New treatment options
A great deal of research is underway to develop knowledge in the fight against bladder cancer. With scientific discussions, new studies, and clinical trials of immunotherapies and target drugs happening worldwide, it means that encouraging new treatments are being offered.
Immunotherapy
The role of our natural immune system is to fight off foreign, unwanted things in the body that can cause damage, such as infections or cancer. However, cancer is often very good at hiding from the body’s natural defences.
Immunotherapy is a type of therapy for cancer that teaches the body’s immune system to fight the cancer. Just as we each have traits that make us different to others, cancers also have traits that make them different to normal cells and other types of cancer.
Immunotherapy differs from chemotherapy because, whilst chemotherapy works to kill cancer cells directly, immunotherapy trains your natural immune defence system to recognise the cancer cells and kill them itself. Some patients have found it difficult to distinguish between the types of treatment, so if you are unclear, do keep asking questions.
A simple reminder is in the names of the treatments: chemotherapy uses chemicals, while immunotherapy supports the immune system.
Immunotherapy drugs
Immunotherapy drugs include:
- atezolizumab (pronounced a-teh-zoh-LIZ-yoo-mab) (Tecentriq®)
- avelumab (pronounced a-VELL-eu-mab) (Bavencio®)
- cetrelimab (pronounced se-TREL-ee-mab)
- durvalumab (pronounced dur-VAL-yoo-mab) (Imfinzi®)
- nivolumab (pronounced niv-OL-yoo-mab) (Opdivo®)
- pembrolizumab (pronounced pem-broh-LIH-zoo-mab) (Keytruda®)
- sasanlimab (pronounced sa-SAN-lee-mab)
- tremelimumab (pronounced treh-meh-LIM-moo-mab) (Imjudo®)
Some of these drugs are not yet available on the NHS for bladder cancer but may be available by enrolling in a clinical trial.
Targeted therapies
Targeted therapies work differently from chemotherapy or immunotherapy. They are drugs that block the growth of cancers by acting on specific weaknesses in some cancer cells.
Unlike immunotherapy treatments, which focus on helping the immune system to destroy the cancer, targeted therapies focus on the cancer itself. Researchers look at the DNA and protein of specific cancers and try to isolate what is unique about them. When that can be defined, researchers can identify the cancer’s ‘Achilles’ heel’ and find ways to destroy it.
Targeted therapy drugs
Targeted therapies include:
- entrectinib (pronounced en-TREK-tih-nib) (Rozlytrek®)
- erdafitinib (pronounced er-da-FI-tih-nib) (Balversa®)
- larotrectinib (pronounced LAR-oh-TREK-tih-nib) (Vitrakvi®)
- rogaratinib (pronounced row-gah-RAT-tih-nib)
- pemigatinib (pronounced pem-ee-GAT-ihn-nib) (Pemazyre®)
- tucatinib (pronounced too-KA-tih-nib) (Tukysa®)
- TYRA-300 (pronounced tie-RAH-three-hundred)
Some of these drugs are not yet available on the NHS for bladder cancer but may be available by enrolling in a clinical trial.
Antibody drug conjugates
Antibody-drug conjugates work by combining chemotherapy with an antibody that seeks out cancer cells. They deliver chemotherapy directly to specific locations in the body. This is different from traditional chemotherapy drugs, which target all cells, including cancer cells and healthy cells.
Antibody drug conjugates
Antibody drug conjugates include:
- disitamab vedotin (pronounced dis-ee-TAM-ab ve-DOE-tin) (Aidixi®)
- enfortumab vedotin (pronounced en-FORT-ue-mab ve-DOE-tin) (Padcev®)
- sacituzumab govitecan (pronounced SAK-ih-TOO-zoo-mab GOH-vih-TEE-kan) (Trodelvy®)
- trastuzumab deruxtecan (pronounced tras-TOOZ-ue-mab der-UX-te-kan) (Enhertu®)
These drugs are not yet available on the NHS for bladder cancer but may be available by enrolling in a clinical trial.
Genomic testing
Are you living in the UK with high-risk, muscle-invasive, advanced or inoperable bladder cancer? You can ask your doctor for a genomic test to look inside the DNA of your cancer.
Cancer is a disease where cells grow out of control, divide and invade other tissues. In a person without cancer, cell division is under control. With cancer, this normal cell division goes out of control. Cells change their nature because mutations have occurred in their DNA. DNA, short for deoxyribonucleic acid, is the molecule that contains the genetic code of the cancer.
Different treatments might work for you if you have certain patterns in your cancer’s DNA. Your doctor will take a piece of your cancer tumour and send it to a lab to look at the DNA inside the cancer and see if your cancer cells have particular patterns in their DNA.
England
Give the Clinician’s guide for requesting whole genome sequencing: cancer to your doctor.
Aberdeen
Give your doctor the link to the Clinical genetics service for the North of Scotland and ask them to contact gram.molgen@nhs.scot
Dundee
Give your doctor the link to the East of Scotland Regional Genetics Service and ask them to contact tay.esrg@nhs.scot
Edinburgh
Give your doctor the link to the South East Scotland Genetic Service and ask them to contact edinburgh.dna@nhslothian.scot.nhs.uk
Glasgow
Give your doctor the link to the West of Scotland Centre for Genomic Medicine and ask them to contact Genetic.Laboratories@ggc.scot.nhs.uk
Wales
Give your doctor the link to the All Wales Medical Genomics Service and ask them to contact WCN.WalesCancerNetwork@wales.nhs.uk
Northern Ireland
Give your doctor the link to the Molecular Diagnostics at the Precision Medicine Centre and ask them to contact m.salto-tellez@qub.ac.uk
Early access to medicines scheme
The early access to medicines scheme (EAMS) aims to give patients with life-threatening or serious conditions access to medicines that are not yet on the NHS, when there is a clear unmet medical need. You can ask your doctor if any treatments available on the early access to medicines scheme might be suitable for you.
Questions to ask your doctor
If you have non-muscle invasive bladder cancer – ask your doctor:
- What clinical trials are available for patients like me?
- Am I suitable to join a clinical trial?
If you have advanced cancer, metastatic cancer, or muscle-invasive bladder cancer – ask your doctor:
- Can I receive immunotherapy or targeted treatment under the NHS?
- What clinical trials are available for patients like me?
- Am I suitable to join a clinical trial?
You could also print out our lists of clinical trials recruiting bladder cancer patients in the UK and outside the UK. Take the appropriate list to your next appointment and discuss options with your medical team.
Downloads
Lab tests
A bladder cancer glossary
Talking to your consultant
To see a full set of our downloads please see our Downloads page.