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Zhang X, Hong B, Li H, Zhao J, Li M, Wei D, Wang Y, Zhang N. Basement membrane-related MMP14 predicts poor prognosis and response to immunotherapy in bladder cancer. BMC Cancer 2024; 24:746. [PMID: 38898429 PMCID: PMC11186261 DOI: 10.1186/s12885-024-12489-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2024] [Accepted: 06/10/2024] [Indexed: 06/21/2024] Open
Abstract
BACKGROUND Basement membrane (BM) is an important component of the extracellular matrix, which plays an important role in the growth and metastasis of tumor cells. However, few biomarkers based on BM have been developed for prognostic assessment and prediction of immunotherapy in bladder cancer (BLCA). METHODS In this study, we used the BLCA public database to explore the relationship between BM-related genes (BMRGs) and prognosis. A novel molecular typing of BLCA was performed using consensus clustering. LASSO regression was used to construct a signature based on BMRGs, and its relationship with prognosis was explored using survival analysis. The pivotal BMRGs were further analyzed to assess its clinical characteristics and immune landscape. Finally, immunohistochemistry was used to detect the expression of the hub gene in BLCA patients who underwent surgery or received immune checkpoint inhibitor (ICI) immunotherapy in our hospital. RESULTS We comprehensively analyzed the relationship between BMRGs and BLCA, and established a prognostic-related signature which was an independent influence on the prognostic prediction of BLCA. We further screened and validated the pivotal gene-MMP14 in public database. In addition, we found that MMP14 expression in muscle invasive bladder cancer (MIBC) was significantly higher and high MMP14 expression had a poorer response to ICI treatment in our cohort. CONCLUSIONS Our findings highlighted the satisfactory value of BMRGs and suggested that MMP14 may be a potential biomarker in predicting prognosis and response to immunotherapy in BLCA.
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Affiliation(s)
- Xuezhou Zhang
- Department of Urology, Beijing Anzhen Hospital, Capital Medical University, 2 Anzhen Road, Chaoyang District, Beijing, 100029, P. R. China
| | - Baoan Hong
- Department of Urology, Beijing Anzhen Hospital, Capital Medical University, 2 Anzhen Road, Chaoyang District, Beijing, 100029, P. R. China
| | - Hongwei Li
- Department of Pathology, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Peking University Cancer Hospital & Institute, Beijing, P. R. China
| | - Jiahui Zhao
- Department of Urology, Beijing Anzhen Hospital, Capital Medical University, 2 Anzhen Road, Chaoyang District, Beijing, 100029, P. R. China
| | - Mingchuan Li
- Department of Urology, Beijing Anzhen Hospital, Capital Medical University, 2 Anzhen Road, Chaoyang District, Beijing, 100029, P. R. China
| | - Dechao Wei
- Department of Urology, Beijing Anzhen Hospital, Capital Medical University, 2 Anzhen Road, Chaoyang District, Beijing, 100029, P. R. China
| | - Yongxing Wang
- Department of Urology, Beijing Anzhen Hospital, Capital Medical University, 2 Anzhen Road, Chaoyang District, Beijing, 100029, P. R. China
| | - Ning Zhang
- Department of Urology, Beijing Anzhen Hospital, Capital Medical University, 2 Anzhen Road, Chaoyang District, Beijing, 100029, P. R. China.
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Tang C, Fan Y, Zhu S. Preliminary findings on the development of a predictive model for BLCA based on disulfidptosis-associated IncRNAs signature. BMC Urol 2024; 24:69. [PMID: 38532369 DOI: 10.1186/s12894-024-01454-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2023] [Accepted: 03/13/2024] [Indexed: 03/28/2024] Open
Abstract
BACKGROUND Bladder urothelial carcinoma (BLCA) is the most common malignancy of the urinary tract, presenting with a wide range of clinical symptoms and prognosis. Disulfidptosis is a newly identified cell death method and closely associated with BLCA progression, prognosis, and treatment outcome. Currently, we need to construct a new prognostic model for disulfidptosis-related long noncoding RNAs (drlncRNAs) to improve the treatment strategy of BLCA. METHODS The data for BLCA samples were obtained from The Cancer Genome Atlas (TCGA), and then 10 unique genes related to disulfidoptosis (DRGs) were identified from research papers. The differences between the two groups showed in this study were used to create the "disulfidptosis-related long noncoding RNAs score" (disulfidptosis-score) prognostic model. RESULTS We identified two groups of drlncRNAs with high and low disulfidptosis scores in this study. Patients with low disulfidptosis scores had a better overall survival rate compared to those with high scores in bladder cancer, and the high disulfidptosis score subtype exhibited more active malignant pathways related to cancer than the low score subtype. We found that the low disulfidptosis-score subgroup had better prognosis than the high disulfidptosis-score subgroup. The expression of mutation burden was much higher in the low disulfidptosis-score group than in the high disulfidptosis-score group. The low disulfidptosis-score subgroup of patients exhibited significantly higher proportions of plasma cells, T cells CD8, and Tregs, while the high-risk subgroup had a greater abundance of Macrophages M0 and Macrophages M2. The disulfidptosis-score showed a strong correlation with the sensitivity of chemotherapeutic drugs, and patients in the low disulfidptosis-score group were more likely to exhibit an immune response and respond positively to immunotherapy. Additionally, we developed a nomogram to enhance the accuracy of the disulfidptosis-clinical score. CONCLUSION Based on our investigation of disulfidptosis-score in BLCA, disulfidptosis-score may have an important role in TME, prognosis, and drug sensitivity. We also investigated the significance of the disulfidoptosis-score in relation to immunotherapy and immune response, providing a basis for improving prognosis and responding to immunotherapy among patients with BLCA.
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Affiliation(s)
- Chao Tang
- Department of Urology, Affiliated Yantai Yuhuangding Hospital, Qingdao University, Yantai, Shandong, China
| | - Yanpeng Fan
- Department of Urology, The First Hospital of Jilin University, Changchun, Jilin, China
| | - Shusheng Zhu
- Department of Urology, Jining No. 1 People's Hospital, Jining, 271000, shandong, China.
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Liu J, Gao Y, Song C, Liao W, Meng L, Yang S, Xiong Y. Immunotherapeutic prospects and progress in bladder cancer. J Cell Mol Med 2024; 28:e18101. [PMID: 38165009 PMCID: PMC10902563 DOI: 10.1111/jcmm.18101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Revised: 11/28/2023] [Accepted: 12/10/2023] [Indexed: 01/03/2024] Open
Abstract
Bladder cancer is one of the most common malignant tumours of the urogenital system, with high morbidity and mortality. In most cases, surgery is considered the first choice of treatment, followed by adjuvant chemotherapy. However, the 5-year recurrence rate is still as high as 65% in patients with non-invasive or in situ tumours and up to 73% in patients with slightly more advanced disease at initial diagnosis. Various treatment methods for bladder cancer have been developed, and hundreds of new immunotherapies are being tested. To date, only a small percentage of people have had success with new treatments, though studies have suggested that the combination of immunotherapy with other therapies improves treatment efficiency and positive outcomes for individuals, with great hopes for the future. In this article, we summarize the origins, therapeutic mechanisms and current status of research on immunotherapeutic agents for bladder cancer.
