This month has seen an initial patient recruited to the DURANCE trial — the first study of bladder cancer treatment coordinated by the CTC in its 25-year history. The trial will be investigating treatment for patients with a specific type of the disease.
Bladder cancer accounts for 3% of new cancer cases in the UK annually, with over 10,000 diagnoses made each year. In 70% of these cases the cancer is found in the tissue that lines the inner surface of the bladder and does not affect the bladder muscle. This is known as non-muscle-invasive bladder cancer (NMIBC). NMIBC is usually treated by removing as much of the cancer tumour as possible, followed by further treatment with the BCG vaccine (which was initially developed to be used against tuberculosis).
However, when bladder cancer is treated, a risk of the cancer remaining or returning is still present. DURANCE’s chief investigator Dr Mark Linch explains: ‘Unfortunately, cancer recurrence is a common event despite optimal treatment. Due to the risk of progression to a more invasive and aggressive form of bladder cancer, the complete removal of the bladder is required when local treatments become ineffective.’
DURANCE will investigate whether bladder removal can be avoided (or at least delayed) for NMIBC patients with recurrent or persistent disease after initial treatment. Patients taking part in the study will receive a drug called durvalumab as well as a cancer vaccine, which are designed to trigger the immune system to target cancer cells. Dr Linch reiterates: ‘DURANCE will look to determine whether this treatment can stimulate an immune reaction against the cancer and, ultimately, avoid or delay the need for surgery.’
DURANCE was opened to recruitment last month at University College London Hospitals NHS Foundation Trust. The trial will aim to recruit 64 patients over a two-year period. You can find more information on the dedicated trial web page.
Image shows University College
Hospital building, part of UCLH, where the first DURANCE patient was recruited; photograph by Mary Hinkley