[HN Gopher] New treatment eliminates bladder cancer in 82% of pa...
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       New treatment eliminates bladder cancer in 82% of patients
        
       Author : geox
       Score  : 258 points
       Date   : 2025-08-13 15:16 UTC (7 hours ago)
        
 (HTM) web link (news.keckmedicine.org)
 (TXT) w3m dump (news.keckmedicine.org)
        
       | newfocogi wrote:
       | My (non-AI) Summary:
       | 
       | - "TAR-200 is a miniature, pretzel-shaped drug-device duo
       | containing a chemotherapy drug, gemcitabine, which is inserted
       | into the bladder through a catheter. Once inside the bladder, the
       | TAR-200 slowly and consistently releases the gemcitabine into the
       | organ for three weeks per treatment cycle."
       | 
       | - Phase 2 Clinical Trial
       | 
       | - 85 patients with high-risk non-muscle-invasive bladder cancer
       | 
       | - "treated patients with TAR-200 every three weeks for six
       | months, and then four times a year for the next two years"
       | 
       | - 70/85 patients--the cancer disappeared and still gone 1yr later
       | in almost 50% patients
       | 
       | - FDA granted TAR-200 a New Drug Application Priority Review
       | 
       | - Johnson & Johnson manufactures TAR-200
        
         | woeirua wrote:
         | Unfortunately the recurrence rate after 1 year here is still
         | quite high. Good progress, but not a cure yet.
        
           | tptacek wrote:
           | Only a small percentage had a recurrence that progressed to
           | later-stage muscle-invasive illness, though.
        
           | lordofgibbons wrote:
           | Do cancers have a tendency to come back with better drug
           | resistance if it's not fully eliminated? at least a
           | resistance to the drug that got rid of it the previous time?
        
             | tomsto wrote:
             | Emphatically so, yes
        
               | codr7 wrote:
               | Return customers generate more profit.
        
               | AnimalMuppet wrote:
               | Not if the same thing can't be used to treat them again.
        
               | GoatInGrey wrote:
               | Cynical take, but not wrong.
               | 
               | Though this reads as though the implied message is
               | preaching the suppressed cure conspiracy theory so I'll
               | respond to that interpretation.
               | 
               | What you're missing the competitive factor of this. If
               | your drug strings your patients along while your
               | competitor releases an effective cure, guess who's
               | getting all the business? Look to Sovaldi and Keytruda
               | for recent examples.
        
               | tptacek wrote:
               | The competitor with the effective cancer cure will take
               | all the business.
        
             | octaane wrote:
             | For some cancers yes, for other cancers, no. Sometimes
             | resistance to therapy is a matter of time, not prior lines
             | of therapy.
        
               | ac2u wrote:
               | I wish I could find the article, but there is a clinic
               | somewhere that ran trials where they deliberately
               | wouldn't treat the cancer too aggressively. Instead they
               | experimented with treatment frequency but with control
               | being the aim instead of elimination.
               | 
               | The theory being that they could keep it at bay
               | indefinitely and lower the chance of selection pressure
               | kicking in. The thought behind their approach is that
               | they wanted their patients to die of something different
               | than their cancer.
        
             | apwell23 wrote:
             | yes they are resistant to that line of therapy once it
             | stops working.
             | 
             | Sometimes that resistance carries over to other lines too.
             | For example, Enzalutamide doesn't work for prostate cancer
             | if you were already treated by abiraterone.
        
           | amacbride wrote:
           | Bladder cancer has a notoriously high recurrence rate,
           | unfortunately. (I worked for years in NMIBC molecular
           | diagnostics.)
        
             | tptacek wrote:
             | Say more? You've got some domain expertise on this story
             | and I assume an interesting story to tell!
        
             | chrisgd wrote:
             | My dad had his bladder removed. Cancer came back 18 months
             | later and he was gone 4 months after that. It sucks.
             | 
             | Plus, I regret that he had to live with a colostomy bag for
             | that time. His quality of life probably higher if they do
             | the other option (name escapes me).
        
             | 0xWTF wrote:
             | FFS, I'm a physician and I had to look up that the acronym.
             | Have mercy on people: NMIBC = non-muscle invasive bladder
             | cancer.
        
       | Teever wrote:
       | > The standard treatment for this type of bladder cancer is an
       | immunotherapy drug, Bacillus Calmette-Guerin,
       | 
       | Can anyone explain why the vaccine for TB works to treat bladder
       | cancer?
        
