Roche (Philippines) Inc. Immunotherapy treatment available for advanced Metastatic Bladder Cancer

Bladder cancer or urothelial cancer (UC) is one of the most common cancers that start in the urothelial cells that line the inside of the bladder. Worldwide, bladder cancer ranks ninth in global incidence with 430,000 new cases diagnosed in 2012 and approximately 145,000 worldwide deaths per year. In the Philippines over 1,500 new cases of UC are reported yearly according to the latest 2018 cancer statistics. Men are three times more likely to suffer from bladder cancer compared to women. The risk of developing bladder cancer increases with age. Overall, 70% of patients who develop bladder cancer present symptoms at the age of 65, although it can happen at any age.

Bladder cancer is a complex and costly disease that is often characterized with trouble and pain when urinating, having to urinate frequently, and in some cases hematuria or the presence of blood in the urine. It is also among the Top 10 causes of global cancer deaths per year. For diagnosed bladder cancer patients the burden of the disease goes beyond affecting quality of life as treatments, hospitalization, and follow-ups result in direct and indirect causes.

Roughly 7 out of every 10 bladder cancers diagnosed are early stage cancers – when they are still highly treatable. However, even cancer treated at this early stage may recur and patients typically need to have follow-ups for years. There is also a percentage of bladder cancer patients that are diagnosed late with advanced stage metastatic urothelial cancer (mUC). 

90% of treatment for bladder cancer is surgery combined with other therapies including chemotherapy, radiation therapy, and immunotherapy. 50% of patients who undergo radical surgery for invasive disease will most likely suffer a relapse. More advanced cancers may require removal of the entire bladder (cystectomy). Following this surgery, patients will need reconstructive surgery for urinary diversion, which can lead to serious complications. 

Unfortunately advanced metastatic bladder cancer is usually associated with poor prognosis and limited treatment options. 30-50% of patients with metastatic bladder cancer are not fit enough to receive first-line cisplatin-based chemotherapy making it harder to determine course of treatment. This is where immunotherapy treatment such as Atezolizumab may be used. 

Immunotherapy is a type of cancer treatment that bolsters your own immune system to fight the cancer. It is a type of biological therapy meaning that it utilizes substances made from living organisms to treat the cancer. For years, researchers have studied the role the immune system plays in addressing cancer and have created immunotherapies to either support the immune system against the cancer or attack the cancer directly. Immunotherapy can be given alone or in combination with other types of cancer therapies. Over the years, it has become increasingly available and viable and effective cancer treatment.

Atezolizumab as first-line treatment for advanced bladder cancer patients

Immunotherapy drugs such as Atezolizumab may help a person’s own immune system fight cancer.  These innovative treatment options help restore cancer immunity to improve outcomes for bladder cancer patients. Atezolizumab is a monoclonal antibody designed to bind with a protein called PD-L1 expressed on tumor cells and tumor-infiltrating immune cells. With its mechanism of action of blocking PD-L1, Atezolizumab reinvigorates the body’s immune system to recognize and destroy cancer cells.

Atezolizumab is approved as a first-line indication bladder cancer monotherapy to treat adult patients after prior platinum containing chemotherapy or patients who are considered ineligible for chemotherapy. In clinical trials, roughly 15% of patients had a least partial shrinkage of their tumors that lasted between 2.1 to 13.8 months. This immunotherapy adds to the treatment options available for first-line treatment of metastatic urothelial cancer regardless of a patient’s PD-L1 status. 

Patients must first consult and seek further information with a medical oncologist to know if they are viable for immunotherapy treatments such as Atezolizumab, as it is a prescription drug. For those prescribed with Atezolizumab that may need financial assistance, Roche (Philippines) Inc. offers a patient support program whereby patients may enroll with the endorsement of their oncologist and by fulfilling a set of standard requirements as prescribed by the program’s nurse coordinator. Once enrolled, patients may avail of discounts on Atezolizumab throughout their treatment through accredited sub-distributors and hospitals.