An anticancer drug that is commonly used to treat lung and colon malignancies is having a benefit and potentially prolonging survival in patients with invasive bladder cancer, researchers reported at the 2009 Clinical Congress of the American College of Surgeons. Results from the first phase II trial-conducted to test the effects of erlotinib on patients with bladder cancer that has invaded the muscle layer-revealed that 16 of 25 patients are still alive 25 months after being treated with the drug before a surgical procedure, and 10 of these patients have no evidence of disease.
These survival statistics are better than those achieved with standard treatment for invasive bladder cancer, which involves surgical removal of the bladder as well as involved muscle [radical cystectomy], the researchers reported. "Bladder cancer is an unforgiving disease. Surgery represents our best chance at controlling and curing invasive bladder cancer, but still only 50 percent of patients undergoing definitive surgical therapy will experience long-term disease-free survival. In those patients who recur after surgery, survival benefits with standard chemotherapy are limited and many patients ultimately succumb to the disease-often within two years. In our study, six patients did die of the disease, but that is much less than 50 percent," according to Angela Smith, MD, a surgical resident in the division of urologic surgery at the University of North Carolina, Chapel Hill.
After treatment with erlotinib, 75 percent of the patients in the clinical trial had organ-confined disease. All patients had muscle invasive disease at the outset of the study. Following a four-week course of oral erlotinib, 25 percent of the patients were pathologically free of disease and 35 percent were pathologically down-staged to indicate they now had super-ficial cancer involvement of the bladder-numbers typically higher than observed with surgery alone. "Fifteen out of 20 patients ended up with disease that was confined to the bladder, and this [result] is very positive because patients have the best chance of cure if the disease is organ-confined," explained Dr. Smith.