For bladder cancer patients who cannot have standard chemo, a new pairing left no trace of cancer in nearly half

When bladder cancer grows into the muscle of the bladder wall, the usual path is major surgery to remove the bladder — and many patients are too frail, or their kidneys too weak, for the standard chemotherapy that normally comes first. In a 695-person trial called VOLGA, people in exactly that position did markedly better when two newer drugs were added around their surgery: durvalumab, an immune therapy that helps the body's own defences attack cancer, and enfortumab vedotin, a drug that carries chemotherapy straight to cancer cells. Given before surgery, with durvalumab continued afterwards, the pairing left no trace of cancer at surgery in 45% of patients, against 10% with the surgery-based approach alone. Two years on, 64% had seen no return or spread of their cancer, against 45%, and 78% were alive, against 69% — a 42% lower risk of death. Serious treatment-related side effects affected 30% of patients on the pairing, in line with what is already known about these drugs. The results are from a planned early look at the data, presented on Saturday at Europe's main cancer congress in Madrid by a team led by Thomas Powles of London, and longer follow-up is still to come.

SDG 3 · Good health and well-being — Mechanism: tech innovation