Bladder cancer patients who receive an immunotherapy drug are a third less likely to have the disease return and are more likely to survive, according to a game-changing study.
Patients with advanced (muscle invasive) bladder cancer had a significantly lower risk of the cancer progressing or coming back when treated with durvalumab, and were more likely to be alive two years after treatment.
Experts from the University of Sheffield and the Barts Cancer Institute at Queen Mary University of London included 1,063 patients with operable bladder cancer in their study.
Patients received standard chemotherapy (cisplatin and gemcitabine) and surgery (530 people), or chemotherapy plus durvalumab before surgery and eight cycles of durvalumab after surgery (533).
The late-stage Phase 3 clinical trial found that patients were 32 percent less likely to experience cancer recurrence or progression if they received immunotherapy, and were more likely to be alive after two years.
Two-year overall survival was 82.2 percent in the durvalumab group and 75.2 percent in the comparison group.
Durvalumab (brand name Imfinzi) is a treatment for non-small cell lung cancer (NSCLC), but it is also being tested in other cancers.
James Catto, professor of urology at the University of Sheffield and honorary consultant urological surgeon, who co-led the study, said: “This is an important advance in the treatment of bladder cancer.
Patients with advanced (muscle-invasive) bladder cancer had a significantly lower risk of the cancer progressing or coming back when treated with durvalumab (file image)

Patients received standard chemotherapy (cisplatin and gemcitabine) and surgery (530 people), or chemotherapy plus durvalumab before surgery and eight cycles of durvalumab after surgery (533) (file image)

Durvalumab (brand name Imfinzi) is a treatment for non-small cell lung cancer (NSCLC), but it is also being tested in other cancers.
‘For many years, survival rates for advanced bladder cancer have remained stagnant, but our findings offer hope to thousands of patients facing this devastating diagnosis.
‘Patients treated with durvalumab before and after surgery had significantly higher survival rates and lower risks of the cancer coming back and did not face any additional serious side effects.
‘This is important for patients undergoing chemotherapy and its numerous and often debilitating side effects.
‘Our hope is that this treatment can be made available to NHS patients as soon as possible following regulatory approval from the Medicines and Healthcare products Regulatory Agency, and that it becomes the new standard of care.
“Recent research suggests that bladder cancer cases will increase by 50% over the next two decades, but yet awareness of bladder cancer in the UK remains low.”
The trial was funded by AstraZeneca and the results were published in the New England Journal of Medicine.
Currently, about half of patients with muscle-invasive bladder cancer experience a recurrence within three years.
Syed Hussain, professor and honorary consultant in medical oncology at the University of Sheffield and Sheffield Hospitals NHS Foundation Trust and principal investigator of the trial, said: “The magnitude of the survival benefit observed will undoubtedly be a game-changer.”

Experts from the University of Sheffield and the Barts Cancer Institute at Queen Mary University of London (pictured) included 1,063 patients with operable bladder cancer in their study.

For many years, survival rates for advanced bladder cancer have remained stagnant (file image)
He added: “These are exciting times in the treatment of muscle-invasive bladder cancer.”
‘We had not observed any additional survival benefit in previous trials investigating additional treatments in combination with standard cisplatin-based chemotherapy before surgery.
“By introducing these exciting new treatments at an earlier stage of the disease, we will continue to see more patients cured of muscle-invasive bladder cancer.”
The study’s senior author, Thomas Powles, professor of genitourinary oncology at the Barts Cancer Institute, Queen Mary University of London, said: “In (the) NIAGARA (trial), we showed for the first time that adding immunotherapy to chemotherapy increases the overall survival rate. This is a big step forward for these patients.’
Ian Flower, 63, from Sheffield, took part in the NIAGARA trial, which was carried out at Sheffield Teaching Hospitals NHS Foundation Trust, after he was diagnosed with operable bladder cancer.
“I was happy to be able to help with the trial, not just for myself, but in the hope that it could help other patients,” he said.
“It’s nice to know that the trial had positive results and I hope it can be made available to other patients.”