Atezolizumab translates into survival benefit for bladder cancer patients with ctDNA positivity

Medical Xpress / European Association of Urology annual congress (EAU22) ^ | July 4, 2022 | Professor Morgan Roupret et al

[ConservativeMind]

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

The research was part of a larger Phase III trial 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.

ctDNA comprises fragments of DNA shed from cancerous cells and tumors that are found in the bloodstream. Sometimes known as a 'liquid biopsy', it has emerged as a promising, minimally invasive biomarker in clinical oncology, but isn't yet widely used as part of a standard detection and treatment tool for any cancers. It involves tumor specific gene sequencing for every patient, so is time-consuming and, at present, relatively expensive.

Professor Roupret added: "These robust findings show that that ctDNA has great potential as a sophisticated tool to monitor patients and choose their most effective treatment."

[ConservativeMind]

Researchers thought atezolizumab (Tecentriq) would help all bladder cancer patients, but it did nothing for the large majority of them, which were found to also not have the ctDNA indicator. Only the worst bladder cancer cases had this, but these really responded well to the drug, getting enough benefit as to now have as good a prognosis as those with a “mild” form of bladder cancer.

This drug is currently available, and the test is, as well.

[ConservativeMind]

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[gleeaikin]

While researching nutritional inputs for my partner’s prostate cancer, I ran into this study on the supplement Astaxanthin (ASX) for treatment of breast cancer. It appears ASX is potentially effective for a number of cancers. It promotes apoptosis (normal cell death) and other death for cancer cells without harm to normal tissues. Specifically it may prevent metastesis. There were 2 reference links on prostate cancer I will check out. You might want to post the link as a separate article as breast cancer is very common.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6210693/#:~:text=According%20to%20the%20collected%20data,reduce%20multiple%20types%20of%20cancer.