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Affiliation(s)
- Junwei Liu
- Department of UrologyRenmin Hospital of Wuhan UniversityWuhanHubei ProvinceChina
| | - Yue Gao
- Department of Party and AdministrationRenmin Hospital of Wuhan UniversityWuhanHubei ProvinceChina
| | - Chao Song
- Department of UrologyRenmin Hospital of Wuhan UniversityWuhanHubei ProvinceChina
| | - Wenbiao Liao
- Department of UrologyRenmin Hospital of Wuhan UniversityWuhanHubei ProvinceChina
| | - Lingchao Meng
- Department of UrologyRenmin Hospital of Wuhan UniversityWuhanHubei ProvinceChina
| | - Sixing Yang
- Department of UrologyRenmin Hospital of Wuhan UniversityWuhanHubei ProvinceChina
| | - Yunhe Xiong
- Department of UrologyRenmin Hospital of Wuhan UniversityWuhanHubei ProvinceChina
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Porreca A, Di Nicola M, Lucarelli G, Dorin VM, Soria F, Terracciano D, Mistretta FA, Luzzago S, Buonerba C, Cantiello F, Mari A, Minervini A, Veccia A, Antonelli A, Musi G, Hurle R, Busetto GM, Del Giudice F, Ferretti S, Perdonà S, Prete PD, Porreca A, Bove P, Crisan N, Russo GI, Damiano R, Amparore D, Porpiglia F, Autorino R, Piccinelli M, Brescia A, Tătaru SO, Crocetto F, Giudice AL, de Cobelli O, Schips L, Ferro M, Marchioni M. Time to progression is the main predictor of survival in patients with high-risk nonmuscle invasive bladder cancer: Results from a machine learning-based analysis of a large multi-institutional database. Urol Oncol 2024; 42:69.e17-69.e25. [PMID: 38302296 DOI: 10.1016/j.urolonc.2024.01.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2023] [Revised: 11/13/2023] [Accepted: 01/01/2024] [Indexed: 02/03/2024]
Abstract
BACKGROUND In patients affected by high-risk nonmuscle invasive bladder cancer (HR-NMIBC) progression to muscle invasive status is considered as the main indicator of local treatment failure. We aimed to investigate the effect of progression and time to progression on overall survival (OS) and to investigate their validity as surrogate endpoints. METHODS A total of 1,510 patients from 18 different institutions treated for T1 high grade NMIBC, followed by a secondary transurethral resection and BCG intravesical instillation. We relied on random survival forest (RSF) to rank covariates based on OS prediction. Cox's regression models were used to quantify the effect of covariates on mortality. RESULTS During a median follow-up of 49.0 months, 485 (32.1%) patients progressed to MIBC, while 163 (10.8%) patients died. The median time to progression was 82 (95%CI: 78.0-93.0) months. In RSF time-to-progression and age were the most predictive covariates of OS. The survival tree defined 5 groups of risk. In multivariable Cox's regression models accounting for progression status as time-dependent covariate, shorter time to progression (as continuous covariate) was associated with longer OS (HR: 9.0, 95%CI: 3.0-6.7; P < 0.001). Virtually same results after time to progression stratification (time to progression ≥10.5 months as reference). CONCLUSION Time to progression is the main predictor of OS in patients with high risk NMIBC treated with BCG and might be considered a coprimary endpoint. In addition, models including time to progression could be considered for patients' stratification in clinical practice and at the time of clinical trials design.
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Affiliation(s)
- Annamaria Porreca
- Biostatistics Laboratory, Department of Medical, Oral and Biotechnological Sciences, "G. d'Annunzio" University of Chieti, Chieti, Italy
| | - Marta Di Nicola
- Biostatistics Laboratory, Department of Medical, Oral and Biotechnological Sciences, "G. d'Annunzio" University of Chieti, Chieti, Italy
| | - Giuseppe Lucarelli
- Urology, Andrology and Kidney Transplantation Unit, Department of Emergency and Organ Transplantation, University of Bari, Bari, Italy
| | - Vartolomei Mihai Dorin
- Department of Cell and Molecular Biology, George Emil Palade University of Medicine, Pharmacy, Sciences and Technology from Târgu Mureș, Târgu Mureș, Romania
| | - Francesco Soria
- Division of Urology, Department of Surgical Sciences, Torino School of Medicine, Torino, Italy
| | - Daniela Terracciano
- Department of Translational Medical Sciences, University Federico II, Napoli, Italy
| | | | - Stefano Luzzago
- Department of Urology, IEO European Institute of Oncology, IRCCS, Milan, Italy
| | - Carlo Buonerba
- CRTR Rare Tumors Reference Center, AOU Federico II, Napoli, Italy
| | - Francesco Cantiello
- Department of Urology, Magna Graecia University of Catanzaro, Catanzaro, Italy
| | - Andrea Mari
- Unit of Oncologic Minimally-Invasive Urology and Andrology, Department of Urology, Careggi Hospital, University of Florence, Florence, Italy
| | - Andrea Minervini
- Unit of Oncologic Minimally-Invasive Urology and Andrology, Department of Urology, Careggi Hospital, University of Florence, Florence, Italy
| | | | | | - Gennaro Musi
- Department of Urology, IEO European Institute of Oncology, IRCCS, Milan, Italy
| | - Rodolfo Hurle
- Department of Urology, Humanitas Clinical and Research Hospital, Rozzano, Milan, Italy
| | | | | | - Simone Ferretti
- Urology Unit, Department of Medical, Oral and Biotechnological Sciences, "SS. Annunziata" Hospital, "G. d'Annunzio" University of Chieti, Chieti, Italy
| | - Sisto Perdonà
- Uro-Gynecological Department, Istituto Nazionale per lo Studio e la Cura dei Tumori, Fondazione "G. Pascale"-IRCCS, Naples, Italy
| | - Paola Del Prete
- Scientific Directorate, Istituto Nazionale per lo Studio e la Cura dei Tumori, Fondazione "G. Pascale"-IRCCS, Naples, Italy
| | - Angelo Porreca
- Department of Robotic Urologic Surgery, Abano Terme Hospital, Abano Terme, Italy
| | - Pierluigi Bove
- Division of Urology, Department of Experimental Medicine and Surgery, Tor Vergata University of Rome, Rome, Italy
| | - Nicolae Crisan
- Department of Urology, University of Medicine and Pharmacy Iuliu Haţieganu, Cluj-Napoca, Romania
| | | | - Rocco Damiano
- Department of Urology, Magna Graecia University of Catanzaro, Catanzaro, Italy
| | - Daniele Amparore
- Division of Urology, Department of Oncology, School of Medicine, San Luigi Hospital, University of Turin, Orbassano, Turin, Italy
| | - Francesco Porpiglia
- Division of Urology, Department of Oncology, School of Medicine, San Luigi Hospital, University of Turin, Orbassano, Turin, Italy
| | | | - Mattia Piccinelli
- Department of Urology, IEO European Institute of Oncology, IRCCS, Milan, Italy
| | - Antonio Brescia
- Department of Urology, IEO European Institute of Oncology, IRCCS, Milan, Italy
| | - Sabin Octavian Tătaru
- I.O.S.U.D., George Emil Palade University of Medicine, Pharmacy, Sciences and Technology from Târgu Mureș, Târgu Mureș, Romania
| | - Felice Crocetto
- Department of Neurosciences, Science of Reproduction and Odontostomatology, University of Naples Federico II, 80131 Naples, Italy
| | | | - Ottavio de Cobelli
- Department of Urology, IEO European Institute of Oncology, IRCCS, Milan, Italy
| | - Luigi Schips
- Urology Unit, Department of Medical, Oral and Biotechnological Sciences, "SS. Annunziata" Hospital, "G. d'Annunzio" University of Chieti, Chieti, Italy
| | - Matteo Ferro
- Department of Urology, IEO European Institute of Oncology, IRCCS, Milan, Italy
| | - Michele Marchioni
- Urology Unit, Department of Medical, Oral and Biotechnological Sciences, "SS. Annunziata" Hospital, "G. d'Annunzio" University of Chieti, Chieti, Italy.
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Zhou J, Dong C, Tan J, Wang G, Li Z, Li S, He Z. Promoting effect and immunologic role of secretogranin II on bladder cancer progression via regulating MAPK and NF-κB pathways. Apoptosis 2024; 29:121-141. [PMID: 37848672 DOI: 10.1007/s10495-023-01898-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/22/2023] [Indexed: 10/19/2023]
Abstract
Bladder cancer (BLCA) is ranked among the top ten most prevalent cancers worldwide and is the second most common malignant tumor within the field of urology. The limited effectiveness of immune targeted therapy in treating BLCA, due to its high metastasis and recurrence rates, necessitates the identification of new therapeutic targets. Secretogranin II (SCG2), a member of the chromaffin granin/secreted granin family, plays a crucial role in the regulated release of peptides and hormones. The role of SCG2 in the tumor microenvironment (TME) of lung adenocarcinoma and colon cancer has been established, but its functional significance in BLCA remains uncertain. This study aimed to investigate SCG2 expression in 15 bladder cancer tissue samples and their corresponding adjacent control tissues. The potential involvement of SCG2 in BLCA progression was assessed using various techniques, including analysis of public databases, immunohistochemistry, Western Blotting, immunofluorescence, wound-healing assay, Transwell assay, and xenograft tumor formation experiments in nude mice. This study provided novel evidence indicating that SCG2 plays a pivotal role in facilitating the proliferation, migration, and invasion of BLCA by activating the MEK/Erk and MEK/IKK/NF-κB signaling pathways, as well as by promoting M2 macrophage polarization. These findings propose the potential of SCG2 as a molecular target for immunotherapy in human BLCA.
