Combination treatment shows promise for rare, fatal cancers
CANCER DIGEST – Nov. 17, 2024 – Researchers at UCLA have found that combining an immunotherapy drug with chemotherapy significantly improves outcomes for patients with small cell bladder cancer and small cell neuroendocrine prostate cancer, two rare forms of cancer that often prove fatal within 13 months of diagnosis.
Small cell carcinomas are a rare, aggressive form of cancer that can arise in bladder, prostate, lung, ovarian and breast cancer. In the case of advanced small cell bladder cancer, survival times are between 7 and 13 months. In small cell neuroendocrine prostate cancer survival times are between 7 and 9 months.
In this small early phase study involving 15 patients, researchers led by doctoral candidate Yiqian Gu, and senior author Dr. Arnold Chin added the immunotherapy drug pembrolizumab (KEYTRUDA®) to standard chemotherapy for 7 patients with small cell urologic cancers and 8 patients with small cell neuroendocrine prostate cancer. The results were published in the journal Cell Reports Medicine.
In the bladder cancer group, only one patient experienced disease progression after a median follow up of nearly three years. For the prostate group median progression free survival reached 27 months. That compared to a median historical average of 7 to 9 months.
While the results of this early trial are not conclusive, they suggests that adding pembrolizumab could increase survival in these patients, according to Chin. In addition the combination treatment was well-tolerated with no patients needing to stop the regimen due to side effects. In addition, blood tests during the treatment showed a significant expansion of certain immune system cells, which could be used to tell if the treatment is working in patients.
The researchers are planning a larger clinical trial to confirm the findings. This study was registered at ClinicalTrials.gov (NCT03582475).
Sources: UCLA Health press release and Cell Reports Medicine
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