Unmet clinical need in bladder cancer treatment


Once upon a time, some sharp-thinking medic came up with a great idea for neatly removing unwanted bits of tissue from their patient – the scalpel. But using it could be a bloody, messy process. Then another bright spark had an even better idea. What about minimising blood loss by burning away those unwanted bits? Boom. Behold the invention of cauterisation. There is a wee bit more to it than that (the writers of Horrible Histories don’t have much to fear from us at Combat!) but this is essentially how the process of innovation often occurs – starting with an identifiably unmet clinical need.

An unmet clinical need often arises due to the current treatment:

  • Not working well enough
  • Being unacceptable to the medics administering it
  • Not being tolerable for the patients receiving it

High-risk, non-muscle-invasive bladder cancer

Take high risk, non-muscle-invasive bladder cancer. In patients for whom the standard BCG therapy doesn’t work, the indicated treatment is radical cystectomy – removal of the bladder. To reduce the risk of recurrence, men also usually have their prostate and seminal vesicles removed, while women often have their womb and fallopian tubes excised, sometimes along with the ovaries and part of the vagina.

For some patients, this treatment is unacceptable, whether that’s due to their current overall health, the sheer scale of the surgery, the risk of urine leakage from a bag or pouch that has to be utilised in the absence of a natural bladder, and the risks of side effects such as impaired sexual function.

Finding safe, effective bladder-sparing treatments for these patients is a huge unmet clinical need. It’s also a major focus of our clinical research programme, where our trials so far and our real-world data series show our intravesical hyperthermic chemo (HIVEC®) treatment is outperforming the alternatives and is well tolerated by patients.

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