         | QuercusMax wrote:
         | This "drug" is a weakened form of the bacterium, which
         | apparently stimulates immune response. So I guess it works for
         | both TB and bladder cancer just by getting your immune system
         | to notice something is amiss?
        
         | imranq wrote:
         | Turning it off and then on again works in a lot of surprising
         | places
        
         | octaane wrote:
         | I can explain. BCG infects the actual epithelial cancer cells
         | inside the bladder, triggering Th-1 response (production and
         | release of cytokines by activated CD4 T cells).
         | 
         | The cytokines induce an inflammatory response, which I turn
         | activates other immune system cells such as CD4 and CD8, NK
         | cells and macrophages.
         | 
         | The immune cells then attack the bladder cancer cells,
         | hopefully destroying them, thus "fighting cancer".
         | 
         | Source: Li J et al, NPJ Vaccines. 2021;6:14.
        
       | tiahura wrote:
       | "almost half the patients were cancer-free a year later."
        
         | onlyrealcuzzo wrote:
         | That's one way of looking at the glass half empty.
         | 
         | If half of people get rid of cancer for 1 year that is still
         | outstanding - ESPECIALLY if the majority of those remain cancer
         | free for quite some time after.
        
           | codr7 wrote:
           | If we wanted patients to survive long term, then maybe we
           | could try a treatment that doesn't destroy their immune
           | system in the process.
        
             | tptacek wrote:
             | Invent it and your grandchildren will retire rich.
        
             | burnt-resistor wrote:
             | The most obvious, naive approach is banking blood & marrow
             | prior to treatment. However, there's a need to clear
             | metastatic cells (CTCs) or train the immune system to find
             | and kill them so that it doesn't reintroduce CTCs upon
             | retransfusion.
        
           | apwell23 wrote:
           | > remain cancer free for quite some time after.
           | 
           | OS is more relevant than PFS
        
         | chiph wrote:
         | One of the things I learned going through my own treatment
         | (prostate) was that everyone's cancer is different. Which makes
         | sense if you think about the variability in malignant cell
         | growth.
         | 
         | So something that cures half the patients and only requires an
         | office or outpatient visit every few weeks (no surgery, no
         | radiation) is astounding. This result will likely lead to
         | further research using this approach.
        
           | apwell23 wrote:
           | Yes my father died in 3 months after getting lutetium 177.
        
         | mcswell wrote:
         | More than half would be nice, but: these tests were run on
         | "individuals with high-risk non-muscle-invasive bladder cancer
         | whose cancer had previously resisted treatment." One could
         | expect that it would be even more effective on patients whose
         | cancers were not resistant to treatment.
        
       | blackhaz wrote:
       | My father currently suffers from bladder cancer, he's currently
       | in palliative care, he's in Ukraine. If there are any medical
       | professionals here, could someone provide an advice - is there
       | any chance to get him access to TAR-200?
        
         | gautamcgoel wrote:
         | So sorry to hear this, I wish him the best.
        
           | octaane wrote:
           | No, the trial is closed to new participants. Check the
           | company website to see if they are having international
           | trials or are open to compassionate use.
        
             | blackhaz wrote:
             | Thank you.
        
           | blackhaz wrote:
           | Thank you.
        
         | apwell23 wrote:
         | 1.look for clinicaltrial on https://clinicaltrials.gov/ .
         | 
         | 2.See if your father qualifies for any
         | 
         | 3. Enroll
         | 
         | 4. Get B2 visa. All medical treatment is usually covered once
         | you are accepted into the program.
         | 
         | good luck!
        
         | moi2388 wrote:
         | There are EU trials as well. Perhaps contact your physician,
         | insurance or Johnson & Johnson directly.
         | 
         | https://euclinicaltrials.eu/ctis-public/view/2023-507685-10-...
         | 
         | To be honest, chances are slim to none. But worth a try.
        
         | pkaye wrote:
         | You may want to look at this study. Its preapproval expanded
         | access. There is an email and phone numbers for the company
         | which is running the study. Usually the further along the drug
         | trial is they more the loosen the criteria. Wouldn't hurt the
         | ask if its suitable for your father.
         | 
         | https://clinicaltrials.gov/study/NCT06877676?intr=TAR-200&ra...
        
         | teyc wrote:
         | Pat Shoon Shiong had a cancer drug approved for targetting
         | bladder cancer, don't know whether Ukrainians can have access
         | though.
        
