Huge excitement at the European Society for Medical Oncology congress for the work of British researcher Thomas Powles, who has combined two advanced therapies, doubling survival in patients with severe forms of the disease.
It’s almost unheard of for an audience of specialists at a medical congress to get to their feet and give a speaker a standing ovation, least of all when it comes to cancer therapies, an area in which progress comes in small steps. But that’s exactly what happened at the event held in Madrid by the European Society for Medical Oncology (ESMO, the Lugano-based scientific organisation that brings together European medical oncologists), on no less than two occasions, in the middle and at the end of the presentation by Thomas Powles, medical oncologist at Saint Bartholomew’s Hospital in London. This was reported in the scientific journal Nature, which also explains the reason for such enthusiasm: for the first time since the 1980s, a specific combination of drugs has been able to double survival in patients with advanced bladder cancer, a result that cannot be achieved with traditional therapies, opening up new possibilities for other types of cancer.
This important result was achieved by combining the monoclonal antibody pembrolizumab (which boosts the immune system) with another antibody, enfortumab, modified to literally “transport” a chemotherapy drug (vedotin) to target cancer cells (to be precise, to target a protein called nectin-4, which is expressed in large quantities by cancer cells, and very little by healthy cells.
Trials extended
Until the congress in Madrid, Thomas Powles’ team had only released data on 120 patients. However, these results were already considered sufficient by the US Food and Drug Administration (the US drug marketing body) for approval of the cocktail developed in London. During the ESMO meeting, Powles presented additional data on a wider group of patients: 880. Once again, the trial confirmed the very positive results, i.e. the almost doubling of survival in patients with advanced bladder cancer (and therefore difficult to treat), going from 16 months following traditional chemotherapy to 31.5 months obtained with the pembrolizumab plus enfortumab-vedotin combination.
The results of other clinical trials with drug “conjugates” (this is the technical term), alone or combined with immunotherapy, were also presented at the congress, for example for breast cancer, confirming the fact that this field is considered promising, and is among the most buoyant at the moment.
Pending issues
There are still some aspects that need to be optimised, because these therapies, initially thought to be less harmful as they only target cancerous cells, in reality have a certain level of toxicity, above all for the lungs and peripheral nerves. It is therefore a matter of urgency to make them less dangerous and to get a better understanding of what types of cancer they can be used with to “make a difference”, as in the case of bladder cancer.
