Hundreds of people in England with aggressive bladder cancer are set to benefit from a new dual‑stage immunotherapy and chemotherapy treatment, following a landmark recommendation from the National Institute for Health and Care Excellence.
The treatment – durvalumab (brand name Imfinzi, manufactured by AstraZeneca) – will be administered alongside chemotherapy before surgery, and on its own after surgery. This marks the first time immunotherapy has been incorporated into both stages of treatment for muscle‑invasive bladder cancer, representing a major step forward in efforts to prevent the disease returning.
Muscle‑invasive bladder cancer is a serious form of the disease in which cancer has spread into the muscle layer of the bladder but not to other parts of the body. It significantly affects quality of life and typically requires surgical removal of the bladder.
Clinical trial results show that patients receiving durvalumab plus chemotherapy before surgery, followed by durvalumab alone afterwards, experience a lower risk of recurrence compared with those receiving chemotherapy only.
More than 630 patients in England are expected to be eligible for the new treatment each year.
Durvalumab is an immunotherapy drug delivered by intravenous infusion. It:
- Is given every three weeks alongside chemotherapy before surgery
- Is then given every four weeks after surgery
- Targets a protein that helps the immune system recognise and attack cancer cells
By strengthening the immune system’s response, durvalumab increases the chance of destroying remaining cancer cells after surgery.
In 2022, there were 18,060 new cases of bladder cancer diagnosed in England. Although most cases occur in people in their 60s and 70s, the disease can affect younger adults as well, and is more common in men. Symptoms can include blood in urine, lower back or abdominal pain, and unexplained weight loss.
Early treatment is crucial to improving long‑term outcomes.
NICE confirmed that this guidance was produced using a simpler assessment process, meaning patients will have faster access to treatment than under standard procedures.
A confidential commercial agreement also means durvalumab will be available to the NHS at a discounted price, helping to ensure the treatment is cost‑effective and widely accessible.
The approval of durvalumab marks one of the most significant developments in bladder cancer treatment in recent years, offering patients a more effective clinical pathway designed to reduce recurrence rates and improve long‑term survival.
The decision supports ongoing NHS efforts to expand access to innovative cancer treatments that deliver meaningful improvements in patient outcomes.
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