A new FDA-approved gene therapy offers an alternative to complete bladder removal for patients with treatment-resistant non-muscle invasive bladder cancer.
About Non-Muscle Invasive Bladder Cancer
Non-muscle invasive bladder cancer (NMIBC) is the most common type of bladder cancer. Typically diagnosed at an early stage, NMIBC remains localized within the bladder without infiltrating the bladder’s muscle wall or spreading to other parts of the body. First-line treatment for this disease involves surgery, followed by immunotherapy. Patients with high-grade papillary cancers or carcinoma in situ, two types of non-muscle invasive bladder cancers, typically receive the bacteria-based immunotherapy Bacillus calmette-guerin (BCG). Despite these treatments, many patients with early-stage bladder cancer treated with BCG experience cancer progression. Limited options exist besides complete bladder removal, so alternative therapies are desired for patients with treatment-resistant NMIBC.
About Gene Therapy Nadofaragene Firadenova
Nadofaragene firadenova (Adstiladrin) is a novel FDA-approved gene therapy intended for patients with NMIBC who no longer respond to first-line treatment BCG. The therapy uses a recombinant adenovirus, a specialized virus capable of delivering genetic material to cells, to incorporate interferons into bladder cell DNA. Interferons are immune cell proteins that signal to nearby cells to heighten their immune defenses. Once the interferon is incorporated into cell DNA, it can block bladder cancer growth. If effective, the therapy has the potential to delay or eliminate the need for complete bladder removal. So far, urologists at UC San Diego have initiated bladder gene treatments on five patients.
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