New Treatment Hopes for People with Transitional Cell Carcinoma

Last updated: February 2022

Transitional cell carcinoma (TCC) is the most common type of bladder cancer. TCC is sometimes called urothelial carcinoma. TCC forms in certain cells that line the bladder. These cells are called urothelial cells.1

The severity of TCC is usually determined by how far tumors have started to spread. Tumors that are only in the inner layer of cells are called noninvasive cancers. Tumors that have grown into deeper layers of the bladder wall are called muscle-invasive cancers. Tumors that have spread beyond the bladder are called metastatic or locally advanced cancer.1

Clinical trials for TCC treatments

Developing new cancer treatments is important because different cancers and different people respond to drugs in different ways. Clinical trials are part of the process of developing new treatments. These trials can help test how safe a drug is and how well it treats that cancer. There are some new clinical trials underway to treat TCC.1,2

It can take a long time for trials to finish and treatments to be approved. But trials are an important step in creating new options for treatment. In the future, these options may better treat people with TCC.1,2

Trial for chemotherapy drug combinations

Surgery is a common treatment for TCC, but it is not always completely successful. People with TCC who receive chemotherapy around the time of their surgery may survive their TCC longer. One trial, called VESPER, is comparing 2 different chemotherapy treatments given before or after surgery to remove cancer. This trial is for people with muscle-invasive TCC. The 2 treatments being compared are:2-4

  • Gemcitabine and cisplatin
  • High-dose methotrexate, vinblastine, doxorubicin, and cisplatin (HD-MVAC)

The VESPER trial will measure progression-free survival for 3 years after treatment. This means it will measure how many participants had their cancer stay the same or get better. It will also measure how long the treatment kept the cancer the same or better. The trial is not finished, so the final data is not yet available. However, early data shows that the participants who received HD-MVAC may have fewer side effects.2-4

Trial of erdafitinib

Another trial is underway to test the safety and effectiveness of a drug called Balversa® (erdafitinib). This trial is studying treatments for people with metastatic or locally advanced TCC. Erdafitinib is already approved for some people with TCC who have tried all the other treatment options and still have TCC. This trial is a step toward allowing people with no prior treatment to try erdafitinib.5,6

The purpose of this trial is to determine the safety and ideal dose of erdafitinib. The trial is looking at 3 options:5,6

  • Erdafitinib alone
  • Erdafitinib with cetrelimab
  • Erdafitinib with cetrelimab and a platinum chemotherapy (cisplatin or carboplatin)

The first 2 options, erdafitinib alone and erdafitinib with cetrelimab, are being tested for people who cannot receive chemotherapy.5,6

This trial is still in progress. Early results show erdafitinib with cetrelimab is safe enough for the participants and appears to be shrinking their tumors. Future results should help us know whether erdafitinib is a good option for TCC.5,6

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