What is muscle-invasive bladder cancer?

Bladder cancer happens when the cells in the bladder begin to grow in an unusual or uncontrolled way.

As cancer grows, it can stay in the inner lining of the bladder or grow deeper into the bladder wall. Doctors use how deep the cancer has grown to describe different types of bladder cancer. The 2 main types are non-muscle–invasive bladder cancer (NMIBC) and muscle-invasive bladder cancer (MIBC).

The bladder wall is made up of several layers. Most bladder cancers start in the inner lining. This is known as non–muscle-invasive bladder cancer.

  • Muscle-invasive bladder cancer

    Cancer that has spread through the lining of the bladder and into the muscle wall of the bladder or beyond.

  • Non-muscle-invasive bladder cancer

    Cancer that has not reached the muscle wall of the bladder.

Muscle-invasive bladder cancer is when the cancer grows deeper into the bladder wall and reaches the muscle layer.

What are some symptoms of MIBC?

Bladder cancer symptoms can vary from person to person, but common symptoms may include:

  • Seeing blood in the urine (most common)
    • The color can vary from slightly rusty to bright red
  • Urinating more often than usual, including at night
  • Pain or burning during urination
  • Urinary tract infection
  • A strong urge to urinate even when the bladder is not full

When the cancer has grown large or spread beyond the bladder to other parts of the body, symptoms may include:

  • Being unable to urinate
  • Pain in the lower back on one side
  • Belly pain
  • Pain or soreness in the bones
  • Losing weight or loss of appetite
  • Swelling in the feet
  • Tiredness

Experiencing these symptoms does not necessarily mean you have bladder cancer. But it is very important to talk to your healthcare team if you notice any of them so they can make a proper diagnosis.

How can MIBC be treated?

Treatment may include surgery, chemotherapy, immunotherapy, radiation, or a combination of these.

Sometimes, additional treatment is recommended after surgery. Just because your doctor recommends treatment after surgery does not mean that the surgery was not successful. Sometimes cancer comes back, even after a successful surgery. Treatment after surgery, or adjuvant treatment, can help lower the chance of that happening.

Important Safety Information and Indication

Indication

What is TECENTRIQ?

TECENTRIQ is a prescription medicine used to treat:

Adults with a type of bladder cancer called muscle invasive bladder cancer (MIBC) that has spread into the muscle layer of the bladder but not to other parts of the body. TECENTRIQ may be used alone as a treatment for your bladder cancer:

  • to help prevent your bladder cancer from coming back after your bladder has been removed by surgery, and
  • small pieces of DNA from the tumor (called circulating tumor DNA [ctDNA]) were found in your blood, showing that cancer cells remain in the body (molecular residual disease). Your healthcare provider will perform a test to make sure that TECENTRIQ is right for you.

It is not known if TECENTRIQ is safe and effective when used:

  • in children for the treatment of MIBC.

Important Safety Information

What is the most important information about TECENTRIQ?

TECENTRIQ can cause your immune system to attack normal organs and tissues in any area of your body and can affect the way they work. These problems can sometimes become severe or life-threatening and can lead to death. You can have more than one of these problems at the same time. These problems may happen anytime during your treatment or even after your treatment has ended.

Call or see your healthcare provider right away if you develop any new or worsening signs or symptoms, including:

Lung problems

  • cough
  • shortness of breath
  • chest pain

Intestinal problems

  • diarrhea (loose stools) or more frequent bowel movements than usual
  • stools that are black, tarry, sticky, or have blood or mucus
  • severe stomach-area (abdomen) pain or tenderness

Liver problems

  • yellowing of your skin or the whites of your eyes
  • severe nausea or vomiting
  • pain on the right side of your stomach area (abdomen)
  • dark urine (tea colored)
  • bleeding or bruising more easily than normal

Hormone gland problems

  • headaches that will not go away or unusual headaches
  • eye sensitivity to light
  • eye problems
  • rapid heartbeat
  • increased sweating
  • extreme tiredness
  • weight gain or weight loss
  • feeling more hungry or thirsty than usual
  • urinating more often than usual
  • hair loss
  • feeling cold
  • constipation
  • your voice gets deeper
  • dizziness or fainting
  • changes in mood or behavior, such as decreased sex drive, irritability, or forgetfulness

