A Luminal Non-Coding RNA-Based Genomic in Patients with Clinically Organ-Confined Bladder Cancer Treated with Radical Cystectomy - Expert Commentary
The study included 134 patients with clinical non-muscle-invasive bladder cancer (cTa/Tis/T1) and 92 with cT2 disease. Using lncRNA expression profiles, the classifier identified 60 patients with luminal favorable subtype, characterized by robust gene expression patterns associated with a less aggressive cancer phenotype. Key findings from multivariate analysis showed that the Luminal favorable subtype had lower odds of upstaging to pathological T3+ disease (OR 0.32, 95% CI 0.12-0.82; P = 0.02), Reduced risk of any upstaging (OR 0.41, 95% CI 0.20-0.83; P = 0.01), Lower risk of upstaging and/or pN+ (OR 0.50, 95% CI 0.25-1.00; P = 0.05) and a significantly better overall survival (hazard ratio 0.33, 95% CI 0.15-0.74; P = 0.007)
Luminal favorable tumors showed higher FGFR3 signaling activity and were more common in non-muscle-invasive disease (35%) compared to cT2 disease (14%). Only 17% of luminal favorable cases were upstaged to non-organ-confined disease at RC, with 10% showing lymph node positive disease.
This study demonstrates the promise of classifiers in identifying less aggressive tumor biology, which could help inform treatment decisions for bladder cancer patients.
Written by: Bishoy M. Faltas, MD, Director of Bladder Cancer Research, Englander Institute for Precision Medicine, Weill Cornell Medicine
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