(UroToday.com) Risk stratification of non-muscle-invasive bladder cancer by the European Association of Urology (EAU) is well defined. Despite adequate treatment and monitoring, ~20% of HR-NMIBC progress to secondary MIBC or metastasis. Delayed cystectomy in progressive patients following intravesical treatment has been demonstrated to confer poor oncologic outcomes.
Thus, there exists an unmet clinical need to identify patients with a high propensity for tumor progression. Dr. Olislagers’ group has previously demonstrated that GATA2 methylation and FGFR3 mutation status incrementally improved the precision of risk stratification beyond the EAU risk groups. In this study, they aimed to validate these findings in a large and independent BCG-treated HR-NMIBC patient cohort. Primary HR-NMIBC Ta/T1 BCG-treated patients from five European hospitals were included.
SNaPshot analysis was performed on FFPE tumor samples to identify FGFR3 mutation status. Bisulfite conversion followed by SNaPshot analysis was performed to determine GATA2 methylation status. Out of 514 included patients, 25% experienced progression during a median follow-up of 68 months (IQR: 54.75). The risk of progression could be stratified based on GATA2 methylation and FGFR3 mutation status into a good, moderate and poor (5-year PFS: 90%, 83%, 77%; n=15%, 50%, 36%, respectively) group (p=0.034). A good prognosis was characterized by GATA2 hypomethylation and mutated FGFR3, whereas a poor outcome was associated with GATA2 hypermethylation and wild-type FGFR3.
Presented by: Mitchell Olislagers, Ph.D. Student, Erasmus MC Cancer Institute
Written by: Roger Li, MD, Urologic Oncologist, Moffitt Cancer Center, during the International Bladder Cancer Network Annual Meeting, September 28-October 1, 2022, Barcelona, Spain