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Affiliation(s)
- Jiawei Zhou
- Department of Urology, Renmin Hospital of Wuhan University, Wuhan, 430060, Hubei, People's Republic of China
| | - Caitao Dong
- Department of Urology, Renmin Hospital of Wuhan University, Wuhan, 430060, Hubei, People's Republic of China
| | - Jing Tan
- Hubei Key Laboratory of Homeostasis, College of Life Sciences, Wuhan University, Wuhan, China
| | - Guijun Wang
- Renmin Hospital of Wuhan University, Wuhan, 430060, Hubei, People's Republic of China
| | - Zhen Li
- Renmin Hospital of Wuhan University, Wuhan, 430060, Hubei, People's Republic of China
| | - Sheng Li
- Department of Urology, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, China
- Department of Biological Repositories, Cancer Precision Diagnosis and Treatment and Translational Medicine Hubei Engineering Research Center, Zhongnan Hospital of Wuhan University, Wuhan, 430071, China
| | - Ziqi He
- Department of Urology, Renmin Hospital of Wuhan University, Wuhan, 430060, Hubei, People's Republic of China.
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Vieira de Sousa T, Guedes de Pinho P, Pinto J. Metabolomic Signatures of Treatment Response in Bladder Cancer. Int J Mol Sci 2023; 24:17543. [PMID: 38139377 PMCID: PMC10743932 DOI: 10.3390/ijms242417543] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2023] [Revised: 12/13/2023] [Accepted: 12/15/2023] [Indexed: 12/24/2023] Open
Abstract
Bladder cancer (BC) stands as one of the most prevalent urological malignancies, with over 500 thousand newly diagnosed cases annually. Treatment decisions in BC depend on factors like the risk of recurrence, the type of tumor, and the stage of the disease. While standard therapeutic approaches encompass transurethral resection of the bladder tumor, radical cystectomy, and chemo- or immunotherapy, these methods exhibit limited efficacy in mitigating the aggressive and recurrent nature of bladder tumors. To overcome this challenge, it is crucial to develop innovative methods for monitoring and predicting treatment responses among patients with BC. Metabolomics is gaining recognition as a promising approach for discovering biomarkers. It has the potential to reveal metabolic disruptions that precisely reflect how BC patients respond to particular treatments, providing a revolutionary method to improve accuracy in monitoring and predicting outcomes. In this article, we present a comprehensive review of studies employing metabolomics approaches to investigate the metabolic responses associated with different treatment modalities for BC. The review encompasses an exploration of various models, samples, and analytical techniques applied in this context. Special emphasis is placed on the reported changes in metabolite levels derived from these studies, highlighting their potential as biomarkers for personalized medicine in BC.
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Affiliation(s)
- Tiago Vieira de Sousa
- Associate Laboratory i4HB–Institute for Health and Bioeconomy, University of Porto, 4050-313 Porto, Portugal;
- UCIBIO–Applied Molecular Biosciences Unit, Laboratory of Toxicology, Faculty of Pharmacy, University of Porto, Rua Jorge Viterbo Ferreira 228, 4050-313 Porto, Portugal
| | - Paula Guedes de Pinho
- Associate Laboratory i4HB–Institute for Health and Bioeconomy, University of Porto, 4050-313 Porto, Portugal;
- UCIBIO–Applied Molecular Biosciences Unit, Laboratory of Toxicology, Faculty of Pharmacy, University of Porto, Rua Jorge Viterbo Ferreira 228, 4050-313 Porto, Portugal
| | - Joana Pinto
- Associate Laboratory i4HB–Institute for Health and Bioeconomy, University of Porto, 4050-313 Porto, Portugal;
- UCIBIO–Applied Molecular Biosciences Unit, Laboratory of Toxicology, Faculty of Pharmacy, University of Porto, Rua Jorge Viterbo Ferreira 228, 4050-313 Porto, Portugal
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7
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Hu H, Yan T, Zhu H, Zhan W, Zhang J, Wang S, Jiang L, Escobar D, Zhang T. A novel immune checkpoint-related signature for prognosis and immune analysis in breast cancer. Clin Exp Med 2023; 23:5139-5159. [PMID: 37930605 DOI: 10.1007/s10238-023-01247-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Accepted: 10/27/2023] [Indexed: 11/07/2023]
Abstract
Breast cancer is one of the most prevailing forms of cancer globally. Immunotherapy has demonstrated efficacy in improving the overall survival of breast cancer. The aim of us was to formulate a novel signature predicated on immune checkpoint-related genes (ICGs) that could anticipate the prognosis and further analyze the immune status of patients with breast cancer. After acquiring data, we pinpointed the definitive ICGs for constructing the prognostic model of breast cancer. We constructed a novel prognostic model and created a fresh risk score called Immune Checkpoint-related Risk Score in breast cancer (ICRSBC). The nomogram was constructed to evaluate the accuracy of the model, and the new web-based tool was created to be more intuitive for predicting prognosis. We also investigated immunotherapy responsiveness and analyzed the tumor mutational burden (TMB) in ICRSBC subgroups. The ICRSBC was found to have significant correlations with the immune environment, immunotherapy responsiveness, and TMB. The expression levels of the 9 ICGs that construct the prognostic model and their promoter methylation levels are significantly different between breast cancer and normal tissues. Furthermore, the mutation profiles, the copy number alterations, and the levels of protein expression also exhibit marked disparities among the 9 ICGs. We have identified and validated a novel signature related to ICGs that is strongly associated with breast cancer progression. This signature enables us to create a risk score for prognosticating the survival and assessing the immune status of individuals affected by breast cancer.
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Affiliation(s)
- Haihong Hu
- Department of Pharmacy, The First Affiliated Hospital, Hengyang Medical School, University of South China, 69 Chuanshan Road, Hengyang, 421001, Hunan, People's Republic of China
- School of Pharmacy, Hengyang Medical College, University of South China, 28 Western Changsheng Road, Hengyang, 421001, Hunan, People's Republic of China
| | - Ting Yan
- Department of Breast and Thyroid Surgery, The First Affiliated Hospital, Hengyang Medical School, University of South China, Hengyang, 421001, Hunan, People's Republic of China
| | - Hongxia Zhu
- Department of Pharmacy, The First Affiliated Hospital, Hengyang Medical School, University of South China, 69 Chuanshan Road, Hengyang, 421001, Hunan, People's Republic of China
- School of Pharmacy, Hengyang Medical College, University of South China, 28 Western Changsheng Road, Hengyang, 421001, Hunan, People's Republic of China
| | - Wendi Zhan
- Department of Pharmacy, The First Affiliated Hospital, Hengyang Medical School, University of South China, 69 Chuanshan Road, Hengyang, 421001, Hunan, People's Republic of China
- School of Pharmacy, Hengyang Medical College, University of South China, 28 Western Changsheng Road, Hengyang, 421001, Hunan, People's Republic of China
| | - Jingdi Zhang
- Department of Pharmacy, The First Affiliated Hospital, Hengyang Medical School, University of South China, 69 Chuanshan Road, Hengyang, 421001, Hunan, People's Republic of China
- School of Pharmacy, Hengyang Medical College, University of South China, 28 Western Changsheng Road, Hengyang, 421001, Hunan, People's Republic of China
| | - Siyu Wang
- Department of Pharmacy, The First Affiliated Hospital, Hengyang Medical School, University of South China, 69 Chuanshan Road, Hengyang, 421001, Hunan, People's Republic of China
- School of Pharmacy, Hengyang Medical College, University of South China, 28 Western Changsheng Road, Hengyang, 421001, Hunan, People's Republic of China
| | - Lingxiang Jiang
- Department of Radiation Oncology, Melvin and Bren Simon Comprehensive Cancer Center, Indiana University School of Medicine, Indianapolis, IN, 46202, USA
| | - David Escobar
- Department of Cancer Biology, College of Medicine and Life Sciences, University of Toledo, Toledo, OH, 43606, USA
| | - Taolan Zhang
- Department of Pharmacy, The First Affiliated Hospital, Hengyang Medical School, University of South China, 69 Chuanshan Road, Hengyang, 421001, Hunan, People's Republic of China.
- School of Pharmacy, Hengyang Medical College, University of South China, 28 Western Changsheng Road, Hengyang, 421001, Hunan, People's Republic of China.
- Phase I Clinical Trial Center, The First Affiliated Hospital, Hengyang Medical School, University of South China, Hengyang, 421001, Hunan, People's Republic of China.
