WA-led study offers alternative treatment for bladder cancer patients amid immunotherapy shortage

West Australian

5 days ago

When Jack Taylor was diagnosed with high-risk bladder cancer at only 20 years old, being told there was a shortage of the potentially life-saving drug he needed was an extra blow.
Bladder cancer immune therapy drug Bacillus Calmette-Guérin (BCG), has been subject to shortages across the world since 2013 due to manufacturing issues, meaning patients are missing out on what doctors consider the gold standard treatment for the disease.
However, a West Australian-led trial could solve the issue, with the results revealing using the chemotherapy drug mitomycin on top of BCG — meaning not as much of the drug was needed — was a safe and effective alternative treatment.
The groundbreaking findings mean doctors from across the country will be able to treat patients with this cancer therapy from now on.
The trial, called ANZUP 1301, recruited 501 patients across 17 sites in Australia, including at Perth's Fiona Stanley Hospital, and the UK between 2013 and 2023.
The addition of the drug mitomycin meant patients required 40 per cent fewer doses of BCG.
Patients also completed their treatment more frequently, suggesting a combination treatment was better tolerated then just the BCG.
Bladder cancer is the 11th most common cancer in the country with the survival rate five years after diagnosis only being 57 per cent.
Mr Taylor had no signs he was unwell until he noticed blood in his urine — a month later he was diagnosed with bladder cancer.
'It's the last thing you expect as a 20-year-old really. I was a bit in shock and quite uncertain about the future,' he said.
'When I got diagnosed, you're already stressed enough and then when you get told there's this potentially life-saving, disease altering treatment but you might not be able to get it — it's pretty soul crushing.'
Mr Taylor was referred to FSH for the trial after undergoing surgery.
He still has three months left of BCG treatment to try and beat his cancer but he said being a part of the trial meant he experienced less side effects and was feeling well.
'I think having local access to high quality research is so important, because if this trial wasn't being run here, I wouldn't have been able to participate in it,' he said.
'It's really great to hear that the trials had such fantastic results and will hopefully go on to help so many other people. I think I'm just grateful that I was able to participate.
'For patients, it's always great to have more choice in terms of the treatments.'
FSH head of urology and UWA urological research and education professor Dickon Hayne said in a time of global BCG shortages, adopting this treatment could dramatically expand access to life-saving bladder cancer treatment.
'We did look at a subgroup of patients who had the nastiest sort of cancer in that group, and those patients did seem to do better in terms of the cancer being treated when we added the mitomycin,' he said.
'We're still experiencing a serious BCG shortage and that's affecting Western Australia as much as it's affecting the whole globe.
'This treatment will mean that we can treat more patients with a safe and effective treatment than we could before.'
The trial was developed through Australian and New Zealand Urogenital and Prostate Cancer Trials Group in collaboration with the National Health and Medical Research Council clinical trials centre.