Atezolizumab to help survival in bladder cancer patients with ctDNA positivity

Researchers treated a group of post-surgery bladder cancer patients with the immunotherapy drug atezolizumab and have found that patients whose blood contained circulating tumour DNA (ctDNA), responded very well to the treatment.

The study is presented at the European Association of Urology annual congress (EAU22), in Amsterdam.

The research was part of a larger Phase III trial, IMvigor010, which looked at whether giving atezolizumab for up to one year to patients following bladder removal surgery improved the patients' survival prospects, compared to a group that received no further treatment after surgery but placed in an observation group. Part of that trial involved patients' levels of ctDNA being measured after surgery, and during further treatment or observation.

Although the trial found no significant difference in overall survival between the two groups in the intention-to-treat population, researchers noticed that a subgroup of patients who were ctDNA positive showed a marked improvement when they were given atezolizumab. These benefits included significantly higher disease-free survival, and significantly higher overall survival, than the observation group. This effect wasn't seen in ctDNA negative patients.

In addition, the researchers also found that patients that were ctDNA positive, but subsequently changed to became ctDNA negative after treatment with atezolizumab, ultimately had a particularly good prognosis.

Researchers noted that patients who were ctDNA positive have a poor prognosis compared to those who are ctDNA negative. But this was the first time they have been able to show that with immunotherapy they can actually change the course of the disease depending on a patient's ctDNA status.

Reference: "Atezolizumab translates into survival benefit for bladder cancer patients with ctDNA positivity" EUROPEAN ASSOCIATION OF UROLOGY, 2022.