Drug May Help Fight Urothelial Cancer, Researchers Find

“The connections linking afatinib with a better response to treatment…are encouraging.”

By Anjali Dhillon

Researchers at the University of Chicago Medical Center (UCMC) recently found that a pre-existing drug may be useful in treating urothelial cancer.

They found that five of six patients diagnosed with advanced metastatic urothelial cell cancer and at least one of two particular genetic mutations, responded to treatment with the drug afatinib. These findings were published in the Journal of Clinical Oncology.

Urothelial cell carcinoma is cancer that affects the urinary tract: the bladder, kidney, and attached organs. It is the eighth leading cause of cancer in the US at 16,000 deaths per year. It is the fourth most common cancer affecting males.

The objective of the trial was to determine whether daily 40 milligram afatinib doses prevent the growth of a tumor for a minimum of three months in primary treatment resistant patients. Afatinib is a drug approved by FDA in 2013 for treating lung cancer.

Patients who demonstrated advanced urothelial cancer were enrolled in a phase 2 clinical trial. They were required to take CT and MRI scans every six weeks and were closely observed for afatinib-related complications.

With the afatinib treatment, patients with at least one of the two genetic abnormalities reached 6.6 months without the progression of cancer, while those without mutation averaged 1.4 months. The sample size was 23 patients, with a median age of 67 years old.

While there was a demonstrated effect on advanced metastatic cancer patients, afatinib seemed to produce an overall varied response in the rest of the sample size. Fourteen patients had a progression of cancer, seven had stabilized cancer, and two experienced shrinkage of tumor. Side effects included diarrhea, rash and fatigue. The daily 40-milligram dose was reduced for three patients. Authors of the study noted the small sample size as a limitation.

In a press release by UCMC, study director Peter O’Donnell, M.D., an assistant professor of medicine said, “The connections linking afatinib with a better response to treatment for this group of patients are encouraging. Our next step is to organize a follow-up trial focused entirely on patients with at least one of these mutations.”