New treatment eliminates bladder cancer in 82% of patients

Scope and Results of TAR-200 Study

• Discussants emphasize the narrow indication: high-risk non-muscle-invasive bladder cancer (NMIBC) that had already failed standard BCG therapy.
• The 82% figure refers to complete response in this refractory group, not all bladder cancers.
• Some point out that all visible tumors were surgically removed first; the study tests prevention/delay of recurrence rather than cure of bulky disease.
• Others note that these were superficial tumors (on the bladder lining), which are often managed for years with repeated minor surgery.
• There is debate over terminology: the press release calls it a “clinical trial,” while the paper’s authors describe it as a “study” without randomization or controls. One commenter argues it still qualifies as a clinical trial in regulatory terms, but with weaker evidence than an RCT.

Cancer Recurrence and Drug Resistance

• Several comments explain that recurrence after partial response is often more drug-resistant, via evolutionary selection similar to antibiotic resistance.
• Some nuance: for certain cancers resistance emerges over time regardless of prior lines; in others, specific prior drugs preclude later options.
• One thread mentions experimental strategies that aim to control rather than eradicate cancer, to reduce selection pressure.
• Bladder cancer is described as having a notoriously high recurrence rate, with detection limits (e.g., imaging can’t see very small tumors) making “true cure” hard to confirm.

BCG and Immune-Based Treatment

• Explanation of why a TB vaccine (BCG) works in bladder cancer: it infects urothelial cancer cells, triggers a Th1 immune response, cytokine release, and recruitment of T cells, NK cells, and macrophages that then attack tumor cells.
• Some personal anecdotes report long-term remission with BCG, though procedures are uncomfortable.

Patient Experiences and Access Concerns

• Multiple users share recent losses or serious illness in family members, describing surgery, cystectomy, stomas, rapid metastasis, and quality-of-life tradeoffs.
• One user from Ukraine asks about access; responses say the main trial is closed, suggest searching clinicaltrials.gov, EU trials, or expanded-access programs, but stress chances are low.

Headlines, PR, and Pharma Incentives

• Several comments criticize the headline as context-free and potentially misleading to non-experts and desperate patients.
• Others counter that, given the refractory cohort, the result is genuinely impressive.
• Brief exchange on the “no profit in cures” idea: some express cynical views about pharma incentives; others rebut that effective cures can dominate markets and are heavily pursued.