Considerations on the use of urine markers in the management of patients with high-grade non–muscle-invasive bladder cancer

Kamat, Ashish M.; Vlahou, Antonia; Taylor, John A.; Hudson, Michael L.; Pesch, Beate; Ingersoll, Molly A.; Todenhöfer, T.; Rhijn, Bas van; Kassouf, Wassim; Grossman, H. Barton; Behrens, Thomas; Chandra, Ashish; Goebell, Peter J.; Palou, Juan; Sänchez‐Carbayo, Marta; Schmitz‐Dräger, Bernd J.

doi:10.1016/j.urolonc.2014.06.017

Cited by 32 publications

(25 citation statements)

References 35 publications

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“…In an effort to reduce the frequency of cystoscopies conducted, several noninvasive biomarkers have been approved by the FDA, albeit with performance rates remaining insufficient to replace current diagnostic and monitoring practices relying on cystoscopy (6). Therefore, a prevailing need for noninvasive biomarkers which will facilitate the timely diagnosis of primary and recurrent urothelial bladder cancer (6), including low-grade NMIBC (7,8), remains unmet to date. Such biomarkers are likely to reduce the frequency of diagnostic cystoscopies conducted, particularly among patients undergoing monitoring for recurrent urothelial bladder cancer.…”

Section: Introductionmentioning

confidence: 99%

Development and Validation of Urine-based Peptide Biomarker Panels for Detecting Bladder Cancer in a Multi-center Study

Frantzi

Kessel

Zwarthoff

et al. 2016

Clinical Cancer Research

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Purpose: Urothelial bladder cancer presents high recurrence rates, mandating continuous monitoring via invasive cystoscopy. The development of noninvasive tests for disease diagnosis and surveillance remains an unmet clinical need. In this study, validation of two urine-based biomarker panels for detecting primary and recurrent urothelial bladder cancer was conducted.Experimental Design: Two studies (total n ¼ 1,357) were performed for detecting primary (n ¼ 721) and relapsed urothelial bladder cancer (n ¼ 636). Cystoscopy was applied for detecting urothelial bladder cancer, while patients negative for recurrence had follow-up for at least one year to exclude presence of an undetected tumor at the time of sampling. Capillary electrophoresis coupled to mass spectrometry (CE-MS) was employed for the identification of urinary peptide biomarkers. The candidate urine-based peptide biomarker panels were derived from nested cross-sectional studies in primary (n ¼ 451) and recurrent (n ¼ 425) urothelial bladder cancer.Results: Two biomarker panels were developed on the basis of 116 and 106 peptide biomarkers using support vector machine algorithms. Validation of the urine-based biomarker panels in independent validation sets, resulted in AUC values of 0.87 and 0.75 for detecting primary (n ¼ 270) and recurrent urothelial bladder cancer (n ¼ 211), respectively. At the optimal threshold, the classifier for detecting primary urothelial bladder cancer exhibited 91% sensitivity and 68% specificity, while the classifier for recurrence demonstrated 87% sensitivity and 51% specificity. Particularly for patients undergoing surveillance, improved performance was achieved when combining the urine-based panel with cytology (AUC ¼ 0.87).Conclusions: The developed urine-based peptide biomarker panel for detecting primary urothelial bladder cancer exhibits good performance. Combination of the urine-based panel and cytology resulted in improved performance for detecting disease recurrence.

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Section: Introductionmentioning

confidence: 99%

Development and Validation of Urine-based Peptide Biomarker Panels for Detecting Bladder Cancer in a Multi-center Study

Frantzi

Kessel

Zwarthoff

et al. 2016

Clinical Cancer Research

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“…Even with a well-trained eye the conventional follow-up of in-office cystoscopy and urine cytology may still miss tumor recurrence in a significant number of cases (4)(5)(6)(7). Current advances in molecular biomarkers that could potentially work synergistically with conventional surveillance to improve overall sensitivity are hopeful; however, their use is still not widely accepted due to several limitations (8).…”

Section: Introductionmentioning

confidence: 99%

Neutrophil-to-lymphocyte ratio is elevated in recurringnonmuscle invasive bladder cancer

