Targeted therapy hope for bladder cancer patients

PATIENTS with a common cancer could be given targeted therapy thanks to a breakthrough scientists hope could lead to a new test to pinpoint which sufferers benefit most from alternative treatments.

The work by Cancer Research UK scientists at the Leeds Institute of Molecular Medicine and Oxford University pinpointed a molecule in cells which predicts the success of radiotherapy in treating individual bladder cancer patients.

In the study, they examined the quantity of a DNA repair protein called MRE11 in the bladder tumour tissue of 86 patients before radiotherapy.

They found that around 70 per cent of patients with high amounts of MRE11 survived at least three years after radiotherapy compared with around 40 per cent of those with low levels.

In 20 to 30 per cent of cases, tumours invade the muscle wall of the bladder, requiring either surgery to remove the tumour along with the bladder or alternatively radiotherapy treatment.

Treatment choices are largely decided by patient preference and the expertise of doctors as there are currently no means of predicting whether radiotherapy or surgery would be better for each patient.

Both treatments lead to similar survival rates. But if predictive markers could be identified, patients could be selected for the treatment most likely to benefit them personally and in some cases could avoid surgery which has a serious impact on quality of life.

Study author Anne Kiltie, Cancer Research UK clinical group leader at the Gray Institute for Radiation Oncology and Biology at Oxford University and formerly from Leeds University, said if further work confirmed the findings, a trial could be carried out to see if the molecule could be used to select patients for radiotherapy or surgery.

“This could lead to a test being developed to identify if a patient will respond well to radiotherapy and enable doctors in the future to personalise their treatment plan,” she said.

Bladder cancer is the seventh most common cancer in the UK. Each year in the UK around 10,300 mainly elderly people are diagnosed with the disease. There are more than twice as many cases of bladder cancer in men than women.

Lesley Walker, Cancer Research UK’s director of cancer information, said significant investment was being made in developing more personalised ways to treat patients based on tiny differences in the genetic makeup of cancer.

“Our researchers are identifying exactly what goes wrong in cancerous cells and they're making more discoveries such as this. Now they're in the process of linking these discoveries to targeted and increasingly more effective treatments,” she said.