The targeting of bladder cancer with inactivated uropathogenic E. coli (UPEC) may offer a viable alternative to Bacillus Calmette–Guérin (BCG) immunotherapy, according to a study recently published in Cells.
For over a century, doctors have used bacteria to boost immunity. BCG is one such example: it is a vaccine against tuberculosis, but can also be used to treat bladder cancer, specifically non-muscle-invasive bladder cancer.
Scientists have wondered if other bacteria could be used for the same purpose. Despite decades of use in medicine, scientists are still not completely sure of how BCG’s anticancer properties work. Furthermore, BCG is only effective in 50% of patients and has significant toxicity.
The study’s authors hence turned their attention to whether UPEC can be used as a substitute to BCG. To do so, they conducted studies on mice and rats to identify if this treatment would work as well.
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Through this study, researchers were able to show that intravesical treatment with formaldehyde-inactivated UPEC (which delivers drugs directly into the bladder via a urinary catheter) was not only safer than BCG, but superior in efficacy. They also found that inactivated UPEC was effective in curing a significant proportion of mice that had advanced cancers.
The study’s authors did not find that inactivated UPEC was associated with any observable side effects. This is in contrast with live-attenuated BCG, which was associated with toxicities such as weight loss.
Another way in which inactivated UPEC was found to be superior to BCG is that it is easier than BCG to produce, and cheaper. This means that inactivated UPEC is a more cost-effective and easily scalable option compared with BCG.
“In summary, we describe a novel, effective, and safe strategy for bladder cancer immunotherapy using inactivated UPEC,” the research team concluded. “This approach might offer multiple advantages over BCG, including enhanced tumor specificity, reduced toxicity, easier manufacturing, and potentially broader accessibility.”
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