Bladder cancer, one of the 10 most common cancers, is notoriously difficult to treat, with up to 80% of patients experiencing a post-treatment recurrence. A common practice is to surgically remove the entire bladder, but this leaves the patient incontinent. Now, a research effort led by the University of Massachusetts Amherst has been awarded a five-year grant providing up to $3.45 million from the National Institutes of Health to develop a new way to prevent the cancer’s recurrence, without removing the organ or aggressive repeated treatments.   

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Govind Srimathveeravalli, lead researcher and associate professor in the Riccio College of Engineering at UMass Amherst, says that bladder cancer recurrence is like whack-a-mole: “[The patient’s] bladder has these diseased cells that we don’t know what they look like, we don’t know where they’re hiding [and] we can’t get rid of them.”

Despite advancements in bladder cancer treatments, the disease relapses in many patients, motivating the search for better, more durable cures. Rather than treating cancer as it re-emerges or relying on cancer biology, Srimathveeravalli is designing a new, medical-device-based approach that targets the inner lining of the bladder, called the urothelium.

“What we are asking is: why allow the progression of diseased urothelial cells that form the inner lining of the bladder to malignancy? Why not exfoliate this cell layer where the diseased cells are hiding, thereby preempt the emergence of cancer and allow the healthy cells in the layer to regenerate? 

One of the challenges of this complex engineering project is that the bladder is large and irregularly shaped, while the cell layer being targeted is about 0.1 mm thick. Srimathveeravalli and his team are reimagining a technique called irreversible electroporation (IRE) to accomplish this goal. Currently, IRE is performed in patients by using a needle electrode to deliver electrical energy inside a solid tumor, killing the tumor cells without harming other structures around it. Instead, Srimathveeravalli and his team are creating a device that transforms this technology from one that targets areas with pinpoint accuracy into a flexible catheter that affects just the innermost layer—only three or four cells thick—of the entire bladder wall. 

“The exciting part of the project is this partnership between UMass and Dr. Jonathan Coleman, a urologic surgeon at Memorial Sloan Kettering Cancer Center, a world-famous cancer hospital in New York City,” Srimathveeravalli adds. While clinical trials are not part of this grant, the partnership strengthens the translational potential of this project.

“If we are successful in showing that this is safe and effective, it is very well positioned to take this into clinical trials as the next step,” he says.