Blue light cystoscopy significantly reduces the risk of recurrence in patients with high-risk bladder cancer compared to white light cystoscopy.
Among patients with high-risk non-muscle invasive bladder cancer, blue light cystoscopy was found to be associated with a statistically significant reduction in risk of recurrence versus white light cystoscopy, according to data from the BRAVO study, which was shared in a news release from Photocure, The Bladder Cancer Company.
The BRAVO study is a real-world evidence study which aimed to assess the impact of blue light cystoscopy on transurethral resection of bladder tumor, and if this had an impact on patient clinical outcomes. The results showed a 38% reduction in risk of recurrence with the investigative therapy versus white light cystoscopy, which the news release noted is in line with prior results from multiple randomized controlled clinical trials.
“Bladder cancer detection plays an important role in preventing cancer recurrence and optimizing appropriate treatment pathways, as previous research has shown that white light cystoscopy alone may not comprehensively detect all non-muscle invasive bladder cancers. In this propensity-score matched cohort study, we found that the use of blue light cystoscopy versus white light cystoscopy alone was associated with [a] significantly decreased 38% risk of recurrence,” study author, Dr. Steven Williams, professor and chief of the Division of Urology, at the University of Texas-Medical Branch, stated in the press release.
“Our results are in line with the recent Cochrane review of nearly 3,000 patients across 15 randomized trials, where the authors found that that blue light cystoscopy may reduce the risk of bladder cancer recurrence by 34%. These data support current [guidelines] recommending blue light cystoscopy usage in patients with non-muscle invasive bladder cancer to increase detection and decrease recurrence”, he continued.
Glossary:
Transurethral resection of bladder tumor (TURBT): a surgical procedure used to diagnose and treat bladder tumors, involving the removal of abnormal tissue from the bladder.
Blue light cystoscopy: a procedure that uses a special solution and blue light to detect bladder cancer, making it easier to identify tumors.
White light cystoscopy: a standard procedure using a cystoscope with a white light source to visualize the bladder’s inner walls, primarily used for initial diagnosis and surveillance of bladder cancer.
More on the BRAVO Study
The BRAVO study — which stands for Bladder Cancer Recurrence Analysis in Veterans and Outcomes — looked at how these two different techniques for examining the bladder — blue light versus white light cystoscopy — affect bladder cancer outcomes in veterans. This study used past medical records from the Veterans Affairs Healthcare System and compared patients with similar characteristics.
A total of 626 patients were included, with 313 in each group. The study focused on a group of patients at high risk for bladder cancer recurrence and tracked their outcomes over three years. The average age at diagnosis was 71 years, and the median follow-up time was 3.7 years.
After three years, patients who underwent blue light cystoscopy had a significantly lower risk of cancer recurrence compared with those who had white light cystoscopy alone. Additionally, there was a trend suggesting that blue light cystoscopy may help slow disease progression, but the number of patients experiencing progression was too small for the results to be statistically significant.
The study suggests that blue light cystoscopy led to improved patient outcomes. Specifically, patients who had blue light cystoscopy were significantly more likely to receive additional treatments. This supports the idea that blue light cystoscopy gives doctors a clearer view of the cancer, allowing for more precise risk assessment and more effective transurethral resection of bladder tumor, according to the news release.
“The exciting long-term real-world results from the BRAVO study complement and confirm the generalizability of prior recurrence outcomes with blue light cystoscopy beyond the randomized controlled trial setting, reflecting a routine clinical practice patient population”, Anders Neijber, chief medical officer of Photocure, concluded in the news release.
Notably, these findings were also shared in a publication of the study featured in JU Open Plus.
Understanding Bladder Cancer Subtypes
Bladder cancer is one of the most common cancers worldwide, ranking as the eighth most prevalent overall and the fifth most common in men. In 2022, approximately 614,000 new cases were diagnosed, and more than 220,000 people died from the disease. Currently, there are nearly two million people living with bladder cancer.
Men account for approximately 75% of all bladder cancer cases. This type of cancer has a high risk of coming back after treatment, with up to 61% of cases recurring within the first year and up to 78% within five years. Because bladder cancer often returns, there is an unmet need for better ways to diagnose and manage bladder cancer to improve patient outcomes.
Bladder cancer is classified into two main types based on how deeply the cancer has grown into the bladder wall, one of which being non-muscle invasive bladder cancer. This type of bladder cancer remains in the inner layer of cells lining the bladder. Contrarily, muscle-invasive bladder cancer references cancer that has spread into the deeper layers of the bladder wall.
For more news on cancer updates, research and education, don’t forget to subscribe to CURE®’s newsletters here.
