Next September 25, at 7 p.m., the “la Caixa” Foundation will hold the debate Bladder cancer: new advances against one of the most common tumors. This event is part of the Caixaresearch Debating Cycle, an agora created to highlight the work of research and health professionals who receive aid from the Foundation through its Research Programs. It will be attended by three prominent scientists: Samuel Sánchez, leader of the Intelligent Nanobiodevices group and ICREA research professor at the Institute of Bioengineering of Catalonia (IBEC) in Barcelona; Antoni Vilaseca, associate physician at the Urology Service at the Hospital Clínic of Barcelona, researcher in the Genetics and Urological Tumors group at IDIBAPS and associate professor at the University of Barcelona (UB); and Marta Dueñas, head of the Genitourinary and Cellular and Molecular Oncology group at the Hospital 12 de Octubre Research Institute (i+12) in Madrid.
The debate will be online and with registration it offers attendees the opportunity to ask questions to the three speakers. Attendance is free, upon registration on the Caixaresearch website. The activity will be recorded, so that those who cannot attend live can witness it when they are available.
A frequent cancer with relapses
Bladder cancer is much less talked about than other tumors, such as breast, lung or colon cancer. However, it is one of the 10 most common in the world and the fifth most common in Spain, with nearly 20,000 new diagnoses per year. Although it does not have a high mortality rate, between 50% and 70% of these tumors return in the following 5 years. To avoid this, very strict monitoring protocols are established. This forces patients to make frequent visits to the hospital to undergo cystoscopy, the diagnostic test for this type of tumors. It consists of introducing a tube with a camera through the urethra to explore the inside of the bladder. It is a painful and expensive procedure for the system, which can also overlook small tumors, invisible at a macroscopic level. Despite these drawbacks, it is the standard screening and monitoring procedure, which patients should undergo 2 to 4 times a year for at least 5 years.
Doctor working in laboratory.
These hospital comings and goings, added to the side effects of the treatments themselves, condition the patient’s quality of life and make this cancer the oncological disease that costs health systems the most per patient. One of the techniques that has been used for 30 years to prevent recurrences and progression of the disease is an immunotherapy protocol that administers drugs directly into the bladder. This treatment produces pain and inflammation, and although it works in a high percentage of patients, it does not achieve the desired therapeutic objectives in all cases. Oncologists cannot know a priori whether treating a specific patient will have therapeutic benefits or not.
To advance the management of bladder cancer, lines of research focus on improving early detection, as well as achieving less harmful treatments for the patient.
Detect from a urine sample
This type of tumor takes time to show its face. The initial symptoms are usually non-specific and oncologists have few effective detection methods and those that exist are quite invasive. Dr. Dueñas and her team at the Doce de Octubre Hospital in Madrid have developed BlaDimiR, a diagnostic system using liquid biopsy that detects traces of tumor RNA in patients’ urine. This system is simple and not painful for the patient.
The BlaDimiR system, in addition to being non-invasive, offers an added advantage: it allows predicting who will respond correctly to standard treatment for bladder cancer and who should resort to alternative therapies. If implemented, this advance would prevent suffering for those patients for whom current therapies are not going to cause benefits and would allow the costs that these interventions entail for the health system to be significantly reduced.
Targeting made easier
New treatment technologies use terms that sound like science fiction to lay people in oncology, such as nanorobots, nanomachines or nanoparticles. These are small artificial spheres, loaded with specific drugs, that are capable of self-propelling to travel inside the body, reach the tumor and penetrate its interior to deposit the chosen drug. This journey through the interior of the bladder is monitored thanks to a complex optical system. Unlike other systems, it does not require prior markers and provides unprecedented resolution.
It seems like the plot of a futuristic film, but it is the summary of the Bladdebots project, led by Samuel Sánchez and in which Antoni Vilaseca also participates. Their nanorobots are porous spheres capable of converting the urea present in urine into their particular propellant fuel. They are loaded with radioactive iodine that allows a much more localized approach to tumors. The combination of both elements allows the treatment to be directed in a more direct and efficient way to the tumor.
Accumulation of nanorobots in the tumor visualized by microscopy.
According to data from trials carried out in mice, a 90% decrease in tumor volume is observed with a single dose. This type of treatment would increase efficiency and reduce the number of hospital appointments, the duration of hospitalization and associated costs. The next step of the research, on which the team is already working, is to study whether these tumors reappear after treatment.
The Bladder Cancer debate will take place on September 25 at 7 p.m. CET.
During the session on September 25, these three experts will present the progress, achievements and difficulties of their respective lines of research.
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