A new type of drug that reduces deaths from bladder cancer could also replace chemotherapy for other cancers.
The drugs, known as antibody-drug conjugates (ADCs), perform chemotherapy-like attacks on cancer cells, but do not cause side effects such as hair loss, fatigue, and nausea.
The treatment is very precise and targets tumors without damaging healthy tissue, so doctors can give high doses.
Early research with the ADC drug enfortumab vedotin in bladder cancer has already shown that it reduces deaths by a third – and trials are underway to test the effectiveness of the experimental therapy in breast and prostate cancer.
Professor Thomas Powles, oncologist, director of the Barts Cancer Center and UK lead investigator for the trial, says ADCs mark ‘a new chapter’ in cancer treatment and may even lead to a cure.
The drugs, known as antibody-drug conjugates (ADCs), perform chemotherapy-like attacks on cancer cells, but do not cause side effects such as hair loss, fatigue, and nausea
He says, “Chemotherapy is a rather blunt tool. When chemotherapy drugs enter your body, they damage cancer cells as well as your healthy cells.
This causes side effects such as hair loss and nausea.
‘ADCs are able to transport cancer-killing drugs directly to the cancer cells with limited effect on the rest of the body. This treatment allows more patients to live relatively normal lives for longer.
“We are still in our infancy, but this could eventually completely replace chemotherapy.”
ADCs are artificial antibodies – similar to those naturally produced by the immune system, but designed to hunt for a particular protein found in cancer cells. They are also made to carry a ‘load’ of chemotherapy drugs.
When they find their target, they attach and deliver the dose directly into the tumor.
The technology allows doctors to tackle the cancer with larger amounts of medication without fear of seriously damaging the body.
Prof Powles says: ‘Different cancers create different proteins and ADCs can be adjusted depending on the cancer. In addition, the load can be any type of cancer-killing drug you need. ‘
Strange science: woman who cried tears of blood …
Tears of blood may sound like macabre fiction, but in fact it is a rare medical condition.
The British Medical Journal reported this month of such a bizarre case: a 25-year-old Indian woman who had been to a hospital in Chandigarh, North India, complained that blood was coming from her eyes.
Doctors diagnosed alternate periods.
Experts say this is not a true period, but it is thought that hormonal changes in the body can weaken the already thin blood vessels, causing bleeding in the blood vessels that connect to the eye.
Doctors stopped the woman’s bleeding by prescribing the birth control pill.
Data published last month from Prof Powles’s study with ADC enfortumab vedotin showed encouraging results. The trial included patients with advanced bladder cancer that had spread to other organs.
These patients usually do not live longer than six months on average. For those taking enfortumab vedotin, survival more than doubled to an average of 13 months.
The therapy is not without its drawbacks – patients have rashes and pins and needles are common, but this can be managed.
Every year more than 10,000 Britons are diagnosed with bladder cancer. When the disease spreads to other organs, as it often does, it becomes almost incurable – and more than 5,000 Britons die from it every year.
Many patients undergo major surgery to remove the bladder and other surrounding organs before undergoing chemotherapy. They can also receive radiotherapy or immunotherapy.
But over time, all treatments become ineffective for bladder cancer.
Patients in the ADC study received enfortumab vedotin after exhausting all other treatments. They visit the hospital once a week for three out of four weeks in a month, where the drug is administered via an IV.
The treatment takes an hour. They will often last for up to a year, depending on how well their cancer responds to the drug.
One patient who underwent the treatment was Peter Smith, 74, a retired plumber from London. Four years ago, he was diagnosed with advanced bladder cancer after noticing blood in his urine that had spread through his pelvis and into his lungs.
He says, “I wasn’t sure how much longer I had.”
Peter was enrolled in the ADC study and started on enfortumab vedotin 18 months ago – and his cancer stopped growing. He says, “I felt an enormous weight off my shoulders, knowing the cancer was under control.”
After 12 months, Peter stopped treatment and now has scans every six weeks to monitor the cancer.
Upcoming studies will explore the effects of a combination of ADCs and immunotherapy.
Prof Powles says, “If we could use ADC to control the cancer, while immunotherapy trains the body to fight the cancer itself, we could soon be talking about a cure for this terrible cancer, as well as for others.”