Breast and ovarian cancer drug could help people with bladder cancer

An established treatment for breast and ovarian cancer could help patients with a common type of bladder cancer, a UK study involving Southampton researchers has suggested.

Urothelial cancer, also known as transitional cell carcinoma, starts in the urothelial cells that line the inside of the bladder. Urothelial cells also line other parts of the urinary tract, such as the part of the kidney that connects to the ureter (called the renal pelvis), the ureters, and the urethra.

In a Phase II multi-centre, umbrella trial, UK scientists tested different treatments for different subtypes of urinary tract cancer, which had grown into surrounding tissues or spread elsewhere in the body.

Patients underwent biomarker pre-screening while receiving first-line chemotherapy. Depending on their biomarkers, patients were eligible to participate in multiple phase II studies evaluating targeted agents in biomarker-defined subgroups.

The first of these studies, led by Dr Simon Crabb from the University of Southampton, has now been presented at the ASCO Genitourinary Cancers symposium.

Patients who were positive for a biomarker for DRD were treated with rucaparib (Rubraca), which is a PARP inhibitor. PARP is a protein found in our cells and helps damaged cells to repair themselves.

Rucaparib works by stopping the PARP protein from doing its repair work in cancer cells and the cell dies.

In the study, patients were randomized to either receive treatment within 10 weeks of completion of chemotherapy with either 600 mg of rucaparib twice daily or a placebo until disease progression.

Rucaparib extended survival by 35.3 weeks (80% CI 11.7-35.6) compared to 15.1 weeks (80% CI 11.9-22.6) with a placebo, the study showed.

Dr Simon Crabb, Associate Professor in Medical Oncology, said: “For the first time, we have randomised data that shows that PARP inhibition, which is already an established treatment for breast and ovarian cancer, has some benefit to patients with urothelial cancer and have a specific genomic biomarker. Phase III trials now to need to take place in a larger cohort of patients. These results suggest that treatment based on patients’ genetics could be a way forward for improving treatment.”

The trial was supported by Cancer Research UK.