There is a lot more room for improvement and collaborative work needed in bladder cancer not only to support on-going research but also to prompt new discoveries in treatment, according to experts who discussed bladder cancer issues at the 7th European Multidisciplinary Meeting on Urological Cancers in Barcelona.
“There are no licensed biomarkers in clinical use for bladder cancers, up to now and unlike in other malignancies and this calls for a more active and collaborative work to offer optimal healthcare to our patients,” said Maria Ribal (ES) who spoke on biomarker research in non-muscle invasive bladder cancer.
Ribal said that although there are many studies and publications examining a long list of biomarkers, none have yet reach the point where it can be widely used in actual clinical practice, and despite the fact that there are six biomarkers approved by the Food and Drug Administration (FDA) such as BTA-STAT, BTA-TRAK, NMP-22, Immunocyt, FISH (UroVysion) and Accu-Dx.
She also noted that urinary biomarkers have so far yielded only false positives and have missed a significant portion of patients with bladder cancer. To address this issue, Ribal said her institution is leading a multi-centre study in the last few years to look into urinary biomarkers.
“Large-scale collaborative research, adoption of replication culture, the registration of studies and protocols and sharing of data, materials and software, are some of the research practices that may help increase the proportion of true research findings,” added Ribal.
Some selected key messages in the session are the following:
“On the Genome Cancer Atlas (S. Lerner): “There are multiple “omic” platforms performed on 412 high-grade muscle invasive bladder tumours (updated analysis still to be integrated). And there is a high percentage of potentially targetable pathways.”
On managing Carcinoma in situ (J. Witjes): “Cytology is important and markers will come. Searching with white light and biopsies not always successful and meaningful . And there are better alternatives for biopsies such as enhanced imaging.”
On pathology of Cis and prognostic implications (E. Comperat): “It is important to recognize and report premalignant lesions, and every focus of Cis has to be reported.”
On surgical management of MIBC (S. Stief): “In a contemporary series of radical cystectomies, tumour stage and grade, type of pathohistology, lymph node status, vascular and lymphovascular invasion showed a significant negative effect on cancer-specific survival.”