Four new drugs approved for metastatic bladder cancer!

In the past month, the FDA has approved four new immunotherapy drugs for treatment of locally advanced or metastatic bladder cancer. On April 17, FDA granted accelerated approval to Genentech/Roche’s Tecentriq (atezolizumab). On May 1, AstraZeneca’s MedImmune division earned FDA’s approval to Imfinzi (durvalumab). On May 9, FDA approved Bavencio (avelumab), a drug from EMD Serono, a partnership of Merck and Pfizer. And on May 19, FDA approved another Merck drug named Keytruda (pembrolizumab). All 4 drugs are approved for bladder cancer patients who either have failed chemotherapy (second line therapy), or first line therapy for patients who are chemo ineligible, usually due to kidney problems or other co-morbidities.

This is great news. One of the press releases quoted on of my doctors, Andrea Apolo of the NCI, as saying that "until recently, there had been limited innovation in urothelial carcinoma, and this approval gives us another treatment to help battle this aggressive disease." She added: "Once urothelial carcinoma progresses after treatment with chemotherapy, the five-year survival rate is alarmingly low."

At last Friday's Hopkins presentation regarding bladder cancer, the panelists were encouraged by these recent approvals. They noted how studies are ongoing to determine if immunotherapy is more effective than chemotherapy, which would make these drugs a first line therapy for everyone with metastatic bladder cancer. Other trials are evaluating whether immunotherapy might be able to reduce the number of radical cystectomies. Although those results are several years away, the breakthrough of these new therapies is very hopeful.

Other targeted therapies are also being studied. This week a new article was published evaluating a drug that regains control of cell cycle deregulation, which is a key driver of bladder cancer disease progression. The article provides an overview of the current status of those CDK4/6 inhibitors in cancer therapy, their potential use in muscle-invasive bladder cancer, and the challenges for their clinical use.

Big pharma has invested billions of dollars in developing these new drugs, and they are saving lives. Keep it up, people!