Grant: Project Grant

Among patients diagnosed with bladder cancer, approximately 75% of patients have superficial bladder tumors at diagnosis. Further, 75% occur in male patients, while females tend to have more aggressive tumors with poorer outcomes. While less life-threating, the recurrent nature of superficial bladder cancer requires long-term surveillance, and the resultant repeated surgeries lead to high costs of treatment. The risk of recurrence over time is high at 50%. Moreover, patients with superficial bladder cancer are commonly elderly, frail and at risk of complications from surgery and hospitalization. There is accumulating evidence that drugs called 5-alpha reductase inhibitors (5-ARIs) reduce the occurrence and recurrence of superficial bladder cancer by up to 50%. 5ARIs are widely prescribed for urinary symptoms related to prostate enlargement which occurs with age and function by suppressing levels of androgens. 5ARIs have few side effects and have previously been found well tolerated in large trials for the prevention of prostate cancer. As off-patent medications, no trials have yet evaluated 5ARIs as treatment for bladder cancer patients. Our pan-Canadian team therefore aims to perform the first clinical trial to assess whether 5ARIs can decrease recurrences of superficial bladder cancer. We focus on patients with superficial bladder cancer for whom there are currently no treatment options to decrease the high recurrence risk. To address unanswered biological questions regarding 5ARI use in patients with bladder cancer, we will perform laboratory analyses of patient and tumor samples. Detailed interviews will help understand patient perspectives on this potential new treatment to guide future studies. Overall, our research will support the development of 5ARIs to meet an important clinical need for bladder cancer patients. Inexpensive, safe and accessible, 5ARIs have excellent potential to benefit patients and decrease health system costs.