Kidney problems

  • decrease in your amount of urine
  • blood in your urine
  • swelling of your ankles
  • loss of appetite

Skin problems

  • rash
  • itching
  • skin blistering or peeling
  • painful sores or ulcers in your mouth or your nose, throat, or genital area
  • fever or flu-like symptoms
  • swollen lymph nodes

Problems can also happen in other organs.
These are not all of the signs and symptoms of immune system problems that can happen with TECENTRIQ. Call or see your healthcare provider right away for any new or worsening signs or symptoms, including:

  • Chest pain, irregular heartbeat, shortness of breath, or swelling of ankles
  • Confusion, sleepiness, memory problems, changes in mood or behavior, stiff neck, balance problems, tingling or numbness of the arms or legs
  • Double vision, blurry vision, sensitivity to light, eye pain, changes in eyesight
  • Persistent or severe muscle pain or weakness, muscle cramps
  • Low red blood cells, bruising

Infusion reactions that can sometimes be severe or life-threatening. Signs and symptoms of infusion reactions may include:

  • chills or shaking
  • itching or rash
  • flushing
  • shortness of breath or wheezing
  • dizziness
  • feeling like passing out
  • fever
  • back or neck pain

Rejection of a transplanted organ or tissue. Your healthcare provider should tell you what signs and symptoms you should report and monitor you depending on the type of organ or tissue transplant that you have had.

Complications, including graft-versus-host disease (GVHD), in people who have received a bone marrow (stem cell) transplant that uses donor stem cells (allogeneic). These complications can be serious and can lead to death. These complications may happen if you underwent transplantation either before or after being treated with TECENTRIQ. Your healthcare provider will monitor you for these complications.

Getting medical treatment right away may help keep these problems from becoming more serious. Your healthcare provider will check you for these problems during your treatment with TECENTRIQ. Your healthcare provider may treat you with corticosteroid or hormone replacement medicines. Your healthcare provider may also need to delay or completely stop treatment with TECENTRIQ if you have severe side effects.

Before you receive TECENTRIQ, tell your healthcare provider about all of your medical conditions, including if you:

  • have immune system problems such as Crohn’s disease, ulcerative colitis, or lupus
  • have received an organ or tissue transplant, including corneal transplant
  • have received or plan to receive a stem cell transplant that uses donor stem cells (allogeneic)
  • have received radiation treatment to your chest area
  • have a condition that affects your nervous system, such as myasthenia gravis or Guillain-Barré syndrome
  • are pregnant or plan to become pregnant. TECENTRIQ can harm your unborn baby. Tell your healthcare provider right away if you become pregnant or think you may be pregnant during treatment with TECENTRIQ. Females who are able to become pregnant:
    • Your healthcare provider should do a pregnancy test before you start treatment with TECENTRIQ.
    • You should use an effective method of birth control during your treatment and for at least 5 months after the last dose of TECENTRIQ.
  • are breastfeeding or plan to breastfeed. It is not known if TECENTRIQ passes into your breast milk. Do not breastfeed during treatment and for at least 5 months after the last dose of TECENTRIQ.

Tell your healthcare provider about all the medicines you take, including prescription and over-the-counter medicines, vitamins, and herbal supplements.

The most common side effects of TECENTRIQ when used alone include:

  • feeling tired or weak
  • decreased appetite
  • nausea
  • cough
  • shortness of breath

TECENTRIQ may cause fertility problems in females, which may affect the ability to have children. Talk to your healthcare provider if you have concerns about fertility.

These are not all the possible side effects of TECENTRIQ. Ask your healthcare provider or pharmacist for more information about the benefits and side effects of TECENTRIQ.

You may report side effects to the FDA at 1-800-FDA-1088 or www.fda.gov/medwatch. You may also report side effects to Genentech at 1-888-835-2555.

Please see full Prescribing Information and Medication Guide for additional Important Safety Information.

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