Predictive clinico-pathological factors to identify BCG, unresponsive patients, after re-resection for T1 high grade non-muscle invasive bladder cancer

Ferro, Matteo; Barone, Biagio; Crocetto, Felice; Lucarelli, Giuseppe; Busetto, Gian Maria; Giudice, Francesco Del; Maggi, Martina; Crocerossa, Fabio; Cantiello, Francesco; Damiano, Rocco; Borghesi, Marco; Bove, Pierluigi; Papalia, Rocco; Mari, Andrea; Luzzago, Stefano; Soria, Francesco; Marchioni, Michele; Civita, Evelina La; Terracciano, Daniela; Mistretta, F.A.; Piccinelli, Mattia Luca; Marmiroli, A.; Russo, Giorgio Ivan; Schips, Luigi; Hurle, Rodolfo; Contieri, Roberto; Perdonà, Sisto; Prete, Paola Del; Mirone, Vincenzo; Tătaru, Octavian Sabin; Musi, Gennaro; Montanari, Emanuele; Cobelli, O. De; Vartolomei, Mihai Dorin

doi:10.1016/j.urolonc.2022.05.016

Cited by 28 publications

(21 citation statements)

References 33 publications

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“… 34 Previous studies showed that BCG-unresponsive patients reported worse oncological outcomes. 35 Both previous studies and our study suggest the potential of tislelizumab as a PD-1 inhibitor in advanced uroepithelial carcinoma, and we hypothesize that whether its role in NMIBC could be extended to achieve recurrence prevention and whether it would be superior to that of BCG will require further experiments in the future to confirm. Meghani reported that intravesical pembrolizumab could be safe and feasible in BCa unresponsive to BCG, but with small sample size, further study needs to be performed.…”

Section: Discussionsupporting

confidence: 62%

The Efficacy and Safety of Tislelizumab as Adjuvant Treatment for Advanced or Metastatic Bladder Cancer in People Living With HIV: A Retrospective Multi-Center Study

Zheng

Wang

et al. 2023

Cancer Control

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Background People living with HIV (PLWH) have a worse prognosis than the general population. Locally advanced or metastatic bladder cancer (BCa) in PLWH has gradually been increasing in recent years. Immune checkpoint inhibitors can improve antitumor activity in the general population, but relevant data in PLWH are unknown. We thus evaluated the efficacy and safety of tislelizumab in PLWH with locally advanced or metastatic BCa. Methods This retrospective study included 24 patients with locally advanced or metastatic BCa, both HIV positive or negative who underwent tislelizumab treatment (200 mg i.v. every 3 weeks, Q3W) from the multi-centers between December 2019 and March 2022. Demographic details, clinical data, and cancer status were collected. The overall survival (OS), progression-free survival (PFS), overall response rate (ORR), disease control rate (DCR), clinical benefit rate (CBR), and treatment-related adverse events (TRAEs) were recorded and evaluated. Results A total of 24 individuals were chosen for this study, 10 had HIV and the other 14 did not. The median OS in the HIV-negative group was 62.3 (95% CI, 52.6 to 72.2) was no longer than that of the PLWH group 41.9 (95% CI, 32.9 to 51.0) weeks (HR .7, [95% CI, .17 to 3.30], P = .70). Furthermore, the median PFS in the HIV-negative group was 50.0 (95% CI, 36.2 to 63.9) was also no longer than that of the PLWH group 35.9 (95% CI, 25.5 to 46.3) (HR, 1.34, [95% CI, .38 to 4.69], P = .63). Of 24 patients, treatment-related adverse events, grade 3 or 4 occurred in 2 in the PLWH group and 3 in the HIV-negative group. Conclusion This retrospective multi-center study suggested that tislelizumab may provide encouraging antitumor activity and could be generally well tolerated. In this retrospective analysis of patients with locally advanced or metastatic BCa, it seems that PLWH may have similar overall and progression-free survival compared to HIV-negative cases.

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Section: Discussionsupporting

confidence: 62%

The Efficacy and Safety of Tislelizumab as Adjuvant Treatment for Advanced or Metastatic Bladder Cancer in People Living With HIV: A Retrospective Multi-Center Study

Zheng

Wang

et al. 2023

Cancer Control

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“…Ferro et al . conducted a retrospective study to investigate the predictive factors in the response to BCG in patients with a T1G3/HG NMIBC diagnosis [ 42 ]. According to their study, multifocality, lymphovascular invasion, and HG on re-TURBT were independent predictors for response to BCG treatment.…”

