Bladder cancer breakthrough

Queen Mary researchers tackle hard-to-treat cancer

Bladder cancer is one of the top ten most common cancers in the world. Despite its prevalence, and the many advances in cancer more broadly, there haven’t been any new treatments developed for advanced bladder cancer in the last 40 years.

When detected early, bladder cancer is highly treatable, with a survival rate as high as 80 per cent. However, because this type of cancer often progresses rapidly, many people are diagnosed at a later stage. For those diagnosed with advanced bladder cancer, their life expectancy can be as low as 6-8 months.

Queen Mary researcher and oncologist Professor Tom Powles has dedicated his career to changing this. Together with his team, he’s been searching for new treatments to improve the outcomes of people with bladder cancer – and they found one.

Drug combination breakthrough

Professor Powles led a clinical trial, called EV302, which looked at whether a combination of two newer drugs – enfortumab vedotin, an antibody-drug conjugate, and pembrolizumab, an immunotherapy treatment – could benefit people with advanced bladder cancer.

Pembrolizumab re-educates the immune system to fight cancer by generating new immune cells educated specifically to fight the cancer. These new immune cells are associated with long-term remission, however, the immunotherapy treatment alone isn’t effective at getting initial control of the cancer. This is where the targeted therapy, enfortumab vedotin, comes in. Enfortumab vedotin targets a protein expressed by bladder cancer cells and disrupts the tumour. This enables the new immune cells to be able to infiltrate into the cancer, resulting in long-term remissions and high response rates. The combination of the two drugs working together makes the treatment so effective – and marks a new approach to developing treatments for cancer.

The results of the trial showed that a combination of the two drugs doubles overall survival for patients with advanced bladder cancer. Life expectancy jumped from one year with chemotherapy to three years. Most importantly, it cured around 30% of patients compared to chemotherapy, where almost all patients died within the year.

A new hope

The combination of enfortumab vedotin and pembrolizumab has resulted in huge hope for people with advanced bladder cancer and their families. And incredibly, in less than two years, it has become available to patients across the world.

Enfortumab vedotin with pembrolizumab is now the first-line treatment for advanced bladder cancer globally, including in the UK where it was made available on the NHS in August 2025. This new treatment means people with advanced bladder cancer and their families can look now at this disease and instead seeing it as a terminal diagnosis, they can see hope – Professor Powles continues to see patients who took part in the trial and have been on the treatment for years