Insight into a disease predominantly influencing males, as highlighted by Deion Sanders' ongoing health struggle
In the realm of cancer research, progress is being made in the treatment of bladder cancer, a disease that affects tens of thousands of individuals each year. Here's a look at some of the latest developments in bladder cancer treatment.
Bladder cancer is more common in men than women, and smoking is the biggest risk factor, according to the American Cancer Society. Other risk factors include exposure to certain chemicals in jobs such as painting, metal and leather work, mining, and firefighting. The disease is the 10th leading cause of cancer death in the United States, with a five-year relative survival rate of 72% to 97% when it has not spread outside the bladder. However, the survival rate drops significantly if the cancer has spread to lymph nodes or other nearby parts of the body.
Recent advancements in aggressive bladder cancer treatment have significantly improved patient outcomes. For high-risk non-muscle-invasive bladder cancer that has resisted previous treatments, the novel TAR-200 drug delivery system administers gemcitabine directly into the bladder, releasing the drug slowly over three weeks per cycle. In a phase 2 clinical trial, this approach eliminated tumors in 82% of patients, with many cancer-free after three months and about half remaining cancer-free after one year. This method overcomes limitations of traditional gemcitabine delivery and offers a major improvement in treatment efficacy for this common bladder cancer form.
In metastatic or unresectable bladder cancer, combining enfortumab vedotin (an antibody-drug conjugate that targets cancer cells) with pembrolizumab (an immunotherapy checkpoint inhibitor) has doubled patient survival times compared to chemotherapy alone. This regimen also more than doubles the duration of cancer remission. Approved on the NHS, this treatment is a major step forward for patients with advanced disease.
For muscle-invasive bladder cancer (MIBC) where patients are ineligible for cisplatin-based chemotherapy, the KEYNOTE-905 (EV-303) phase 3 trial demonstrated that neoadjuvant and adjuvant treatment with pembrolizumab plus enfortumab vedotin significantly improved event-free survival, overall survival, and pathologic complete response rates compared to surgery alone. This combination therapy is the first systemic treatment showing clear survival benefits in this population, addressing a previously unmet clinical need.
Collectively, these recent advancements—novel local drug delivery for non-muscle-invasive disease, combination immunotherapy/antibody-drug conjugates for metastatic disease, and systemic therapy improving survival in muscle-invasive disease—represent major progress in aggressive bladder cancer management, providing new hope through improved survival and longer-term remission for patients traditionally facing poor outcomes.
Notable cases include Deion Sanders, the Colorado football coach, who was diagnosed with an aggressive form of bladder cancer earlier this year. Sanders underwent surgery to remove his bladder and is now considered cured by his doctors. Symptoms of advanced bladder cancer can include an inability to urinate, bone pain, loss of appetite, weakness, swollen feet, and lower back pain on one side. The most common symptom of bladder cancer is blood in the urine. Long-term use of a urinary catheter increases the risk of bladder cancer.
The incidence rate of bladder cancer has decreased by 1% per year in recent years. The American Cancer Society predicts 85,000 new bladder cancer cases in 2025, with over 65,000 in men. The five-year relative survival rate is 9% if the cancer has spread further. Death rates for bladder cancer have remained relatively stable, declining by 1% per year since 2013.
Treatment options for bladder cancer include surgery, radiation, chemotherapy, targeted drug therapy, and immunotherapy. It's important for individuals with symptoms or a family history of bladder cancer to consult with their healthcare provider for regular screenings and early detection.
[1] TAR-200 in Non-Muscle-Invasive Bladder Cancer: Phase 2 Study Results [2] FDA Approves Enfortumab Vedotin for Advanced Bladder Cancer [3] Pembrolizumab plus Enfortumab Vedotin in Urothelial Carcinoma [4] TAR-200: A New Hope for High-Risk Bladder Cancer Patients [5] Pembrolizumab plus Enfortumab Vedotin Shows Promise in Muscle-Invasive Bladder Cancer
- The TAR-200 drug delivery system, which administers gemcitabine directly into the bladder, has shown promising results in patients with high-risk non-muscle-invasive bladder cancer, with a high elimination rate of tumors and improved five-year survival rates.
- The application of enfortumab vedotin, an antibody-drug conjugate that targets cancer cells, in combination with pembrolizumab, an immunotherapy checkpoint inhibitor, has doubled the survival times of patients with metastatic or unresectable bladder cancer, while also increasing the duration of cancer remission.
- In cases of muscle-invasive bladder cancer, the use of pembrolizumab plus enfortumab vedotin as neoadjuvant and adjuvant treatment has significantly improved event-free survival, overall survival, and pathologic complete response rates compared to surgery alone, offering a new systemic treatment with clear survival benefits.
- The novel local drug delivery method for non-muscle-invasive disease, the combination immunotherapy/antibody-drug conjugates for metastatic disease, and systemic therapy improving survival in muscle-invasive disease represent major advancements in aggressive bladder cancer management, providing new hope through improved survival and longer-term remission for patients.
- Deion Sanders, the Colorado football coach, underwent surgery for an aggressive form of bladder cancer and is now considered cured by his doctors, demonstrating the potential positive impact of these advancements on bladder cancer outcomes.
