Pretzel-Shaped Device Could Make a Big Difference in Bladder Cancer Treatment
For patients with early-stage bladder cancer, treatment often consists of repeat surgeries, frequent procedures and side effects that can be tough to tolerate. But a new approach may change that: a tiny drug-releasing system, shaped like a pretzel, that sits inside the bladder and quietly fights cancer.
“It’s a pretzel-shaped drug-eluting stent,” said Roger Li, MD, a genitourinary oncologist at Moffitt Cancer Center. “Instead of putting patients through repeat surgeries, we can just put the pretzel in and let it work.”
Roger Li, MD
The device is called TAR-210 and it slowly releases the cancer-fighting drug erdafitinib directly to the tumors inside the bladder. It’s designed for patients with non-muscle invasive bladder cancer whose tumors have FGFR gene alterations, which are a driver of cancer growth. While FGFR alterations are common in low-grade bladder cancers and targeting them directly has been a challenge.
“These tumors have high propensity to recur, but they don’t necessarily progress to the point where they’re an imminent danger to patients’ lives,” Li explained. “So, the patients are less likely to want to experience much toxicity while going through the treatment.”
Oral erdafitinib had previously been approved for later-stage bladder cancer, but when tried in earlier disease stages, the side effects were too harsh. That’s when researchers looked for a new delivery method.
At Moffitt, Li and his team participated in the first-in-human study of TAR-210 and saw promising results early. “Of the seven patients we enrolled, six had a complete response,” Li said. “Their tumors basically just melted away after three months with the pretzel inside the bladder.”
The device fits into the routine surveillance protocol for bladder cancer and is implanted during simple in-office procedure. Patients already undergo cystoscopies every few months to check for tumor regrowth.
“Now we can use those same visits to replace the device,” Li said. “Overall, we are reducing the treatment burden without compromising care.”
Li is leading a global, multicentered phase 3 trial comparing TAR-210 to the standard-of-care bladder chemotherapy infusions. It is hoped that with positive results from this trial, TAR-210 will be available to patients world-wide. The next steps are focused on monitoring resistance and tailoring combinations. Li also notes that the bladder is a great testing ground to try out these types of innovative therapies.
“The bladder lends itself very well to these innovative treatment methods because it’s meant to contain fluid and it’s very easily accessed,” Li said. “We’re beginning to understand a lot more about these tumors and with the ultimate goal of providing truly personalized care for every one of our patients.”