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8
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Yu D, Chen C, Sun L, Wu S, Tang X, Mei L, Lei C, Wang D, Wang X, Cheng L, Li S. KRT13-expressing epithelial cell population predicts better response to chemotherapy and immunotherapy in bladder cancer: Comprehensive evidences based on BCa database. Comput Biol Med 2023; 158:106795. [PMID: 36989746 DOI: 10.1016/j.compbiomed.2023.106795] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Revised: 03/04/2023] [Accepted: 03/20/2023] [Indexed: 03/29/2023]
Abstract
Neoadjuvant chemotherapy (NAC) prior to surgery and immune checkpoint therapy (ICT) has revolutionized bladder cancer (BCa) treatment. Patients likely to benefit from these therapies need to be accurately stratified; however, this remains a major clinical challenge. In the present study, single-cell RNA sequencing was used to evaluate the predictive ability of an epithelial cell population highly expressing keratin 13 (KRT13) to assess therapeutic response in BCa. The presence of KRT13-enriched tumors indicated favorable outcomes after NAC and superior response to ICT in patients with BCa. Furthermore, KRT13 population characteristics appeared to be closely related to changes in the immune microenvironment in the vicinity of this cell population. We constructed a prognostic model using an artificial neural network based on the gene signatures in the KRT13 population; the model demonstrated strong robustness and superiority. Additionally, a user-friendly and open-access web application named BCa database was developed for researchers to study BCa by mining the connective map database.
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9
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Zhou L, Xu G, Huang F, Chen W, Zhang J, Tang Y. Apoptosis related genes mediated molecular subtypes depict the hallmarks of the tumor microenvironment and guide immunotherapy in bladder cancer. BMC Med Genomics 2023; 16:88. [PMID: 37118734 PMCID: PMC10148450 DOI: 10.1186/s12920-023-01525-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2022] [Accepted: 04/23/2023] [Indexed: 04/30/2023] Open
Abstract
Apoptosis has been discovered as a mechanism of cell death. The purpose of this study is to identify the diagnostic signature factors related to bladder cancer (BLCA) through apoptosis related genes (ARGs). Clinicopathological parameters and transcriptomics data of 1,440 BLCA patients were obtained from 7 datasets (GSE13507, GSE31684, GSE32548, GSE32894, GSE48075, TCGA-BLCA, and IMvigor210). We first identified prognosis-related ARGs in BLCA and used them to construct two ARGs molecular subtypes by using consensus clustering algorithm. By using principal component analysis algorithms, a ARGscore was constructed to quantify the index of individualized patient. High ARGscore correlated with progressive malignancy and poor outcomes in BLCA patients. High ARGscore was associated with higher immune cell, higher estimate scores, higher stromal scores, higher immune scores, higher immune checkpoint, and lower tumor purity, which was consistent with the "immunity tidal model theory". Preclinically, BLCA immunotherapy cohorts confirmed patients with low ARGscore demonstrated significant therapeutic advantages and clinical benefits. These findings contribute to our understanding of ARGs and immunotherapy in BLCA. The ARGscore is a potentially useful tool to predict the prognosis and immunotherapy in BLCA.
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Affiliation(s)
- Liquan Zhou
- Department of Urology, The Second Affiliated Hospital, Guangxi Medical University, Nanning, 530006, Guangxi, China
| | - Guanglong Xu
- Department of Urology, The Second Affiliated Hospital, Guangxi Medical University, Nanning, 530006, Guangxi, China
| | - Fu Huang
- Department of Urology, The Second Affiliated Hospital, Guangxi Medical University, Nanning, 530006, Guangxi, China
| | - Wenyuan Chen
- Department of Urology, The Second Affiliated Hospital, Guangxi Medical University, Nanning, 530006, Guangxi, China
| | - Jiange Zhang
- Department of Urology, The Second Affiliated Hospital, Guangxi Medical University, Nanning, 530006, Guangxi, China
| | - Yong Tang
- Department of Urology, Wuming Hospital, Guangxi Medical University, Nanning, 530199, Guangxi, China.
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10
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Semeniuk-Wojtaś A, Poddębniak-Strama K, Modzelewska M, Baryła M, Dziąg-Dudek E, Syryło T, Górnicka B, Jakieła A, Stec R. Tumour microenvironment as a predictive factor for immunotherapy in non-muscle-invasive bladder cancer. Cancer Immunol Immunother 2023:10.1007/s00262-023-03376-9. [PMID: 36928373 DOI: 10.1007/s00262-023-03376-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Accepted: 01/09/2023] [Indexed: 03/18/2023]
Abstract
Bladder cancer (BC) can be divided into two subgroups depending on invasion of the muscular layer: non-muscle-invasive bladder cancer (NMIBC) and muscle-invasive bladder cancer (MIBC). Its aggressiveness is associated, inter alia, with genetic aberrations like losses of 1p, 6q, 9p, 9q and 13q; gain of 5p; or alterations in the p53 and p16 pathways. Moreover, there are reported metabolic disturbances connected with poor diagnosis-for example, enhanced aerobic glycolysis, gluconeogenesis or haem catabolism.Currently, the primary way of treatment method is transurethral resection of the bladder tumour (TURBT) with adjuvant Bacillus Calmette-Guérin (BCG) therapy for NMIBC or radical cystectomy for MIBC combined with chemotherapy or immunotherapy. However, intravesical BCG immunotherapy and immune checkpoint inhibitors are not efficient in every case, so appropriate biomarkers are needed in order to select the proper treatment options. It seems that the success of immunotherapy depends mainly on the tumour microenvironment (TME), which reflects the molecular disturbances in the tumour. TME consists of specific conditions like hypoxia or local acidosis and different populations of immune cells including tumour-infiltrating lymphocytes, natural killer cells, neutrophils and B lymphocytes, which are responsible for shaping the response against tumour neoantigens and crucial pathways like the PD-L1/PD-1 axis.In this review, we summarise holistically the impact of the immune system, genetic alterations and metabolic changes that are key factors in immunotherapy success. These findings should enable better understanding of the TME complexity in case of NMIBC and causes of failures of current therapies.
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Affiliation(s)
| | | | | | | | | | - Tomasz Syryło
- Department of General, Active and Oncological Urology, Military Institute of Medicine, Warsaw, Poland
| | - Barbara Górnicka
- Pathomorphology Department, Medical University of Warsaw, Warsaw, Poland
| | - Anna Jakieła
- Oncology Department, 4 Military Clinical Hospital with a Polyclinic, Wroclaw, Poland
| | - Rafał Stec
- Oncology Department, Medical University of Warsaw, Warsaw, Poland
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11
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Jin W, Yang Q, Chi H, Wei K, Zhang P, Zhao G, Chen S, Xia Z, Li X. Ensemble deep learning enhanced with self-attention for predicting immunotherapeutic responses to cancers. Front Immunol 2022; 13:1025330. [PMID: 36532083 PMCID: PMC9751999 DOI: 10.3389/fimmu.2022.1025330] [Citation(s) in RCA: 28] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Accepted: 11/11/2022] [Indexed: 12/02/2022] Open
Abstract
Introduction Despite the many benefits immunotherapy has brought to patients with different cancers, its clinical applications and improvements are still hindered by drug resistance. Fostering a reliable approach to identifying sufferers who are sensitive to certain immunotherapeutic agents is of great clinical relevance. Methods We propose an ELISE (Ensemble Learning for Immunotherapeutic Response Evaluation) pipeline to generate a robust and highly accurate approach to predicting individual responses to immunotherapies. ELISE employed iterative univariable logistic regression to select genetic features of patients, using Monte Carlo Tree Search (MCTS) to tune hyperparameters. In each trial, ELISE selected multiple models for integration based on add or concatenate stacking strategies, including deep neural network, automatic feature interaction learning via self-attentive neural networks, deep factorization machine, compressed interaction network, and linear neural network, then adopted the best trial to generate a final approach. SHapley Additive exPlanations (SHAP) algorithm was applied to interpret ELISE, which was then validated in an independent test set. Result Regarding prediction of responses to atezolizumab within esophageal adenocarcinoma (EAC) patients, ELISE demonstrated a superior accuracy (Area Under Curve [AUC] = 100.00%). AC005786.3 (Mean [|SHAP value|] = 0.0097) was distinguished as the most valuable contributor to ELISE output, followed by SNORD3D (0.0092), RN7SKP72 (0.0081), EREG (0.0069), IGHV4-80 (0.0063), and MIR4526 (0.0063). Mechanistically, immunoglobulin complex, immunoglobulin production, adaptive immune response, antigen binding and others, were downregulated in ELISE-neg EAC subtypes and resulted in unfavorable responses. More encouragingly, ELISE could be extended to accurately estimate the responsiveness of various immunotherapeutic agents against other cancers, including PD1/PD-L1 suppressor against metastatic urothelial cancer (AUC = 88.86%), and MAGE-A3 immunotherapy against metastatic melanoma (AUC = 100.00%). Discussion This study presented deep insights into integrating ensemble deep learning with self-attention as a mechanism for predicting immunotherapy responses to human cancers, highlighting ELISE as a potential tool to generate reliable approaches to individualized treatment.
