Here are some of the top stories from the recent Gastrointestinal Cancers Symposium as well as the Genitourinary Cancers Symposium. 

Highlights from the Gastrointestinal and Genitourinary Cancer Conferences 

The FDA is certainly staying busy as 2023 comes to a close, approving three treatments for patients with cancer last week alone.

Additionally, exciting study findings were released regarding a cancer vaccine for the treatment of melanoma.

FDA Approves Iwilfin for High-Risk Neuroblastoma in Adults and Children

The FDA approved has Iwilfin (eflornithine) for the treatment of adult and pediatric patients with high-risk neuroblastoma who have shown at least a partial response to a previous multiagent modality therapy, which includes anti-GD2 immunotherapy.

Notably, the FDA reported that this drug is the first approval of a therapy used to reduce the risk of relapse in children with high-risk neuroblastoma. Neuroblastoma, as the National Cancer Institute explained on its website, is a cancer of immature nerve cells that most typically occurs in children, and often begins in the adrenal glands.

The FDA said the major efficacy outcome measure behind the approval was event-free survival (EFS; time after treatment when cancer does not come back or worsen; disease progression), while other notable findings included overall survival (OS; length of time from diagnosis or start of treatment when a patient is still alive).

FDA Approves Welireg for Advanced Kidney Cancer Subtype

The FDA approved Welireg ((beluztifan) for patients with advanced renal cell carcinoma (RCC) who have been previously treated with a programmed death receptor-1 (PD-1) or programmed death-ligand 1 (PD-L1) inhibitor, and a vascular endothelial growth factor tyrosine kinase inhibitor (VEGF-TKI).

The approval was based on findings from the LITESPARK-005 trial. Trial findings presented earlier this year at the European Society of Medical Oncology Annual Congress (ESMO) showed that at a median follow-up of 18.4 months, patients treated with Welireg experienced objective response rates (patients whose disease responded partially or completely to treatment) of 21.9%, compared with 3.5% among patients treated with Afinitor (everolimus), and 12-month progression-free survival (PFS; the time a patient lives without their disease spreading or worsening) rates were 33.7% on Welireg versus 17.6% with Afinitor, and 18-month PFS rates were 22.5% and 9%, respectively.

FDA Approves Padcev-Keytruda Combo in Advanced Bladder Cancer

The FDA has additionally approved Padcev (enfortumab vedotin-ejfv) plus Ketruda (pembrolizumab) for patients with locally advanced or metastatic bladder cancer. Alongside this, the FDA previously 

unable to be treated with cisplatin-containing chemotherapy

In the recent EV-302/KN-A39 trial, both OS and PFS showed significant improvements among the Padcev plus Keytruda group of patients, as the median overall survival for these patients was 31.5 months, while a cohort treated with chemotherapy experienced a median OS of 16.1 months.

Regarding progression-free survival, the median was 12.5 months for the Padcev-Keytruda combination group and 6.3 months in the chemotherapy group.

Cancer Vaccine Plus Keytruda Reduces Risk of Recurrence or Death in Melanoma

Patients with advanced-stage melanoma continue to experience reduced risk of recurrence or death following treatment with a combination of mRNA vaccine mRNA-4157 (V940), an investigational individualized neoantigen therapy (INT), and Keytruda, according to recent study findings.

The mRNA-4157 (V940) and Keytruda combination reduced the risk of recurrence or death by 49% and the risk of distant metastasis or death by 62% when compared with treatment with Keytruda alone in patients with stage 3 or 4 melanoma with high risk of recurrence following complete resection, as determined by 

 study, according to a news release from drug manufacturers Moderna and Merck.

The latest findings, from a median planned follow-up of approximately three years, build on previously announced primarily analysis data from a median planned follow-up of approximately two years which showed that the combination reduced the risk of recurrence or death by 44% and the risk of distance metastasis or death by 65% when compared with Keytruda alone.

Food and Drug Administration (FDA) granted Breakthrough Therapy Designation

 to the combination for the post-surgical treatment of patients with high-risk melanoma earlier this year.

Moderna and Merck have also announced the phase 3 INTerpath-001 (V940-001) clinical trial to evaluate the combination as an adjuvant treatment for patients with resected, high-risk stage 3B to 4 melanoma, which is currently enrolling participants, as well as a phase 3 trial for the treatment of patients with non-small cell lung cancer treated with the combination regimen.

