Researchers find out why one type of chemotherapy works best for bladder cancer

Tisch Cancer Institute researchers have found that a certain type of chemotherapy improves the immune system’s ability to fight bladder cancer, especially when combined with immunotherapy.

These results, published in Cell Reports Medicine, may explain why the approach, cisplatin chemotherapy, can lead to a cure in a small subset of patients with metastatic or advanced bladder cancer. The researchers also believe their results could explain why clinical trials combining another type of chemotherapy, carboplatin-based chemotherapy, with immunotherapy have not been successful, while others using cisplatin with immunotherapy is successful.

“We have known for decades that cisplatin works better than carboplatin in bladder cancer. However, the mechanisms underlying these clinical observations have remained elusive until now,” said the lead author of the study. study, Matthew Galsky, MD, co-director of the Center of Excellence for Bladder Cancer at the Tisch Cancer Institute at Mount Sinai.

“This study provides clues as to why cisplatin-based chemotherapy may achieve durable disease control in a subset of patients with metastatic bladder cancer, provides clues about which patients are likely to ‘reap such benefit and provides a basis for developing even better treatment regimens that exploit the immunomodulatory effects of cisplatin-based chemotherapy.

Bladder cancer affects approximately 83,000 people each year in the United States. Metastatic bladder cancer is particularly difficult to cure with current treatments. These results therefore constitute an important step towards using available drugs as efficiently as possible and determining effective combination therapies.

The study found that cisplatin chemotherapy may be most effective when the body has generated a pre-existing, but contained, immune response against the tumor. The study further found that cisplatin damages the DNA of cancer cells, which may lead to changes in the expression of genes that could improve the ability of the body’s immune system to detect cancer cells.

This research was part of a large team scientific effort that used biological samples from an international Phase III clinical trial involving multiple institutions.