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Affiliation(s)
- Wenyi Jin
- Department of Orthopedics, Renmin Hospital of Wuhan University, Wuhan, China
| | - Qian Yang
- Clinical Molecular Medicine Testing Center, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Hao Chi
- Clinical Medical Collage, Southwest Medical University, Luzhou, China
| | - Kongyuan Wei
- Department of General, Visceral and Transplantation Surgery, University of Heidelberg, Heidelberg, Germany
| | - Pengpeng Zhang
- Department of Thoracic Surgery, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Guodong Zhao
- Faculty of Hepatopancreatobiliary Surgery, The First Medical Center of Chinese People’s Liberation Army (PLA) General Hospital, Beijing, China
| | - Shi Chen
- Clinical Molecular Medicine Testing Center, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Zhijia Xia
- Department of General, Visceral, and Transplant Surgery, Ludwig-Maximilians-University Munich, Munich, Germany,*Correspondence: Zhijia Xia, ; Xiaosong Li,
| | - Xiaosong Li
- Clinical Molecular Medicine Testing Center, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China,*Correspondence: Zhijia Xia, ; Xiaosong Li,
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12
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Yu Y, Huang Y, Li C, Ou S, Xu C, Kang Z. Clinical value of M1 macrophage-related genes identification in bladder urothelial carcinoma and in vitro validation. Front Genet 2022; 13:1047004. [PMID: 36468020 PMCID: PMC9709473 DOI: 10.3389/fgene.2022.1047004] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2022] [Accepted: 10/31/2022] [Indexed: 07/20/2023] Open
Abstract
Background: Tumor microenvironment (TME) takes a non-negligible role in the progression and metastasis of bladder urothelial carcinoma (BLCA) and tumor development could be inhibited by macrophage M1 in TME. The role of macrophage M1-related genes in BLCA adjuvant therapy has not been studied well. Methods: CIBERSOR algorithm was applied for identification tumor-infiltrating immune cells (TICs) subtypes of subjects from The Cancer Genome Atlas (TCGA) and Gene Expression Omnibus (GEO) data sets. We identified potential modules of M1 macrophages by weighted gene co-expression network analysis (WGCNA). Nomogram was determined by one-way Cox regression and lasso regression analysis for M1 macrophage genes. The data from GEO are taken to verify the models externally. Kaplan-Meier and receiver operating characteristic (ROC) curves validated prognostic value of M1 macrophage genes. Finally, we divided patients into the low-risk group (LRG) and the high-risk group (HRG) based on the median risk score (RS), and the predictive value of RS in patients with BLCA immunotherapy and chemotherapy was investigated. Bladder cancer (T24, 5637, and BIU-87) and bladder uroepithelial cell line (SV-HUC-1) were used for in vitro validation. Reverse transcription-quantitative polymerase chain reaction (RT-qPCR) was employed to validate the associated genes mRNA level. Results: 111 macrophage M1-related genes were identified using WGCNA. RS model containing three prognostically significant M1 macrophage-associated genes (FBXO6, OAS1, and TMEM229B) was formed by multiple Cox analysis, and a polygenic risk model and a comprehensive prognostic line plot was developed. The calibration curve clarified RS was a good predictor of prognosis. Patients in the LRG were more suitable for programmed cell death protein 1 (PD1) and cytotoxic T lymphocyte associate protein-4 (CTLA4) combination immunotherapy. Finally, chemotherapeutic drug models showed patients in the LRG were more sensitive to gemcitabine and mitomycin. RT-qPCR result elucidated the upregulation of FBXO6, TMEM229B, and downregulation of OAS1 in BLCA cell lines. Conclusion: A predictive model based on M1 macrophage-related genes can help guide us in the treatment of BLCA.
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Affiliation(s)
- Yang Yu
- The Fifth Affiliated Hospital of Zhengzhou University, Zhengzhou University, Zhengzhou, China
| | - Yuexi Huang
- Department of Nephrology, The Affiliated Hospital of Southwest Medical University, Luzhou, China
| | - Chen Li
- Department of Biology, Chemistry, Pharmacy, Free University of Berlin, Berlin, Germany
| | - Santao Ou
- Department of Nephrology, The Affiliated Hospital of Southwest Medical University, Luzhou, China
| | - Chaojie Xu
- The Fifth Affiliated Hospital of Zhengzhou University, Zhengzhou University, Zhengzhou, China
| | - Zhengjun Kang
- The Fifth Affiliated Hospital of Zhengzhou University, Zhengzhou University, Zhengzhou, China
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13
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Compérat E, Amin MB, Cathomas R, Choudhury A, De Santis M, Kamat A, Stenzl A, Thoeny HC, Witjes JA. Current best practice for bladder cancer: a narrative review of diagnostics and treatments. Lancet 2022; 400:1712-1721. [PMID: 36174585 DOI: 10.1016/s0140-6736(22)01188-6] [Citation(s) in RCA: 96] [Impact Index Per Article: 48.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Revised: 05/05/2022] [Accepted: 06/10/2022] [Indexed: 12/20/2022]
Abstract
This Seminar presents the current best practice for the diagnosis and management of bladder cancer. The scope of this Seminar ranges from current challenges in pathology, such as the evolving histological and molecular classification of disease, to advances in personalised medicine and novel imaging approaches. We discuss the current role of radiotherapy, surgical management of non-muscle-invasive and muscle-invasive disease, highlight the challenges of treatment of metastatic bladder cancer, and discuss the latest developments in systemic therapy. This Seminar is intended to provide physicians with knowledge of current issues in bladder cancer.
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Affiliation(s)
- Eva Compérat
- Department of Pathology, Tenon Hospital, Sorbonne University, Paris, France; Department of Pathology, Medical University of Vienna, Vienna, Austria.
| | - Mahul B Amin
- Department of Pathology and Laboratory Medicine and Urology, University of Tennessee Health Science, Memphis, TN, USA
| | - Richard Cathomas
- Department of Oncology/Hematology, Kantonsspital Graubünden, Chur, Switzerland
| | - Ananya Choudhury
- Department of Clinical Oncology, The Christie NHS Foundation Trust and University of Manchester, Manchester, UK
| | - Maria De Santis
- Department of Urology, Charité University Hospital, Berlin, Germany
| | - Ashish Kamat
- Department of Urology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Arnulf Stenzl
- Department of Urology, University Hospital, Tübingen, Germany
| | - Harriet C Thoeny
- Department of Radiology, HFR Fribourg-Hôpital Cantonal, University of Fribourg, Villars-sur-Glâne, Switzerland; Department of Urology, Inselspital University Hospital, Bern, Switzerland
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14
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Chen W, Liu N, Yuan Y, Zhu M, Hu X, Hu W, Wang S, Wang C, Huang B, Xing D. ALT-803 in the treatment of non-muscle-invasive bladder cancer: Preclinical and clinical evidence and translational potential. Front Immunol 2022; 13:1040669. [PMID: 36439125 PMCID: PMC9684637 DOI: 10.3389/fimmu.2022.1040669] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Accepted: 10/19/2022] [Indexed: 11/11/2022] Open
Abstract
Bladder cancer (BCa) is one of the most common malignant tumors that cause death. Approximately 75%–85% of BCa develop into non-muscle-invasive bladder cancer (NMIBC). Bacillus Calmette-Guérin (BCG) is the gold standard for avoiding cystectomy in the treatment of NMIBC. Unfortunately, up to 30% of patients do not respond to BCG treatment, and up to 70% of BCG responders relapse. The United States Food and Drug Administration (FDA) approved valrubicin (1998) and pembrolizumab (2020) for the treatment of BCG-unresponsive (BCGu) NMBIC. However, the complete remission rate for valrubicin and pembrolizumab was only 16% and 40.6%, respectively. ALT-803 (N-803) is an IL-15 superagonist and reduces tumor burden by promoting the proliferation and activation of NK cells and CD8+ T cells. The FDA received (23 May 2022) and accepted to review (28 July 2022) the marketing submission of ALT-803 plus BCG for the treatment of BCGu NMIBC. However, the FDA previously rejected the application for oportuzumab monatox (OM) due to a lack of data comparing it with pembrolizumab on August 20, 2021. Interestingly, the clinical efficacy and safety of ALT-803 were higher than that of pembrolizumab and OM, suggesting that ALT-803 may be approved by FDA. This review aims to further knowledge of the preclinical and clinical evidence of ALT-803 in the treatment of NMIBC and discuss its translational potential.