The Food and Drug Administration recently approved treatment for some patients with neuroblastoma, kidney cancer and bladder cancer. Elsewhere, a cancer vaccine made headlines for the treatment of patients with melanoma.

FDA Approves 3 Treatments, Cancer Vaccine Shows Promise

It’s been more than 35 years since Peter Kahan and Dr. Ravi Munver first met. Back then, they were a teacher and his student, respectively. These days, the two men remain connected, but their relationship has evolved — Munver is now a key member of Kahan’s bladder cancer care team.

“To have to have a somebody who really looks upon you as a friend as (your) doctor, (who) really can see you as more than just another patient is great,” said Kahan, who described his connection with Munver, a urologic oncologist and vice chair of the department of urology at Hackensack University Medical Center in New Jersey, as “completely” crucial to his cancer journey.

“You know, there are a lot of physicians who are phenomenal,” said Munver. “But when you meet them, to them you're a patient, and they care for you as a patient. It's very different when you either have a personal relationship with a physician, or you have a physician who literally has a motto that says ‘I treat all of my patients like my friends and family,’ meaning if Peter walked in the door or a family friend walked in the door or a distant family member walked in the door, I would treat them all exactly the same. One would not get more time or better treatment than another. So, when you have physicians that have that model where they treat every patient as if they were their own family member or friend, you just get a different feel flavor and level of care.”

Kahan was Munver’s honors physics teacher at the Dwight-Englewood school in northern New Jersey in 1987, where he noted that Munver was “one of my best students. … He was extremely meticulous and careful in his work.”

“Of all the sciences that I took — biology, chemistry, physics — physics really came easy to me, because it was math-based,” Munver said. “And I just remember obviously trying to do well in the class, but also enjoying the material. You have a great teacher, a teacher who teaches the material, who loves the material and has a passion for it, it makes that class that much easier and more fun and enjoyable, especially when you're first semester senior applying to college. And once I'd gotten into college, obviously, it was just a continuation of just more fun and learning. So, I really enjoyed class and I think what I remember most about it was it was a topic that was easy for me but enjoyable and very different from all of the other natural sciences.”

The two men re-connected years later at a memorial service for a former teacher at Dwight-Englewood. Kahan, retired from teaching and living in upstate New York, discovered blood in his urine in 2019, and he subsequently received a diagnosis of high-grade non-muscle invasive bladder cancer from his local urologist.

Treatment with the immunotherapy bacillus calmette-guerin (BCG) and the chemotherapy mitomycin inserted directly into the bladder followed. When his cancer recurred, Munver’s doctors recommended he seek a cystectomy, or removal of the bladder and prostate, at Memorial Sloan-Kettering Cancer Center in New York City.

Kahan reached out to Munver, looking for a second opinion.

“As director of minimally invasive and robotic urologic surgery, I'm always looking at novel techniques, novel therapies that can offer patients good results, as well as a great quality of life,” said Munver. “And when Peter had told me about the traditional therapies that were being used, we use them as well. We use BCG. … When BCG fails, many urologists will jump to the next step, which is removal of the bladder. And that's what I learned in residency 22 years ago, and that's what people learned 30 years ago, and that’s what people learned 50 years ago, it was that was the only algorithm.

“However, a lot has changed, and I wanted to make sure that if he needed his bladder out, that (that) was the right thing to do. And it didn't have to be (done by) with me with robotic surgery, it could have been at any other institution of his choice. But at least I wanted to offer him a second opinion from someone who is in the academic space and knows all of the latest therapies out there.”

Munver surgically removed the tumor and treated him with the immunotherapy combination of BCG and interferon. When the tumor returned, Hackensack had received approval for the novel chemotherapy drug combination of gemcitabine and docetaxel, administered in liquid form directly into the bladder.

“In combination, the two medicines would really have a cancer cell destroying effect, and the clinical trials have been going on for years but we weren't able to accrue enough patients across the country and across the world to really see a demonstrable effect, we needed at least several year(s’ of) data to be able to say, ‘Yes, this works compared to our traditional therapies,’” Munver said.

“It's a massive undertaking to bring a new therapy to our patients, and we’d been working on it for months,” Dr. Nitin Yerram, director of urologic research at Hackensack, said in a statement. “Right when we were about to go live, Peter was looking for options.”