       | TheAmazingRace wrote:
       | I really wish this was available earlier, because I just lost a
       | family member to bladder cancer yesterday morning. :(
        
         | ecoffey wrote:
         | That is tough, I'm sorry for your loss.
        
           | TheAmazingRace wrote:
           | Thank you for the condolences.
        
         | javiramos wrote:
         | Sorry for your loss.
        
         | xxr wrote:
         | Very sorry for your loss. An uncle had bladder cancer about 15
         | years ago, and while he survived, it began a very steep decline
         | that led to his passing in 2022.
        
         | bdcravens wrote:
         | So sorry to hear. My father passed from bladder cancer that
         | metastasized 20 years ago.
        
         | selectodude wrote:
         | Always kind of bittersweet to read these breakthroughs in
         | cancer treatment.
        
       | A_D_E_P_T wrote:
       | There's an open access paper on the development of the drug here:
       | 
       | > https://www.sciencedirect.com/science/article/pii/S107814392...
        
       | pugworthy wrote:
       | To be clear, here is the rest of what the article title should
       | be...
       | 
       | > ...for individuals with high-risk non-muscle-invasive bladder
       | cancer whose cancer had previously resisted treatment
        
         | tptacek wrote:
         | Only those patients were admitted to the trial, so the
         | effectiveness of the treatment on later-stage muscle-invasive
         | disease is unknown. That it's scoped to patients who are BCG-
         | unresponsive ("previously resisted treatment") makes the
         | breakthrough more significant, not less.
        
         | GoatInGrey wrote:
         | This is relatively common with experimental therapies in
         | trials, and thus shouldn't be interpreted as the final say on
         | its usage.
         | 
         | Part of the reason why is that it's difficult to convince
         | patients or providers to reach for the experimental treatment
         | in trial before the current standard of care. Many first-line
         | treatments began as second/third-line or salvage treatments
         | before experiencing _line promotion_ or (if surgery is
         | involved) _neoadjuvant promotion_. Keytruda is a good example
         | of this progression in action.
        
       | ltbarcly3 wrote:
       | "New treatment eliminates bladder cancer in 82% of patients" -
       | current HN title (matches article)
       | 
       | I don't like headlines like this because they lack any necessary
       | context. Knowing that a treatment eliminates cancer in 82% of
       | patients isn't data unless we know more or already experts in
       | this field. For all I know the previous treatment was 99%
       | effective but just cost more or something. PR-style headlines
       | very often use misleading statistics to get attention, so this
       | wouldn't even be surprising.
       | 
       | - What was the previous treatment's success rate? Was it 22% or
       | 81%?
       | 
       | - What are the other tradeoffs? If the previous treatment was
       | also 82% maybe this one doesn't cause incontinence, or maybe it's
       | non-invasive?
       | 
       | How you should make a title:
       | 
       | "New treatment eliminates cancer in 82% of patients, a major
       | improvement"
       | 
       | "New treatment is first non-invasive way to eliminates cancer in
       | 82% of patients"
       | 
       | "New treatment way to eliminates cancer in 82% of patients -
       | without causing incontinence"
       | 
       | "New treatment eliminates cancer in 82% of patients without
       | radiation"
        
         | tptacek wrote:
         | This is 81% CR in patients who had already had recurrence and
         | progression after front-line treatment, so neither of your
         | concerns about the headline are relevant to the actual story.
        
         | GoatInGrey wrote:
         | Dumb question: why not rely on the article contents to provide
         | context?
        
       | virtualwhys wrote:
       | My father had bladder cancer, which was caught relatively early
       | as the cancer had not yet spread beyond the bladder wall.
       | 
       | The doctor performed a rather uncomfortable surgery (the pathway
       | for a man is not pleasant) and then injected the TB virus into
       | his bladder, which is apparently an effective treatment for this
       | type of cancer.
       | 
       | It's been 20 years now, no recurrence. Think he was treated at
       | Dana Farber in Boston.
       | 
       | Having gone through what was likely a life saving treatment he
       | has become, ironically, anti-western medicine -- don't blame him,
       | having a surgical implement shoved up main street doesn't sound
       | like a walk in the park :)
        
       | hereme888 wrote:
       | That's not 82% of bladder cancers.
       | 
       | It's 82% of those whose bladder cancer is fortunately not
       | invading the muscle, and after failing current standard
       | treatments.
        
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       (page generated 2025-08-13 23:01 UTC)