Pioneering trial will test DNA in the TUMOURS of patients with advanced bladder cancer – allowing doctors to prescribe personalised drug treatments

A pioneering UK trial will allow patients with advanced bladder cancer to receive personalised drug treatments depending on the DNA in their tumours.

Currently the deadly disease is treated using chemotherapy, surgery and sometimes radiotherapy. However, research suggests some patients would do better on new drugs known as immunotherapy that are tailored to boost an individual’s immune system.

Other patients do not respond to either chemotherapy or immunotherapy and their only hope is immediate surgery to try to root out the tumours.

But scientists now believe they can predict which treatment is best suited for patients depending on the genetic traits of the cancer itself.

In a first-of-its-kind trial, about 160 patients will receive treatment tailored to the DNA of their cancer. Researchers hope the study will fundamentally change the way cancer is treated on the NHS and will ultimately save thousands of lives.

Currently, bladder cancer is treated using chemotherapy, surgery and sometimes radiotherapy

‘Most advanced bladder cancer patients receive the same treatment even though it works better for some and much worse for others,’ says Professor James Catto, a urological surgeon and chief investigator of the study at Sheffield Teaching Hospitals NHS Foundation Trust. ‘Survival rates for bladder cancer have remained unchanged for nearly three decades. We hope this trial could change that.’

Each year about 5,000 people in the UK die from bladder cancer, which affects 10,000 annually. If spotted early it can usually be cured using surgery or drug therapies.

In 2020, artist Tracey Emin revealed she had been diagnosed with it. She underwent operations to remove her bladder and other pelvic organs, and is currently cancer-free.

However, if the disease spreads into surrounding organs then it almost always becomes incurable.

In the new trial, taking place at 20 sites around the country and funded by the National Institute for Health and Care Research, half of the 320 participants will receive the current standard treatment – three months of chemo followed by surgery – while the other half will get a tailored treatment plan based on the DNA of their cancer.

Participants will need to have bladder cancer which is in danger of spreading but has not yet left the organ.

Of the patients who receive the personalised treatments, those whose tumours show signs of resistance to chemotherapy will instead undergo surgery straight away. Those whose cancer has genetic traits which suggest it is responsive to immunotherapy will receive these drugs in place of chemo, before receiving surgery.

‘Not all forms of bladder cancer are the same,’ says Prof Catto. ‘Treatment of the disease should reflect that.’