The Future of Drug Development in Urothelial Cancer – Robert Dreicer, M.D., M.S., FACP

Dr. Robert Dreicer, Chair of the Department of Solid Tumor Oncology at the Cleveland Clinic, recently published an editorial in the Journal of Clinical Oncology titled “The Future of Drug Development in Urothelial Cancer.”  He kindly agreed to write a short piece for BCAN, below, on the take-away points for the bladder cancer patient community.

In the late 1980’s the community of urologic oncologists was energized following the initial reports of patients with bladder cancer obtaining significant benefit from the novel combination of chemotherapy drugs referred to as MVAC which was built around the chemotherapy drug cisplatin which had already had a transformative effect on how cancer doctors managed patients with testicular cancer. Only now with the perspective of several decades can we appreciate that as important as those developments were, little, if any, progress has been made in the intervening decades.

Recently, a new generation of drugs have slowly moved there way into clinical trials, however drug development in advanced urothelial cancer (bladder, renal pelvis, ureter, uretha) remains challenging given that many novel drugs are first evaluated in more common cancers such as lung and breast cancer, and there are ongoing difficulties in completing clinical trials in part because many patients with advanced urothelial cancer are older and have other significant medical problems.

Despite the challenges, there is hope. In the fall of 2011 a group of experts in urothelial carcinoma attended a National Cancer Institute Sponsored workshop entitled “Novel Neoadjuvant Therapy for Bladder Cancer” where plans to develop new strategies and new studies were discussed. Two of the clinical trials discussed at that meeting are currently in late stage development. The participants of that conference came away energized to push hard on a number of fronts to move the field forward…..NOW.

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