Thomas Powles

Bladder cancer is what Dr. Thomas Powles, a urologist at Queen Mary University of London, calls a “Cinderella cancer”: neglected and left behind, attracting little attention or resources. The few treatments aren’t very effective, and most patients die within a year of getting diagnosed. 

For more than two decades, Powles has been studying ways to improve patients’ survival, and in 2023, he tested a new combination of treatments. While he was hopeful about the effect that the new drug combo might have, he was also realistic. “We had tried every combination of drugs and saw negative results, so I made the assumption that this one also wasn’t going to work,” he says.

Powles was happy to be wrong. The drug combination, which pairs a medication that enhances the immune system’s attack on bladder-cancer cells with an antibody targeted to those bladder-cancer cells that also carries a chemotherapy agent, more than doubled the median survival of patients, from just over a year to 2½ years. “I was shocked, and the first thing I did was look at the data to make sure it was robust,” he says. “It was beyond my expectations.” 

In true Cinderella form, the combination has now transformed the once dismal and ignored disease of bladder cancer into one that’s finally drawing attention and hope. And he sees an even brighter future for the broader approach; the antibody appears to enhance the reaction of the immune-based therapy it’s paired with. That means more powerful duos could prove more effective in bladder cancer—“I think we are going to cure bladder cancer with this approach,” he says—as well as potentially treat other stubborn cancers, such as head and neck and certain breast cancers.