New gene therapy for bladder cancer offers better chance to avoid bladder removal

When we think of smoking-related cancers, lung cancer usually comes to mind.

But smoking is also a major driver for bladder cancer.

Now, a new treatment has come to Philadelphia to help more patients keep their quality of life.

Dr. Rosalia Viterbo, a urologist at Fox Chase Cancer Center, says bladder cancer patients used to be mostly older adults.

Not anymore.

"We've started to see it now in younger adults," reflecting the younger shift in cancer overall.

Of the country's 83,000 new cases a year, most are male, and most are current or former smokers.

Dr. Viterbo says carcinogens in tobacco - or vaping - get into the bloodstream, then pass through the kidneys into the bladder.

To diagnose this cancer, doctors use a tiny camera, looking for growths or abnormalities on bladder walls.

"Once the cancer is diagnosed, then we assess if it's low-grade or high-grade, whether it's on the surface or deeper. The stage of the tumor often dictates the treatment," she explains.

Treatments range from surveillance (retesting) every three months to bladder removal.

Recently, the FDA approved Adstiladrin, the first gene therapy for bladder cancer.

It's for patients whose cancer returns after the standard treatment BCG, Bacillus Calmette-Guerin.

A modified gene attached to a killed virus goes directly into the bladder.

"The gene then produces a protein," she says. "That helps the body recognize it and then kill the cancer."

Dr. Viterbo says Adstiladrin has some advantages for patients.

"It's delivered once every 3 months in the office," she notes.

"Some patients will go into remission and will just require surveillance. And some patients will need continued treatments in the future."

The drug's maker says those are also delivered in a doctor's office.

Dr. Viterbo says Adstiladrin is the first new treatment in decades for this stage of bladder cancer.

"This gives us one more option to try and preserve the bladder and maintain a patient's quality of life," she says.

According to data from the drug's trials, 75% of the Adstiladrin patients still had their bladders.