For patients with bladder cancer, there is a test that can help care providers determine who is likely to have more aggressive disease than suggested by initial clinical staging after transurethral resection of the bladder tumor, researchers have found.
Veracyte, Inc., a cancer diagnostics company, has announced data regarding its Decipher Bladder Genomic Subtyping Classifier test via a news release, with study findings having been published in European Urology Open Science.
“Molecular subtyping in [clinically non–muscle-invasive bladder cancer] suggests that luminal tumors harbor less aggressive disease, as reflected by lower rates of pathological upstaging to [muscle-invasive bladder cancer (MIBC)] and/or pN+,” researchers wrote in their study findings. “In addition, in MIBC, luminal tumors were associated with favorable outcomes with [radical cystectomy], even in the absence of systemic [neoadjuvant chemotherapy], validating previous findings.”
Glossary:
Luminal tumors: a relatively less-aggressive subtype of bladder cancer.
Muscle-invasive bladder cancer: cancer that has grown into the muscle layer of the bladder wall or deeper.
Neoadjuvant chemotherapy: chemotherapy administered prior to primary treatment, such as surgery.
pN+: when bladder cancer has spread to nearby lymph nodes.
Radical cystectomy: surgical removal of the bladder.
Transurethral resection of the bladder tumor: removal of bladder tumors through the urethra.
Upstaging: when the stage of a patient’s cancer is changed from a lower stage, meaning less extensive disease, to a higher stage, meaning more extensive disease.
In the study, the data of 226 patients — 134 patents with high-risk non-muscle-invasive bladder cancer (NMIBC) and 92 patients with muscle-invasive bladder cancer (MIBC) that had grown into but not through the bladder’s muscle layer — from eight medical centers who underwent radical cystectomy without neoadjuvant chemotherapy were analyzed.
Researchers found that 33% of patients (19% for NMIBC and 53% for MIBC) experienced upstaging to non-organ-confined disease. And, using the Decipher Bladder test, researchers learned that patients with NMIBC with non-luminal tumors were more likely to be upstaged to MIBC, with a rate of 51%, versus 32% of patients with luminal tumors. Additionally, patients with non-luminal bladder cancer had a 67% higher risk of death compared to those with luminal-subtype bladder cancer.
The Decipher Bladder test, according to the news release, is a 219-gene test that is intended for use among patients who have received a diagnosis of bladder cancer.
“Accurate clinical staging in bladder cancer can be challenging, limiting clinicians’ ability to guide treatment decisions for their patients,” stated Dr. Yair Lotan, professor of urology and chief of urologic oncology at UT Southwestern Medical Center and corresponding author on the study, in a statement in the news release. “Our findings suggest that molecular subtyping information provided by the Decipher Bladder test can help clinicians better identify which patients may benefit from more-intensive treatment with neoadjuvant chemotherapy and which will not and can thus avoid its toxicity.”
“We are increasing our collaboration efforts with leading clinician-scientists to improve and further personalize bladder cancer care, similar to our approach in prostate cancer which has amassed over 85 publications from analysis of hundreds of thousands of patient transcriptomes,” said Elai Davicioni, medical director, Urology, at Veracyte, in the news release. “This approach is the lynchpin of our Veracyte Diagnostics Platform, which helps facilitate evidence generation, reimbursement and adoption for our tests. It also provides insights that fuel continued innovation, with the overall goal of supporting physicians to deliver better, more-personalized patient care.”
Reference:
“Molecular Subtyping for Predicting Pathological Upstaging and Survival Outcomes in Clinically Organ-confined Bladder Cancer Patients Undergoing Radical Cystectomy” by Joep J. de Jong et al., European Urology Open Science.
For more news on cancer updates, research and education, don’t forget to subscribe to CURE®’s newsletters here.