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Affiliation(s)
- Wujun Chen
- Cancer Institute, The Affiliated Hospital of Qingdao University, Qingdao University, Qingdao Cancer Institute, Qingdao, Shandong, China
| | - Ning Liu
- Cancer Institute, The Affiliated Hospital of Qingdao University, Qingdao University, Qingdao Cancer Institute, Qingdao, Shandong, China
| | - Yang Yuan
- Cancer Institute, The Affiliated Hospital of Qingdao University, Qingdao University, Qingdao Cancer Institute, Qingdao, Shandong, China
| | - Meng Zhu
- Cancer Institute, The Affiliated Hospital of Qingdao University, Qingdao University, Qingdao Cancer Institute, Qingdao, Shandong, China
- Department of Neurosurgery, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, China
| | - Xiaokun Hu
- Cancer Institute, The Affiliated Hospital of Qingdao University, Qingdao University, Qingdao Cancer Institute, Qingdao, Shandong, China
- Interventional Medicine Center, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, China
| | - Wenchao Hu
- Cancer Institute, The Affiliated Hospital of Qingdao University, Qingdao University, Qingdao Cancer Institute, Qingdao, Shandong, China
- Department of Endocrinology, Qilu Hospital (Qingdao), Cheeloo College of Medicine, Shandong University, Qingdao, Shandong, China
| | - Shuai Wang
- School of Medical Imaging, Radiotherapy Department, Affiliated Hospital of Weifang Medical University, Weifang Medical University, Weifang, Shandong, China
| | - Chao Wang
- Cancer Institute, The Affiliated Hospital of Qingdao University, Qingdao University, Qingdao Cancer Institute, Qingdao, Shandong, China
| | - Binghuan Huang
- Cancer Institute, The Affiliated Hospital of Qingdao University, Qingdao University, Qingdao Cancer Institute, Qingdao, Shandong, China
- *Correspondence: Binghuan Huang, ; Dongming Xing,
| | - Dongming Xing
- Cancer Institute, The Affiliated Hospital of Qingdao University, Qingdao University, Qingdao Cancer Institute, Qingdao, Shandong, China
- School of Life Sciences, Tsinghua University, Beijing, China
- *Correspondence: Binghuan Huang, ; Dongming Xing,
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15
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Wang J, He X, Bai Y, Du G, Cai M. Identification and validation of novel biomarkers affecting bladder cancer immunotherapy via machine learning and its association with M2 macrophages. Front Immunol 2022; 13:1051063. [PMID: 36439109 PMCID: PMC9681792 DOI: 10.3389/fimmu.2022.1051063] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Accepted: 10/17/2022] [Indexed: 09/22/2023] Open
Abstract
BACKGROUND Immunotherapy has shown promising results in bladder cancer therapy options. METHODS Analysis of open-access data was conducted using the R software. Open-access data were obtained from The Cancer Genome Atlas (TCGA), Gene Expression Omnibus (GEO), and IMvigor210 databases. Immunofluorescence and co-culture systems were utilized to validate the effect of PTHLH on M2 macrophage polarization. RESULTS Here, through the combined (TCGA, GSE128959, GSE13507, and GSE83586) and IMvigor210 cohorts, we comprehensively investigated the biological and immune microenvironment differences in patients with diverse immunotherapy responses. Meanwhile, we found that M2 macrophage could affect bladder cancer immunotherapy sensibility. Moreover, based on the machine learning algorithm (LASSO logistics regression), PTHLH, BHMT2, and NGFR were identified, which all have good prediction abilities for patient immunotherapy. Then, a logistics regression model was established based on PTHLH, BHMT2, and NGFR, and each patient was assigned a logistics score. Subsequently, we investigated the difference in patients with high low logistics scores, including biological enrichment, immune microenvironment, and genomic characteristics. Meanwhile, data from the Human Protein Atlas database indicated a higher protein level of PTHLH in bladder cancer tissue. Immunofluorescence indicated that the knockdown of PTHLH in bladder cancer cells can significantly inhibit the M2 polarization of co-culture M0 macrophages. CONCLUSIONS Our study investigated the difference between bladder cancer immunotherapy responders and non-responders. Meanwhile, the PTHLH was identified as a novel biomarker for bladder cancer immunotherapy.
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Affiliation(s)
- Junkang Wang
- Department of Outpatient, Sichuan Academy of Medical Sciences and Sichuan Provincial People’s Hospital, Chengdu, Sichuan, China
| | - Xiaojuan He
- Department of Outpatient, Sichuan Academy of Medical Sciences and Sichuan Provincial People’s Hospital, Chengdu, Sichuan, China
| | - Yifeng Bai
- Department of Cancer Center, Sichuan Academy of Medical Sciences and Sichuan People’s Hospital, Chengdu, Sichuan, China
| | - Guanghui Du
- Department of Outpatient, Sichuan Academy of Medical Sciences and Sichuan Provincial People’s Hospital, Chengdu, Sichuan, China
| | - Minhong Cai
- Healthcare-associated Infection Management Office, Sichuan Academy of Medical Sciences and Sichuan People’s Hospital, Chengdu, Sichuan, China
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16
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Ward Grados DF, Ahmadi H, Griffith TS, Warlick CA. Immunotherapy for Bladder Cancer: Latest Advances and Ongoing Clinical Trials. Immunol Invest 2022; 51:2226-2251. [PMID: 36083246 DOI: 10.1080/08820139.2022.2118606] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
For nearly 50 years, immunotherapy has been used in patients with bladder cancer in the form of Mycobacterium bovis Bacillus Calmette-Guerin (BCG), which is still the first-line therapy for non-muscle invasive disease. However, the remarkable results obtained with checkpoint inhibitor drugs, including Pembrolizumab and Atezolizumab, have fueled the quest to optimize these and other forms of immunotherapy for both non-muscle invasive as well as advanced bladder cancer. In this review we summarize the current state of the rapidly evolving field of immunotherapy in bladder cancer highlighting novel approaches and ongoing trials in this exciting area of research.
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Affiliation(s)
| | - Hamed Ahmadi
- Department of Urology, University of Minnesota, Minneapolis, MN, USA
| | - Thomas S Griffith
- Department of Urology, University of Minnesota, Minneapolis, MN, USA.,Masonic Cancer Center, University of Minnesota, Minneapolis, MN, USA
| | - Christopher A Warlick
- Department of Urology, University of Minnesota, Minneapolis, MN, USA.,Masonic Cancer Center, University of Minnesota, Minneapolis, MN, USA
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17
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Zhang Z, Li D, Yun H, Liu W, Chai K, Tong J, Zeng T, Gao Z, Xie Y. CAR-T Cells in the Treatment of Urologic Neoplasms: Present and Future. Front Oncol 2022; 12:915171. [PMID: 35860578 PMCID: PMC9292130 DOI: 10.3389/fonc.2022.915171] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Accepted: 06/13/2022] [Indexed: 12/14/2022] Open
Abstract
In recent years, with the breakthrough of CAR-T cells in the treatment of hematological tumors, they are increasingly being used to treat solid tumors, including urologic neoplasms. There are many relatively specific targets for urologic neoplasms, especially prostate cancer. Besides, urologic neoplasms tend to progress more slowly than tumors in other organs of the body, providing ample time for CAR-T cell application. Therefore, CAR-T cells technology has inherent advantages in urologic neoplasms. CAR-T cells in the treatment of urologic neoplasms have been extensively studied and preliminary achievements have been made. However, no breakthrough has been made due to the problems of targeting extra-tumor cytotoxicity and poor anti-tumor activity. we systematacially summarized the research actuality of CAR-T cells in urologic neoplasms, discussed the potential value and difficulties of the research. The application of CAR-T cells in the treatment of urologic neoplasms requires improvement of function through screening for better targets, modification of CAR structures, or in combination with other antitumor approaches.
