New Bladder Cancer Treatment Reduces Death Risk by 47%

After more than two decades without progress, patients facing one of the most aggressive forms of bladder cancer finally have a treatment that works better than chemotherapy alone.

A groundbreaking international study led by Mount Sinai researchers has found that combining two drugs, enfortumab vedotin and pembrolizumab, cuts the risk of cancer returning or spreading by nearly half. The results are so compelling that the FDA approved the treatment this month.

Bladder cancer affects nearly 85,000 Americans each year, making it the sixth most common cancer in the United States. About one in four cases are muscle-invasive, an aggressive type that frequently returns after surgery and spreads to other organs.

For patients facing surgery to remove their bladder, the standard approach has remained unchanged since the early 2000s: chemotherapy before the procedure, then hope for the best. Dr. Matthew Galsky, who led the study, knew patients deserved more options.

The new treatment works by attacking cancer cells in two ways. Enfortumab vedotin targets a protein called Nectin-4 found on bladder cancer cells and delivers cancer-killing medicine directly to them. Pembrolizumab helps the immune system recognize and destroy any remaining cancer cells.

The study tracked 808 patients at 158 medical centers worldwide. Half received the new drug combination before and after surgery, while the other half got standard chemotherapy before surgery only.

Two years later, the difference was clear. Nearly 80% of patients who received the new treatment remained free of cancer progression, recurrence, or death. In the chemotherapy group, that number was 66%.

Even more striking: more than half of patients receiving the new drugs had no detectable cancer left in their bodies by the time of surgery. Only one-third of chemotherapy patients achieved that result.

The Bright Side

This breakthrough builds on earlier success stories. The same drug combination already helps patients with advanced bladder cancer, and now it's proving effective for people with earlier-stage disease who have better chances of being cured.

Dr. Galsky notes that careful monitoring remains essential since the new treatment does cause more side effects than standard chemotherapy. However, experienced cancer care teams can manage these effects while giving patients a much better shot at long-term survival.

The FDA's rapid approval means patients across the country can access this treatment now, not years from now. For thousands of families facing a bladder cancer diagnosis, that timeline makes all the difference.