We talk to Dr. Iwona Skoneczna from the National Institute of Oncology. Maria Skłodowska-Curie National Research Institute, Grochowski Hospital Rafał Masztak, MD, PhD.
MRS
Bladder cancer: it's time to change treatment standards
Published Feb. 7, 2022 12:09
Fot. MedExpress TV
- Poland is one of the countries with a high incidence of bladder cancer and high cancer mortality.
- Early diagnosis is a problem. A large proportion of patients present with invasive and advanced disease.
- If the cancer becomes invasive, the patient is offered a major surgery to remove the bladder with surrounding organs. Unfortunately, bladder cancer has a tendency to grow into blood vessels and is capable of distant metastasis.
- In the case of systemic disease in Poland, we use chemotherapy.
- We have evidence that immunotherapy works for these patients. We know that when relapse occurs after chemotherapy, we can use immunotherapy.
- We also know that it is better not to wait for the disease to come back after chemotherapy but to strengthen the treatment effect by giving early immunotherapy.
- Such a drug is avelumab, which has advantages in treating relapse after chemotherapy, with long survival times and relatively little toxicity for immunotherapy.
- When administered as maintenance treatment, Avelumab gives overall survival gains over 7 months - results that we have not seen for a long time in the bladder.
- In turn, for patients in whom immunotherapy did not work, there are more drugs. We have a drug waiting for European approval - enfortumab vedotin.
- Fortunately for these patients, treatment and survival options are emerging.
- We should continue to work on primary prevention, shorten the path of the patient.
- In the case of invasive cancer, there should be a quick decision to radical surgery, possibly to add chemotherapy, and in the case of metastatic disease and reaction to chemotherapy, it is important to refer patients to centers that have access to early maintenance immunotherapy avelumab.
- And when chemotherapy is not working, we would like to have access to immunotherapy for patients in this group as well.