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Affiliation(s)
- Zhengchao Zhang
- Department of Urology, The Third Affiliated Hospital of Gansu University of Traditional Chinese Medicine, Baiyin, China
- Department of General Surgery, Second Hospital of Lanzhou University, Lanzhou, China
| | - Dong Li
- Department of Urology, The Third Affiliated Hospital of Gansu University of Traditional Chinese Medicine, Baiyin, China
| | - Heng Yun
- Department of Urology, The Third Affiliated Hospital of Gansu University of Traditional Chinese Medicine, Baiyin, China
| | - Wei Liu
- Department of Urology, The Third Affiliated Hospital of Gansu University of Traditional Chinese Medicine, Baiyin, China
| | - Keqiang Chai
- Department of Urology, The Third Affiliated Hospital of Gansu University of Traditional Chinese Medicine, Baiyin, China
| | - Jie Tong
- Department of Urology, The Third Affiliated Hospital of Gansu University of Traditional Chinese Medicine, Baiyin, China
| | - Tongwei Zeng
- Department of Urology, The Third Affiliated Hospital of Gansu University of Traditional Chinese Medicine, Baiyin, China
| | - Zhenghua Gao
- Department of Urology, The Third Affiliated Hospital of Gansu University of Traditional Chinese Medicine, Baiyin, China
- *Correspondence: Yongqiang Xie, ; Zhenghua Gao,
| | - Yongqiang Xie
- Department of Urology, The Third Affiliated Hospital of Gansu University of Traditional Chinese Medicine, Baiyin, China
- *Correspondence: Yongqiang Xie, ; Zhenghua Gao,
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18
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Fan Z, He H, Chen L. The Combined Clinical Efficacy and Safety Analysis of Adoptive Immunotherapy with Radiotherapy and Chemotherapy in Non-Small-Cell Lung Cancer: Systematic Review and Meta-Analysis. Appl Bionics Biomech 2022; 2022:2731744. [PMID: 35706510 PMCID: PMC9192301 DOI: 10.1155/2022/2731744] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2022] [Revised: 05/19/2022] [Accepted: 05/21/2022] [Indexed: 12/03/2022] Open
Abstract
Objective To explore the differential efficacy of chemoradiotherapy combined with adoptive immunotherapy and radiochemotherapy alone in patients with non-small-cell lung cancer (NSCLC). Methods Qualified randomized controlled trial (randomized controlled trial, RCT), or nonrandomized concurrent controlled trial (NRCCT), published in various databases, including PubMed, EMBASE, Chinese journal full-text database, Medline, Cochrane database, and VIP Chinese database, and the Revman5. 0 software performed the data analysis. Results We found the significantly different curative effect between the experimental and control groups (OR = 1.94, 95% CI (1.46, 2.58), P < 0.001, I 2 = 0%, Z = 4.59), effect of adoptive immunotherapy on the progression of disease (OR = 1.80, 95% CI (1.38, 2.35), P < 0.001, I 2 = 0%, Z = 4.33), adoptive immunotherapy on overall survival (OR = 2.19, 95% CI (1.60, 2.99), P < 0.001, I 2 = 0%, Z = 4.91), and adverse effects of adoptive immunotherapy (OR = 1.76, 95% CI (1.25, 2.48), P = 0.001, I 2 = 0%, Z = 3.26). Conclusion Adoptive immunotherapy combined with microradiotherapy can decrease the recurrence of NSCLC and improve patient survival, as well as early patients can be benefited more significantly from immunotherapy.
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Affiliation(s)
- Zhiming Fan
- Departments of Oncology, The First Naval Hospital of Southern Theater of People's Liberation Army, Zhanjiang, Guangdong, China
| | - Honggui He
- Departments of Oncology, The First Naval Hospital of Southern Theater of People's Liberation Army, Zhanjiang, Guangdong, China
| | - Liqun Chen
- Departments of Oncology, The First Naval Hospital of Southern Theater of People's Liberation Army, Zhanjiang, Guangdong, China
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19
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İnce O, Yıldız H, Kisbet T, Ertürk ŞM, Önder H. Classification of retinoblastoma-1 gene mutation with machine learning-based models in bladder cancer. Heliyon 2022; 8:e09311. [PMID: 35520623 PMCID: PMC9061624 DOI: 10.1016/j.heliyon.2022.e09311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2021] [Revised: 01/19/2022] [Accepted: 04/20/2022] [Indexed: 11/19/2022] Open
Abstract
Purpose This study aims to evaluate the potential of machine learning algorithms built with radiomics features from computed tomography urography (CTU) images that classify RB1 gene mutation status in bladder cancer. Method The study enrolled CTU images of 18 patients with and 54 without RB1 mutation from a public database. Image and data preprocessing were performed after data augmentation. Feature selection steps were consisted of filter and wrapper methods. Pearson’s correlation analysis was the filter, and a wrapper-based sequential feature selection algorithm was the wrapper. Models with XGBoost, Random Forest (RF), and k-Nearest Neighbors (kNN) algorithms were developed. Performance metrics of the models were calculated. Models’ performances were compared by using Friedman’s test. Results 8 features were selected from 851 total extracted features. Accuracy, sensitivity, specificity, precision, recall, F1 measure and AUC were 84%, 80%, 88%, 86%, 80%, 0.83 and 0.84, for XGBoost; 72%, 80%, 65%, 67%, 80%, 0.73 and 0.72 for RF; 66%, 53%, 76%, 67%, 53%, 0.60 and 0.65 for kNN, respectively. XGBoost model had outperformed kNN model in Friedman’s test (p = 0.006). Conclusions Machine learning algorithms with radiomics features from CTU images show promising results in classifying bladder cancer by RB1 mutation status non-invasively.
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Affiliation(s)
- Okan İnce
- Health Sciences University Prof. Dr. Cemil Tascioglu City Hospital, Department of Radiology, Turkey
- Corresponding author.
| | - Hülya Yıldız
- Health Sciences University Prof. Dr. Cemil Tascioglu City Hospital, Department of Radiology, Turkey
| | - Tanju Kisbet
- Health Sciences University Prof. Dr. Cemil Tascioglu City Hospital, Department of Radiology, Turkey
| | - Şükrü Mehmet Ertürk
- Istanbul University Istanbul Medical Faculty, Department of Radiology, Turkey
| | - Hakan Önder
- Health Sciences University Prof. Dr. Cemil Tascioglu City Hospital, Department of Radiology, Turkey
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20
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Behtash N, Guitinavard F, Ahmadi N, Bizhanzadeh S. Recurrent primary malignant melanoma of the urinary bladder; a case report. Urol Case Rep 2022; 42:102026. [PMID: 35530537 PMCID: PMC9073205 DOI: 10.1016/j.eucr.2022.102026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2021] [Accepted: 02/04/2022] [Indexed: 11/26/2022] Open
Abstract
Primary malignant melanoma (PMM) of the urinary bladder is a rare disease. Symptoms include gross hematuria and irritative LUTS. The diagnosis is made with cystoscopy and TURBT. Treatment options include TURBT and adjuvant therapies. We present a 61-year-old female who was referred with persistent irritative LUTS without gross or microscopic hematuria. After undergoing cystoscopy, TURBT, and extensive workup, she was diagnosed with PMM of the urinary bladder. Due to her past medical history, recurrent PMM of the urinary bladder was the final diagnosis. She refused to receive further treatment or refer for follow-up.
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Affiliation(s)
- Negar Behtash
- Urology Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Fateme Guitinavard
- Urology Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Navid Ahmadi
- Students' Scientific Research Center, Tehran University of Medical Sciences, Tehran, Iran
- Corresponding author.
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21
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Compérat E. Latest Developments and Current Problems in Bladder Cancer. World J Urol 2021; 39:4009-4010. [PMID: 34643773 DOI: 10.1007/s00345-021-03857-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Affiliation(s)
- Eva Compérat
- Department of Pathology, Hôpital Tenon, Sorbonne University, Paris VI, Paris, France.
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22
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Lamm DL, Morales A. A BCG success story: From prevention of tuberculosis to optimal bladder cancer treatment. Vaccine 2021; 39:7308-7318. [PMID: 34417051 DOI: 10.1016/j.vaccine.2021.08.026] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Revised: 07/13/2021] [Accepted: 08/06/2021] [Indexed: 01/22/2023]
Abstract
BCG remains the most important vaccine for tuberculosis 100 years after its first use, and over the past 4 decades it has become the most widely accepted, effective drug used in the treatment of aggressive localized bladder cancer. This review chronicles the narrow path that led to approval and world-wide acceptance of BCG immunotherapy for bladder cancer while immunotherapy trials in other malignancies were abandoned. Six intravesical instillations of 5x10^8 CFU of BCG weekly after bladder tumor resection, first reported in 1976, is superior to resection alone and resection plus intravesical chemotherapy. Maintenance of effective immune stimulation is surprisingly difficult, but 3 weekly treatments 3, 6, and 12, 18, 24, 30 and 36 months after induction produces further significant reduction in tumor recurrence. This 3 week BCG maintenance schedule alone has reduced disease progression and mortality in multicenter randomized clinical trials. In the new age of immuno-oncology patients with many types of cancer now benefit from immunotherapy, but currently these modern agents are prohibitively expensive for most of the world. In contrast, the low cost and therefore low profitability of BCG has resulted in recurrent shortages that threaten both bladder cancer patients and children at risk for tuberculosis and other serious infections. Humanity has greatly benefited from early 20th century science that developed BCG and the benevolence of doctors Calmette and Guerin who put people over profit and widely shared cultures of the vaccine. The 21st century is bringing new immunotherapies and greatly expanding the types of malignancies that can be treated. Recombinant technology is expected to improve both the efficacy and production of BCG, hopefully expanding the availability of BCG and relieving the recurring supply shortage for both vaccination and cancer therapy.
