EAU 2018: Emerging Biomarkers for Bladder Cancer Prognostication
Three sources of bladder cancer markers include urine, blood and tissue. Several studies have linked FGFR3 to progression, but not recurrence. A previous meta-analysis of 168 publications for p53 have demonstrated that there is insufficient evidence to conclude whether changes in p53 acts as a marker of outcome in patients with bladder cancer [1]. ERCC2 is a gene involved in nucleotide excision repair with prior studies suggesting a response associated with survival. Luminal vs basal mutations have also been previously described, where basal mutations are more aggressive and associated with shorter survival and chemosensitive to cisplatin. Luminal subtypes are chemotherapy resistant and p-53-like mutation is the most aggressive.
Circulating tumor DNA is a fraction of cell-free DNA and varies by stage. This entails a blood draw, ie. a non-invasive blood liquid biopsy. Changes are reflective and bladder cancer has a high mutational burden (90% tP53 or tP53, PIK3CA or Tert).
There are serval issues that Dr. Klatte sees forthcoming. There is often associated pathology, which adds little to the standard of care (conflicting results]. There are conflicting results and bioinformatics, research environment, research, and lack of validation studies. To date, the question remains whether a stoic disease has the potential to progress. For sure at first date, the question remains whether loci disease can lead to metastasis. Markers, according the EAU NIMBC cancer database demonstrate that FGFR3 mutation rate, and are prompting but need further validation.
Dr. Klatte concluded noting that (i) evidence is still low (ii) none of the published markers are ready for time or can be regarded as a ‘biomarker”, and (iii) more research is needed.
Presented by: Tobias Klatte, Addenbrooke’s Hospital, Cambridge, United Kingdom
Written by: Zachary Klaassen, MD, Urologic Oncology Fellow, University of Toronto, Princess Margaret Cancer Centre, twitter: @zklaassen_md at the 2018 European Association of Urology Meeting EAU18, 16-20 March, 2018 Copenhagen, Denmark
References:
1. Malats N, Bustos A, Nascimento CM, et al. p53 as a prognostic marker for bladder cancer: A meta-analysis and review. Lancet Oncol 2005;6(9):678-686.