First-of-its-kind trial hopes to improve survival rates for bladder cancer
Researchers are trialling a new approach to treating advanced bladder cancer that could save lives.
They will investigate if treatments can be tailored to genetic causes of the disease.
The GUSTO trial is jointly led by the University of Southampton (UoS), Sheffield Teaching Hospitals NHS Foundation Trust and the University of Leeds.
Over 300 patients will take part at 20 sites across the UK. They include University Hospital Southampton NHS Foundation Trust (UHS).
First-of-its-kind research
About 10,000 people in the UK are diagnosed with bladder cancer every year.
Muscle-invasive bladder cancer is an advanced type of cancer. It occurs when cancer cells spread into or through the bladder muscle. As soon as this happens, there is a higher chance that it will spread to other parts of the body.
Simon Crabb, Professor of Experimental Cancer Therapeutics at UoS, is the co-chief investigator of the study. He is also an Honorary Consultant at UHS.
“GUSTO is attempting to fundamentally change our approach to the treatment of bladder cancer,” explained Prof Crabb.
He continued: “We hope to utilise the biological characteristics of each cancer to tailor the correct treatment choices. The aim is to provide the right treatment to the right patient and so improve outcomes as well as avoid unnecessary side effects.”
Transforming treatment options
Most patients with cancer of the bladder wall will have chemotherapy. They may also need surgery to remove the bladder or radiotherapy.
Until now, it has not been possible to say how individuals will respond to this treatment. However, new research suggests that different genetic causes of bladder cancers may respond differently to treatment.
Some patients may respond best to chemotherapy, while other subtypes of the cancer may respond better to immunotherapy. Others may not respond to either chemotherapy or immunotherapy - and require immediate surgery.
“New possibilities”
The GUSTO trial is jointly funded by a National Institute for Health and Care Research (NIHR) and Medical Research Council (MRC) partnership.
James Catto, Professor of Urology at the University of Sheffield and co-chief investigator, said:
“We are very excited to be launching this new study. It has been in development for the best part of four years.
“Recent advances in understanding genetic causes that lead to bladder cancer have opened new possibilities in how we can better treat this awful disease.
“Survival rates for the disease also remain unchanged. By tailoring treatments to genetic markers of the disease, we hope to help patients get the right treatment for their specific disease. This could also boost quality of life following surgery.”
During the first part of the study, the research team will look to establish if genetic profiling from tumour samples can be turned around fast enough so as not to delay treatment.
The team will also work with an American laboratory with ‘next generation’ facilities. The lab will undertake the complex processing needed to measure the RNA levels of 200 genes and identify individual cancer subtypes.
Half of the patients in the study will receive treatments based on their genetic subtype. The other half will receive the current standard treatment.
Image courtesy: University of Southampton