Studies have shown that up to half of patients respond to this novel therapy and are able to avoid surgery, Yerram said.

Kahan began treatment with the chemotherapy combination in January 2022, and he tells 

® it has been approximately a year and a half since any tumors were found, through florescence in situ hybridization (FISH) tests, which check for chromosomal multiplications, have come back positive. “It's not necessarily that there are cancer cells, but there are cells that have a tendency to increase their proliferation. And we often see those in cancer cells,” Munver said.

“We have several patients who are on this therapy right now, and several of the patients do have a positive urine test, but there's visibly no evidence of tumor I can see,” said Munver. “And I can see tumors as small as one to two millimeters. … As I mentioned to Peter, if the tumors return, basically the bladder cancer will declare itself and to this point, it is not, and we are just monitoring him very closely. And you know, we cross our fingers and hope that this therapy keeps him with a really good quality of life for many years to come.”

In this episode of the “Cancer Horizons” podcast, Kahan and Munver speak with 

about the importance of their friendship and their decision to embrace a new treatment option.

Hackensack Meridian John Theurer Cancer Center

“I treat all of my patients like my friends and family,” said Dr. Ravi Munver of Hackensack University Medical Center, who first met Peter Kahan as his honors physics teacher more than 35 years ago.

Retired Teacher Turns to Former Student for Innovative Bladder Cancer Care

James R. Scott served in the army during the Vietnam War and was consequently exposed to the Agent Orange. He was later diagnosed with bladder cancer, 

which was recently recognized by the U.S. Department of Veterans Affairs as a potential effect

In this episode of the “CURE® Talks Cancer” podcast, Scott shares his story and reacts to the VA’s update.

“Had I not had good insurance, you know, Lord only knows where I would be today,” said Scott. “And that's the thing that hurts, because there are so many people out there – so many former military people – who do not have good insurance, (and) they possibly did not get any treatment. They may have just died.”

In this episode of the “CURE® Talks Cancer” podcast, a cancer survivor who served in the Vietnam War shares the story of his Agent Orange exposure and bladder cancer.

Vietnam Veteran Discusses Agent Orange Exposure and Bladder Cancer

After spending 15 years working in cancer research, Henry Scowcroft’s scientific understanding of the disease was quickly made personal when his fiancée, Zarah Harrison, was diagnosed with stage 4 bladder cancer in 2016.

Although Harrison died nine months after her diagnosis, the memories of their love and the difficult journey of Harrison’s illness inspired Scowcroft to write his first book, “Cross Everything.”

“I think there's a degree to which I had to write the book, because I had to get it out of my head and down on paper to make sense of it,” said Scowcroft. “But also, I felt like there were insights, there were things I discovered about cancer that really surprised me. And I figured that, in writing it down, it might be helpful to other people.”

® Talks Cancer” podcast, Scowcroft discusses his experiences writing the book and offers his advice for other caregivers.

In this episode of the “CURE® Talks Cancer” podcast, Henry Scowcroft discusses his experiences writing a book about his late wife’s cancer journey and offers advice for other caregivers.

A Cancer Research Writer Turns His Pain Into Hope For Others

One pediatric oncology nurse’s experience came full circle when she herself was diagnosed with bladder cancer in 2010, and went on to serve as her husband’s caregiver for the same disease just six years later.

In a letter to her younger self — through Merck’s Your Cancer Game Plan “With Love, Me” campaign – Karen opened up about her experiences as both a patient and caregiver, and how outside support helped.

“And then one day, complete shock and disbelief. After two years, you’ll become the caregiver as your husband is diagnosed with bladder cancer. You’ll both realize this new journey is paved by what you learned and experienced,” she wrote.

In this week’s episode of the “CURE Talks Cancer” podcast, we spoke with a bladder cancer survivor turned caregiver about the advice she would give her newly-diagnosed self.

From Patient to Cancer Caregiver

The withdrawal of the FDA accelerated approval for locally advanced or metastatic urothelial carcinoma, a type of bladder cancer, does not affect other indications of the therapy.

FDA Approval of Trodelvy Withdrawn for Urothelial Carcinoma

The FDA has accepted a new drug application for the intravesical solution of UGN-102 in low-grade intermediate-risk non–muscle-invasive bladder cancer.

Bladder Cancer

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