Section: Discussionmentioning

confidence: 99%

Effects of intravesical BCG maintenance therapy duration on recurrence rate in high-risk non-muscle invasive bladder cancer (NMIBC): Systematic review and network meta-analysis according to EAU COVID-19 recommendations

et al. 2022

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Purpose During the coronavirus disease 2019 (COVID-19) pandemic, the European Association of Urology (EAU) recommended that courses of intravesical bacillus Calmette-Guérin (BCG) therapy lasting more than 1 year could be safely terminated for patients with high-risk non-muscle-invasive bladder cancer (NMIBC). Thus, we conducted a systematic review and network meta-analysis according to EAU’s COVID-19 recommendations. Materials and methods A systematic review was performed following the Preferred Reporting Items for Systematic Review and Meta-Analysis guidelines. We conducted a network meta-analysis of recurrence rate in patients with NMIBC receiving induction therapy (M0) and those receiving maintenance therapy lasting 1 year (M1) and more than 1 year (M2). Results Nineteen studies of 3,957 patients were included for the network meta-analysis. In a node-split forest plot using Bayesian Markov Chain Monte Carlo (MCMC) modeling, there were no differences between the M1 and M2 groups in recurrence rate [odds ratio (OR) 0.95 (0.73–1.2)]. However, recurrence rate in the M0 group was higher than that in the M1 [OR 1.9 (1.5–2.5)] and M2 [OR 2.0 (1.7–2.4)] groups. P-score tests using frequentist inference to rank the treatments in the network demonstrated that the therapy used in the M2 group (P-score 0.8701) was superior to that used in the M1 (P-score 0.6299) and M0 groups (P-score 0). In rank-probability tests using MCMC modeling, the M2 group showed the highest rank, followed by the M1 and M0 groups. Conclusion In the network meta-analysis, there were no differences between those receiving BCG maintenance therapies in terms of recurrence rate. In the rank tests, therapy lasting more than 1-year appears to be most effective. During the COVID-19 pandemic, 1-year maintenance therapy can be used, but after the COVID-19 pandemic, therapy lasting more than 1-year could be beneficial.

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“…[12][13][14][15] Intravesical Bacillus Calmette-Guérin injections and observation of treatment response helped predict clinical outcomes in patients with bladder cancer, and patients who did not respond to Bacillus Calmette-Guérin reported a worse prognosis. [16][17][18][19][20][21][22] Researchers incorporating the Modified Glasgow Prognostic Score, Systemic Combined Inflammatory Score, Circulating Tumor Cells, and long-stranded noncoding RNA into clinical practice is easily applied and can help improve the prediction of cancer outcomes in patients with NMIBC. [23][24][25][26] The advent of neoadjuvant immunotherapy in combination with cisplatin-based chemotherapy has resulted in complete response rates far beyond expectations for bladder cancer patients.…”

Section: Discussionmentioning

confidence: 99%

A prognostic model for bladder cancer based on cytoskeleton-related genes

et al. 2023

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Background: A typical cancerous growth in the urinary tract, bladder cancer (BLCA) has a dismal survival rate and a poor chance of being cured. The cytoskeleton has been shown to be tightly related to tumor invasion and metastasis. Nevertheless, the expression of genes associated with the cytoskeleton and their prognostic significance in BLCA remain unknown.Methods: In our study, we performed differential expression analysis of cytoskeleton-related genes between BLCA versus normal bladder tissues. According to the outcomes of this analysis of differentially expressed genes, all BLCA cases doing nonnegative matrix decomposition clustering analysis be classified into different molecular subtypes and were subjected to Immune cell infiltration analysis. We then constructed a cytoskeleton-associated gene prediction model for BLCA, and performed risk score independent prognostic analysis and receiver operating characteristic curve analyses to evaluate and validate the prognostic value of the model. Furthermore, enrichment analysis, clinical correlation analysis of prognostic models, and immune cell correlation analysis were carried out.Results: We identified 546 differentially expressed genes that are linked to the cytoskeleton, including 314 up-regulated genes and 232 down-regulated genes. All BLCA cases doing nonnegative matrix decomposition clustering analysis could be classified into 2 molecular subtypes, and we observed differences (P < .05) in C1 and C2 immune scores about 9 cell types. Next, we obtained 129 significantly expressed cytoskeleton-related genes. A final optimized model was constructed consisting of 11 cytoskeleton-related genes. Survival curves and risk assessment predicted the prognostic risk in both groups of patients with BLCA. Survival curves and receiver operating characteristic curves were used to evaluate and validate the prognostic value of the model. Significant enrichment pathways for cytoskeleton-associated genes in bladder cancer samples were explored by Gene set enrichment analysis enrichment analysis. After we obtained the risk scores, a clinical correlation analysis was performed to examine which clinical traits were related to the risk scores. Finally, we demonstrated a correlation between different immune cells. Conclusion:Cytoskeleton-related genes have an important predictive value for BLCA, and the prognostic model we constructed may enable personalized treatment of BLCA.

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Predictive clinico-pathological factors to identify BCG, unresponsive patients, after re-resection for T1 high grade non-muscle invasive bladder cancer

Cited by 28 publications

References 33 publications

The Efficacy and Safety of Tislelizumab as Adjuvant Treatment for Advanced or Metastatic Bladder Cancer in People Living With HIV: A Retrospective Multi-Center Study

The Efficacy and Safety of Tislelizumab as Adjuvant Treatment for Advanced or Metastatic Bladder Cancer in People Living With HIV: A Retrospective Multi-Center Study

Effects of intravesical BCG maintenance therapy duration on recurrence rate in high-risk non-muscle invasive bladder cancer (NMIBC): Systematic review and network meta-analysis according to EAU COVID-19 recommendations

A prognostic model for bladder cancer based on cytoskeleton-related genes

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