Cancer scientists have designed the first molecular test to predict which bladder cancer patients may have cancer involvement in their lymph nodes at the time of surgery—which could help doctors determine which patients are good candidates for pre-surgical, or neo-adjuvant, chemotherapy.
The test analyzes 20 genes on tumor biopsies, according to a paper published online Jan. 20, 2011, in Lancet Oncology.
"Randomized clinical trials have shown that giving neo-adjuvant chemotherapy extends patient lives, but only 5 to 15 percent of patients benefit," says urologic surgeon Dan Theodorescu, MD, PhD, director of the University of Colorado Cancer Center and lead author of the study. "Patients who have cancer in the lymph nodes at time of diagnosis are likely to benefit the most."
The study analyzed patient tumor samples from the United States, Canada and Germany. It was funded by the National Cancer Institute.
"Today, only about 2 percent of people with invasive bladder cancer have pre-surgical chemotherapy because it's quite difficult to get through and there is fear of delaying surgery," Theodorescu says. "We need a better way to predict who will benefit, and that's what this test does by identifying patients with a high likelihood of lymph node involvement before surgery."
By the time a third of people are diagnosed, bladder cancer has invaded from the bladder lining into the bladder muscle. Gold-standard treatment includes surgical removal of the bladder and the surrounding lymph nodes; some people also undergo radiation treatment. Even with these treatments, the cancer will recur and spread in about half the people—which is almost always fatal.
Bladder cancer is diagnosed during a procedure called a transurethral resection—essentially a biopsy of the bladder. Using the new test, pathologists can determine the levels for the 20 genes in the diagnostic tissue sample and indicate whether the patient has cancer in the lymph nodes.
"We validated the test's ability to predict lymph node spread of the cancer in a large sample of patients from a randomized trial," said Theodorescu. "The predictive ability held up. If this new test is used to guide neo-adjuvant chemotherapy, we hope it will both help people with positive nodes live longer and keep people with negative nodes from being overtreated."
A clinical trial of using the test as a treatment guide is being planned.Incidence of bladder cancer is increasing in the United States, with about 70,530 new cases diagnosed in 2010 according to the American Cancer Society. About 500,000 people are bladder cancer survivors today. Bladder cancer is the fourth most common cancer diagnosed in American men, who are three times more likely to be diagnosed with the disease than women.
About the University of Colorado Cancer Center
The University of Colorado Cancer Center is the Rocky Mountain region's only National Cancer Institute-designated comprehensive cancer center. NCI has given only 40 cancer centers this designation, deeming membership as "the best of the best." Headquartered on the University of Colorado Anschutz Medical Campus, UCCC is a consortium of three state universities (Colorado State University, University of Colorado at Boulder and University of Colorado Denver) and six institutions (The Children's Hospital, Denver Health, Denver VA Medical Center, National Jewish Health, University of Colorado Hospital and Kaiser Permanente Colorado's Institute of Health Research). Together, our 400+ members are working to ease the cancer burden through cancer care, research, education and prevention and control. Learn more at www.uccc.info.
Caitlin Jenney | EurekAlert!
More genes are active in high-performance maize
19.01.2018 | Rheinische Friedrich-Wilhelms-Universität Bonn
How plants see light
19.01.2018 | Albert-Ludwigs-Universität Freiburg im Breisgau
On the way to an intelligent laboratory, physicists from Innsbruck and Vienna present an artificial agent that autonomously designs quantum experiments. In initial experiments, the system has independently (re)discovered experimental techniques that are nowadays standard in modern quantum optical laboratories. This shows how machines could play a more creative role in research in the future.
We carry smartphones in our pockets, the streets are dotted with semi-autonomous cars, but in the research laboratory experiments are still being designed by...
What enables electrons to be transferred swiftly, for example during photosynthesis? An interdisciplinary team of researchers has worked out the details of how...
For the first time, scientists have precisely measured the effective electrical charge of a single molecule in solution. This fundamental insight of an SNSF Professor could also pave the way for future medical diagnostics.
Electrical charge is one of the key properties that allows molecules to interact. Life itself depends on this phenomenon: many biological processes involve...
At the JEC World Composite Show in Paris in March 2018, the Fraunhofer Institute for Laser Technology ILT will be focusing on the latest trends and innovations in laser machining of composites. Among other things, researchers at the booth shared with the Aachen Center for Integrative Lightweight Production (AZL) will demonstrate how lasers can be used for joining, structuring, cutting and drilling composite materials.
No other industry has attracted as much public attention to composite materials as the automotive industry, which along with the aerospace industry is a driver...
Scientists at Tokyo Institute of Technology (Tokyo Tech) and Tohoku University have developed high-quality GFO epitaxial films and systematically investigated their ferroelectric and ferromagnetic properties. They also demonstrated the room-temperature magnetocapacitance effects of these GFO thin films.
Multiferroic materials show magnetically driven ferroelectricity. They are attracting increasing attention because of their fascinating properties such as...
08.01.2018 | Event News
11.12.2017 | Event News
08.12.2017 | Event News
19.01.2018 | Materials Sciences
19.01.2018 | Health and Medicine
19.01.2018 | Physics and Astronomy