Researchers have found that a new type of drug that helps target chemotherapy directly to cancer cells may increase the survival of patients with the most common form of bladder cancer.

According to the results from a phase III clinical trial, the risk of death was 30 percent lower with the new drug than with chemotherapy in patients with locally advanced or metastatic urothelial cancer. However, the researchers say, the side effects of the drug were manageable and overall similar to chemotherapy. "This new type of drug has led to a survival advantage in bladder cancer which has been difficult to achieve in this difficult disease. It reduced the death rate by 30 percent and beat chemotherapy in every setting, so this really is a big deal," said lead author Tom Powles, Professor of Genitourinary Oncology at Queen Mary University of London.

For the study, published in the New England Journal of Medicine, the team involved 608 patients in 19 countries and tested a new 'antibody-drug conjugates' (ADC) drug enfortumab vedotin, in adult patients with locally advanced or metastatic urothelial cancer who were previously treated with platinum-based chemotherapy and an immunotherapy drug, called a PD-1/L1 inhibitor.

The team found that the risk of death was 30 percent lower with the new drug than with chemotherapy, with a median survival of approximately 13 months for the new drug. Median progression-free survival, which is the time without progression of cancer, was 5.6 months for the new drug vs 3.7 months for chemotherapy.

Overall response rate, the percentage of patients with either complete or partial response, was 40.6 percent versus 17.9 percent of patients in the chemotherapy arm. Urothelial cancer is the most common type of bladder cancer (90 percent of cases) and can also be found in the renal pelvis (where urine collects inside the kidney), ureter (the tube that connects the kidneys to the bladder) and urethra. Globally, approximately 549,000 new cases of bladder cancer and 200,000 deaths are reported annually.