Yürük¹,

Saitz²,

Gönültaş³

et al. 2017

Turk J Med Sci

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Materials and methods Study designAfter approval by our institutional review board, the medical records of 428 consecutive initially diagnosed Background/aim: Although it has been shown that the neutrophil-to-lymphocyte ratio (NLR) may predict the progression of nonmuscle invasive bladder cancer (NMIBC), its association with the recurrence of NMIBC has been poorly studied. The aim of this study is to evaluate the association between NLR and disease recurrence in patients with NMIBC. Materials and methods:The medical records of 428 consecutive initially diagnosed NMIBC patients who underwent transurethral resection between January 2010 and July 2014 were retrospectively reviewed. Patients without a preoperative NLR (n = 6), without a minimum of 6 months of follow-up (n = 56), who were lost to follow-up (n = 38), or who had progressive disease during follow-up (n = 42) were excluded. The demographics, tumor characteristics, and NLRs of patients with and without tumor recurrence were compared.Results: Of 286 patients who met the inclusion criteria, 68 (17.43%) had recurrent disease. Tumor size (P = 0.198), tumor type (P = 0.929), and the presence of carcinoma in situ (P = 0.373) were also similar between groups. Patients with recurrent disease had a higher mean NLR (2.62 ± 0.99 vs. 2.2 ± 0.96, P = 0.002). Conclusion:Our results show that NLR may be used as a predictor of recurrence in patients with NMIBC; however, prospective studies are required to validate these findings.

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“…Thus, the identification of the risks behind disease recurrence and mortality in bladder cancer is critical for adequate surveillance and selection of adjuvant therapies (13,14). Numerous studies have previously investigated potential prognostic factors for patients with bladder cancer, in order to guide therapeutic approaches and improve survival outcomes (15). Lymph node metastasis was previously identified as an important prognostic factor in patients with BTCC, since the survival rate of patients with lymph node metastasis of bladder cancer is usually low (16).…”

Section: Discussionmentioning

confidence: 99%

CCR7 as a predictive biomarker associated with computed tomography for the diagnosis of lymph node metastasis in bladder carcinoma

Chen

Liu

et al. 2015

Oncology Letters

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Abstract. The aim of the present study was to investigate whether the expression levels of CC-chemokine receptor 7 (CCR7) combined with computed tomography (CT) was associated with lymph node metastasis in bladder transitional cell carcinoma (BTCC). For this purpose, 115 cases of BTCC were analyzed at the Department of Urology of Xiangya Hospital, Central South University (Changsha, China). Preoperative CT scans of abdomen and pelvis, immunohistochemistry of CCR7 expression in the tumor specimens and pathological findings for lymph node metastasis were assessed. In addition, the sensitivity, specificity and accuracy of CCR7 and CT for the diagnosis of lymph node metastasis in BTCC were evaluated separately and jointly. The expression levels of CCR7 were observed to be significantly higher in BTCC than in normal controls (P<0.01). Multivariate analysis indicated that the overexpression of CCR7 was an independent predictor for lymph node metastasis in BTCC (P<0.05). The sensitivity, specificity and accuracy of CCR7 combined with CT scan for the diagnosis of lymph node metastasis in BTCC were 92.3, 83.6 and 70.0%, respectively. By contrast, the sensitivity, specificity and accuracy of CCR7 alone were 88.1, 69.9 and 76.5%, respectively, while the sensitivity, specificity and accuracy of CT alone were 52.4, 79.5 and 69.6%, respectively. The results of the present study indicated that CCR7 is an independent predictor of lymph node metastasis in BTCC. Therefore, the use of CCR7 combined with CT may improve the accuracy of the diagnosis of lymph node metastasis in BTCC.

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Considerations on the use of urine markers in the management of patients with high-grade non–muscle-invasive bladder cancer

Cited by 32 publications

References 35 publications

Development and Validation of Urine-based Peptide Biomarker Panels for Detecting Bladder Cancer in a Multi-center Study

Development and Validation of Urine-based Peptide Biomarker Panels for Detecting Bladder Cancer in a Multi-center Study

Neutrophil-to-lymphocyte ratio is elevated in recurringnonmuscle invasive bladder cancer

CCR7 as a predictive biomarker associated with computed tomography for the diagnosis of lymph node metastasis in bladder carcinoma

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