To predict response of patients with muscle invasive bladder cancer (MIBC) to neoadjuvant chemotherapy (NAC) through analysis of molecular profile assessed clinically (radiologically and by pathological examination of transurethral resection biopsy [TURBT] specimens) and definitively with histopathological examination after radical cystectomy (RC).
In a prospective study, tumor biopsies were obtained from patients with urothelial MIBC (T2-4a N0-2 M0) during TURBT. Patients were eligible for RC received 4 cycles of cisplatin-based NAC. DNA repair genes (BRACA1, ERCC1) & CTR gene m-RNA expression levels were assessed in resected tissue. The response to chemotherapy was assessed clinically (radiologically & TURBT) following NAC. Response was re-assessed for 64 patients who underwent RC and predictors of cancer-free survival (CFS) were calculated. Receiver operating characteristic (ROC) curve was used to delineate cutoff value copes with the best sensitivity and specificity for prediction of response to NAC.
The study included 104 patients, 42 (40.4%) responded well to NAC clinically. Out of 64 patients who underwent RC, 26 (40.6%) showed good response to NAC. CFS at 18 months for patients who underwent RC was 60%. Statistical analysis showed that molecular profile was an independent predictor of good response to NAC both clinically and pathologically and also predicted better CFS.
Molecular profile could play a decisive role in early detection of patients with MIBC who will get benefit from preoperative NAC.
Clinical genitourinary cancer. 2023 Aug 10 [Epub ahead of print]
Ahmed Elkarta, Amira Awadalla, Ahmed El-Hefnawy, Ahmed Mosbah, Hassan Abolenein, Ahmed Shokeir
Urology department, Urology and Nephrology Center, Mansoura University, Mansoura, Egypt., Center of Excellence of Genome and Cancer Research, Urology and Nephrology Center, Mansoura University, Mansoura, Egypt., Urology department, Urology and Nephrology Center, Mansoura University, Mansoura, Egypt; Center of Excellence of Genome and Cancer Research, Urology and Nephrology Center, Mansoura University, Mansoura, Egypt., Urology department, Urology and Nephrology Center, Mansoura University, Mansoura, Egypt; Center of Excellence of Genome and Cancer Research, Urology and Nephrology Center, Mansoura University, Mansoura, Egypt. Electronic address: .