Biomarker test could predict outcome for bladder cancer patients

A set of molecular biomarkers might predict the recurrence of bladder cancer and survival from the disease better than conventional prognostic features, University of Texas Southwestern Medical Center, Dallas, researchers have found. Once a patient undergoes radical cystectomy, researchers say a routine tissue analysis could easily test for the presence of altered proteins that they found to help ascertain the chances that the cancer will return.

"Our goal is to identify patients who have a higher chance of recurring and dying from bladder cancer," said lead author Jose Karam, MD, who worked on the study with Yair Lotan, MD. "If we can identify key biomarker alterations in these patients, we might be able to predict who will benefit from postoperative treatments such as chemotherapy."

Researchers collected archival tissue from 226 patients who underwent radical surgery for bladder cancer between January 1987 and December 2002. They tested the tissue for the protein biomarkers and found that patients who showed alterations in all four biomarkers had a significantly increased rate of mortality from cancer after surgery, as reported in Lancet Oncology (2007; 8:128-36).

Patients who showed no mutations in the four biomarkers had a 90% chance of survival at 5 years compared with less than 20% if they had four altered markers. The findings suggest that alterations in the biomarkers indicate a malfunction in programmed cell death, leading to increased chances of cancer recurrence and mortality.

"Patients who have alterations on all four biomarkers might benefit from adjuvant chemotherapy, even if the cancer appears to be confined to their bladder. Otherwise, their chances for survival are likely to be poor," Dr. Karam said. "Likewise, those who show none of the biomarkers might not need unnecessary chemotherapy."