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Affiliation(s)
- Donald L Lamm
- Department of Surgery, University of Arizona, Phoenix, AZ, USA.
| | - Alvaro Morales
- Department of Urology, Queen's University. Kingston. Ontario, Canada
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Ahdoot M, Theodorescu D. Immunotherapy of high risk non-muscle invasive bladder cancer. Expert Rev Clin Pharmacol 2021; 14:1345-1352. [PMID: 34187272 DOI: 10.1080/17512433.2021.1950531] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
INTRODUCTION Bladder cancer remains a prevalent and often lethal cancer. Fortunately, recent clinical trials using immunotherapeutics demonstrate promise to improve treatment outcomes. Several of these immunotherapies have already established their value in the metastatic space and likely will soon have indications in the non-metastatic space. AREAS COVERED This review will cover immunotherapies ranging for well-studied BCG administration to more novel medications such as PD-L1/PD-1 inhibitors, CTLA-4 inhibitors, IL-15 super agonists, and immune modulating gene therapies. Specifically, the article will address the mechanisms of actions, clinical evidence supporting their use, and the presence of any FDA regulatory approval for these medications in the treatment of high-risk non-muscle invasive bladder cancer. EXPERT OPINION With the publication of clinical data supporting the use of immunotherapies, these novel medications are likely to be adopted for treatment of high grade non-metastatic bladder cancer. While BCG is likely to remain a primary medication for high grade bladder cancer for the near future, BCG will likely be co-administered with immunomodulatory medications in some patients to enhance the medications effect in the future. Clinical trials are still ongoing and will demonstrate which of these multiple treatment options yield results worthy of a modification in our current treatment paradigm.
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Affiliation(s)
- Michael Ahdoot
- Department of Surgery (Urology), Cedars-Sinai Medical Center, 8700 Beverly Blvd: Los Angeles CA 90048, Los Angeles, CA, USA.,Cedars-Sinai Samuel Oschin Comprehensive Cancer Institute, 8700 Beverly Blvd: Los Angeles CA 90048, USA
| | - Dan Theodorescu
- Department of Surgery (Urology), Cedars-Sinai Medical Center, 8700 Beverly Blvd: Los Angeles CA 90048, Los Angeles, CA, USA.,Cedars-Sinai Samuel Oschin Comprehensive Cancer Institute, 8700 Beverly Blvd: Los Angeles CA 90048, USA.,Department of Pathology and Laboratory Medicine, Cedars-Sinai Medical Center, 8700 Beverly Blvd: Los Angeles CA 90048, USA
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24
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El Gharib K, Lilly E, Chebel R. Checkpoint inhibitors in BCG-unresponsive nonmuscle invasive bladder cancer: can they help spare the bladder? Immunotherapy 2021; 13:1105-1111. [PMID: 34184569 DOI: 10.2217/imt-2021-0030] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Intravesical BCG therapy has been for years, the standard of care in nonmuscle-invasive bladder cancer. But upon recurrence/relapse, radical cystectomy is imposed, due to the paucity of other therapeutic options. Immunotherapy has been revolutionizing cancer treatment, and its indications continue to broaden. It has been approved for the treatment of advanced urothelial cancer of the bladder, mainly as a second-line therapy. Its activity is being studied in nonmuscle-invasive bladder cancer that is not responsive to BCG; we herein report the trials investigating these checkpoint inhibitors (pembrolizumab, nivolumab, atezolizumab, durvalumab and avelumab) in this particular setting.
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Affiliation(s)
- Khalil El Gharib
- Department of Hematology-Oncology, Faculty of Medicine, Saint Joseph University, Beirut, Lebanon
| | - Eddy Lilly
- Department of Urology, Faculty of Medicine, Saint Joseph University, Beirut, Lebanon
| | - Roy Chebel
- Department of Urology, Faculty of Medicine, Saint Joseph University, Beirut, Lebanon
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Current application of the enhanced recovery after surgery protocol for patients undergoing radical cystectomy: lessons learned from European excellence centers. World J Urol 2021; 40:1317-1323. [PMID: 34076754 DOI: 10.1007/s00345-021-03746-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2021] [Accepted: 05/25/2021] [Indexed: 10/21/2022] Open
Abstract
PURPOSE There is no consensus on which items of Enhanced Recovery After Surgery (ERAS) should and should not be implemented in radical cystectomy (RC). The aim of this study is to report current practices across European high-volume RC centers involved in ERAS. METHODS Based on the recommendations of the ERAS society, we developed a survey with 17 questions that were validated by the Young Academic Urologists-urothelial group. The survey was distributed to European expert centers that implement ERAS for RC. Only one answer per-center was allowed to keep a representative overview of the different centers. RESULTS 70 surgeons fulfilled the eligibility criteria. Of note, 28.6% of surgeons do not work with a referent anesthesiologist and 25% have not yet assessed the implementation of ERAS in their center. Avoiding bowel preparation, thromboprophylaxis, and removal of the nasogastric tube were widely implemented (> 90%application). On the other hand, preoperative carbohydrate loading, opioid-sparing anesthesia, and audits were less likely to be applied. Common barriers to ERAS implementation were difficulty in changing habits (55%), followed by a lack of communication across surgeons and anesthesiologist (33%). Responders found that performing a regular audit (14%), opioid-sparing anesthesia (14%) and early mobilization (13%) were the most difficult items to implement. CONCLUSION In this survey, we identified the ERAS items most and less commonly applied. Collaboration with anesthesiologists as well as regular audits remain a challenge for ERAS implementation. These results support the need to uniform ERAS for RC patients and develop strategies to help departments implement ERAS.
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Xylinas E, Roumiguié M, Sargos P. Immunotherapy in genitourinary cancers: achievements and perspectives. World J Urol 2021; 39:1317. [PMID: 34003335 DOI: 10.1007/s00345-021-03726-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Affiliation(s)
- Evanguelos Xylinas
- Department of Urology, Bichat-Claude Bernard Hospital, Assistance-Publique-Hôpitaux de Paris, Université de Paris, Paris, France.
| | - Mathieu Roumiguié
- Department of Urology, CHU Rangueil IUCT Oncopole Toulouse, Toulouse, France
| | - Paul Sargos
- Department of Radiotherapy, Institut Bergonié, Bordeaux, France
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Wang S, Jin S, Shu Q, Wu S. Strategies to Get Drugs across Bladder Penetrating Barriers for Improving Bladder Cancer Therapy. Pharmaceutics 2021; 13:166. [PMID: 33513793 PMCID: PMC7912621 DOI: 10.3390/pharmaceutics13020166] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Revised: 01/21/2021] [Accepted: 01/21/2021] [Indexed: 12/20/2022] Open
Abstract
Bladder cancer is a significant public health concern and social burden due to its high recurrence risk. Intravesical drug instillation is the primary therapy for bladder cancer to prevent recurrence. However, the intravesical drug therapeutic effect is limited by bladder penetrating barriers. The inadequate intravesical treatment might cause the low drug concentration in lesions, resulting in a high recurrence/progression rate of bladder cancer. Many strategies to get drugs across bladder penetrating barriers have been developed to improve intravesical treatment, including physical and chemical methods. This review summarizes the classical and updated literature and presents insights into great therapeutic potential strategies to overcome bladder penetrating barriers for improving the intravesical treatment of bladder cancer.
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Affiliation(s)
- Shupeng Wang
- School of Material Science and Engineering, Beijing Institute of Technology, Beijing 100081, China; (S.W.); (S.J.)
| | - Shaohua Jin
- School of Material Science and Engineering, Beijing Institute of Technology, Beijing 100081, China; (S.W.); (S.J.)
| | - Qinghai Shu
- School of Material Science and Engineering, Beijing Institute of Technology, Beijing 100081, China; (S.W.); (S.J.)
| | - Song Wu
- School of Medicine, Shenzhen University, Shenzhen 518000, China
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