Progressive tissue biomarker profiling in non-muscle-invasive bladder cancer

Abstract

The recurrence rate of non-muscle-invasive bladder cancer (NMIBC) is up to 60% within the first year of therapy. Accurate risk stratification is necessary for patient counselling, follow-up scheduling and individualized therapeutic decision making. Current prognostic models rely on clinicopathologic features, but their discrimination remains limited when in external cohorts. Despite intense efforts regarding the value of biomarkers in prognosticating outcomes in NMIBC, clinical utility remains suboptimal. It is clear that a single biomarker is not enough for the prediction of disease recurrence. Therefore, panels of non-redundant biomarkers have been created and integrated in clinical prognostic model further research relying on high throughput technologies is required. Areas covered: We performed a systematic research of the English-language literature on tissue biomarkers for prediction of NMIBC outcomes up to December 2017. Expert commentary: Despite the essential milestones achieved in our knowledge and understanding of the molecular biology underlying NMIBC, no biomarker has been implemented together with clinical feature in clinical practice. Integration of such biomarkers into predictive and prognostic model could, however, improve our accuracy, thereby paving the way for personalized medicine in the management of NMIBC.

Correlation of Muscle Invasion in Bladder Cancer with Cell Adhesion Properties and Oncoprotein Overexpression Using E-Cadherin and HER2/neu Immunohistochemical Markers.

“…Matching findings were also reached by Baumgart et al, 2007 [22], who demonstrated notable decrease in E-cadherin marker staining in their cases from NMIBC to MIBC in 572 UBC cases. D'Andrea et al (2018) [23] examined E-cadherin as a proposed biomarker for recurrences prediction in NMIBC and although its positivity in most of the cases, E-cadherin failed to predict the recurrences in this study. Otto et al, 2017 [18], approved E-cadherin as a prognostic marker that is lost in progressive cases with above 75% positivity rate in their cases.…”

Analysis of CXCL9, PD1 and PD-L1 mRNA in Stage T1 Non-Muscle Invasive Bladder Cancer and Their Association with Prognosis

“…NMIBC treatment comprises transurethral resection of the bladder (TURB) and, depending on the risk of progression, instillation with bacillus Calmette-Guerin (BCG) or mitomycin [ 3 , 4 , 5 ]. However, high-risk NMIBC remains a challenge because 30% to 60% of patients with stage pT1 NMIBC develop local recurrence, and up to 20% experience disease progression to MIBC [ 6 , 7 , 8 ]. There is heterogeneity in stage pT1 NMIBC, and its risk stratification is based only on clinicopathological parameters that necessitate lifelong follow-up [ 9 ].…”

Non-muscle invasive bladder cancer biomarkers beyond morphology

“…P53 is considered a crucial tumor suppressor gene, encoding for a protein (p53) that plays a central role in arresting the cell cycle, activating DNA repair, and inducing apoptosis. Immunohistochemistry represents a surrogate to the analysis of p53 mutational status since nuclear immunoreactivity is highly concordant with genomic mutations (7)(8)(9). Indeed, proteins encoded by mutated p53 have prolonged half-life with an increased nuclear accumulation, which is responsible for immunohistochemical detection (10).…”