Application of a multiplex urinalysis test for predicting treatment response in patients with bcg unresponsive bladder cancer: a pilot study

You have accessJournal of UrologyCME1 Apr 2023PD25-04 APPLICATION OF A MULTIPLEX URINALYSIS TEST FOR PREDICTING TREATMENT RESPONSE IN PATIENTS WITH BCG UNRESPONSIVE BLADDER CANCER: A PILOT STUDY Hideki Furuya, Kaoru Murakami, Ian Pagano, Runpu Chen, Yijun Sun, Nari Kim, Edward Kadel, Cheryl Wong, Nicole Davarpanah, and Charles Rosser Hideki FuruyaHideki Furuya More articles by this author , Kaoru MurakamiKaoru Murakami More articles by this author , Ian PaganoIan Pagano More articles by this author , Runpu ChenRunpu Chen More articles by this author , Yijun SunYijun Sun More articles by this author , Nari KimNari Kim More articles by this author , Edward KadelEdward Kadel More articles by this author , Cheryl WongCheryl Wong More articles by this author , Nicole DavarpanahNicole Davarpanah More articles by this author , and Charles RosserCharles Rosser More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003303.04AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Recently, we reported that OncuriaTM, a multiplex urinalysis test, could be predictive of BCG treatment response. Furthermore, high-grade BCG unresponsive bladder cancer have limited treatment options. Such patients are offered either radical cystectomy or systemic therapy. One of the systemic therapies include immune-oncology agents, e.g., PD-1 or PD-L1 inhibitors. In this study, we tested the performance of OncuriaTM in a BCG unresponsive cohort to determine if it could predict response to a PDL1 inhibitor. METHODS: OncuriaTM data was evaluated in voided urine samples obtained from a prospectively collected cohort of 18 subjects who have BCG-unresponsive NMIBC with treatment of atezolizumab monotherapy or atezolizumab BCG combination (provided by Genentech, NCT02792192). The urine samples were collected prior to treatment in both arms. The OncuriaTM test, which measures 10 cancer-associated biomarkers was performed in an independent clinical laboratory. Predictive models were previously developed using supervised learning and cross-validation analyses. Model performance was validated using ROC curves. RESULTS: Pre-treatment urinary concentrations of MMP9, VEGFA, CA9, SDC1, PAI1, APOE, A1AT, ANG and MMP10 were increased in patients who developed disease recurrence. A combinatorial predictive model of treatment outcome achieved sensitivity and specificity of >90%. CONCLUSIONS: Previous pilot study found that monitoring the urinary levels of a cancer-associated biomarker panel enabled the discrimination of patients who did not respond to intravesical BCG therapy. In this study, we noted the performance of OncuriaTM for the prediction of systemic PDL1 inhibitor treatment response. A limitation of this study includes its small sample size. With further study, the multiplex OncuriaTM test may be applicable for the clinical evaluation of bladder cancer patients who have not previously responded to intravesical BCG treatment and is considering systemic immune-oncology options. Source of Funding: NIH/NCI R21CA263230, NIH/NCI R01CA198887 © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e730 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Hideki Furuya More articles by this author Kaoru Murakami More articles by this author Ian Pagano More articles by this author Runpu Chen More articles by this author Yijun Sun More articles by this author Nari Kim More articles by this author Edward Kadel More articles by this author Cheryl Wong More articles by this author Nicole Davarpanah More articles by this author Charles Rosser More articles by this author Expand All Advertisement PDF downloadLoading ...