(UroToday.com) The 2024 ESMO annual meeting included a session on urothelial carcinoma, featuring a presentation by Dr. Dag Rune Stormoen discussing the genetic profile in early and late stage urothelial tract cancer. Urothelial carcinoma is the 13th most lethal cancer worldwide, with ongoing gaps in the knowledge of the mutational landscape in patients with advanced disease after multiple lines of prior treatment. This study presented at ESMO 2024 compared the genomic, transcriptomics, and targeted treatment options between metastatic urothelial carcinoma patients treated with multiple lines of therapy to newly diagnosed, untreated muscle invasive bladder cancer.
Genomic and clinical data was retrieved from heavily treated metastatic urothelial carcinoma patients referred to the Copenhagen Prospective Personalized Oncology (CoPPO) project at Rigshospitalet, University of Copenhagen. Biopsies in CoPPO were performed at the time of enrollment. Data for pre-treated muscle invasive bladder cancer urothelial carcinoma patients were acquired from the Cancer Genome Atlas Bladder Cancer (TCGA BLCA) cohort. Analyses included RNA count data and 523 highly important cancer-related genes (TrueSight Oncology-500) for comparative analysis.
Patients from the CoPPO cohort (n = 31) had a lower median age at first-line treatment than the TCGA BLCA cohort (n = 412), with no significant gender disparity. The predominant histology was urothelial cell carcinoma in both cohorts. Genomic analysis revealed no significant difference between the top mutated genes in the two cohorts, specifically looking into DNA damage repair genes. Molecular subtyping indicated a higher frequency of neuroendocrine differentiation in the CoPPO cohort:
Thirteen percent of patients in the CoPPO cohort received targeted therapy based on genomic findings, and 16% received non-targeted treatment, totaling 29% receiving CoPPO treatment (9 patients), and the remaining 71% received best supportive care. Kaplan-Meier analysis showed a non-significant survival benefit for the intervention group in the CoPPO cohort.
Dr. Stormoen concluded this presentation by discussing the genetic profile in early and late stage urothelial tract cancer and the following take-home points:
- When focusing on 523 highly relevant cancer genes, the mutational profile of metastatic urothelial carcinoma patients who have undergone numerous treatment lines resembles that of newly diagnosed muscle invasive bladder cancer
- These alterations can be targeted, indicating the potential advantage of early genomic testing for personalized treatment within clinical trials
Presented by: Dag Rune Stormoen, MD, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
Written by: Zachary Klaassen, MD, MSc – Urologic Oncologist, Associate Professor of Urology, Georgia Cancer Center, Wellstar MCG Health, @zklaassen_md on Twitter during the 2024 European Society of Medical Oncology (ESMO) Annual Meeting, Barcelona, Spain, Fri, Sept 13 – Tues, Sept 17, 2024.
Related Content: Genetic Profiles in Early vs. Late Stage Urothelial Cancer - Dag Stormoen