New urine test for bladder cancer could reduce the need for time-consuming and invasive diagnostic procedures

European Urological Tumors (2022). DOI: 10.1016 / j.euo.2022.03.005″ width=”800″ height=”530″/>

Mutation frequencies across stages and grades of incident bladder cancer. Data are shown for the six most mutated genes (overall) in row 1 pTa (n = 23), row 2 pTa (n = 42), row 3 pTa (n = 15), row 3 pT1 (n = 24), and row 2 pTa (n = 37). cpDNA = urinary granule DNA; MIBC = muscle invasive bladder cancer. credit: European Urological Tumors (2022). DOI: 10.1016 / j.euo.2022.03.005

Birmingham researchers funded by Cancer Research UK and the liquid biopsies company Nonakos have developed a new urine test for bladder cancer, which could reduce the need for invasive and time-consuming procedures to diagnose the disease.

The test will use a highly sensitive liquid biopsy technology developed by Nonacus in conjunction with a panel of biomarkers developed by Mr. Rick Bryan and Dr Douglas Ward of the University of Birmingham’s Bladder Cancer Research Center, to detect the presence of bladder cancer by finding DNA from cancer cells present in the urine.

The biomarker panel, consisting of 443 gene mutations common in bladder cancer, was validated in a deep sequencing study recently published in European Urological Tumors.

In this study, funded by Cancer Research UK and the Medical Research Council, researchers used the test to analyze urine from 165 people with bladder cancer who had experienced hematuria (blood in the urine), and successfully detected the disease in 144 people with bladder cancer. of them (87%).

The researchers also looked at the use of the test in 293 patients who had already been treated for bladder cancer and were being monitored for recurring cancer. In this setting, the test returned a higher proportion of false-positive results than when used in a hematuria clinic (37.5% vs. 15.2%), with 99 positive urine tests without tumor seen by cystoscopy on the same day. However, during follow-up follow-up, patients with these positive results had approximately three times higher rates (11% vs 4%) of cancer recurrence within 24 months suggesting that testing can help detect recurring disease before it becomes visible. Through cystoscopy (examination of the bladder with a camera). More research is needed to use the test for monitoring.

Lead researcher Mr. Richard Bryan said: “Although cystoscopy is good at detecting bladder cancer, it is invasive and time-consuming for patients, so we need a better way to diagnose patients. Our testing in the future may be an easier way to get people With bladder cancer diagnosed faster, it could mean that tens of thousands of cystoscopy procedures on healthy patients each year could be avoided.”

Ian Foulkes, Executive Director of Research and Innovation at Cancer Research UK, said: “These results show that this urine test can help diagnose bladder cancer more easily. Early detection of cancer is key to improving patient outcomes, and such research can help “In identifying patients with bladder cancer. Need treatment sooner, while relieving the stress of diagnostic procedures on the NHS. We look forward to seeing how the test performs in the next clinical trial.”

The researchers are working in partnership with Nonacus, a company that provides genetic testing products for precision medicine and liquid biopsy, to transform their approach into a clinical test for patients to be used within the NHS, and will begin a clinical study involving more than 3,000 patients. To assess how powerful the test is in reducing the number of cystoscopy.

Each year, more than 300,000 cystoscopy procedures are performed in England, however, about 80% of patients with hematuria who undergo cystoscopy do not have any cancers or abnormalities. Researchers believe that using a urine test in a hematuria clinic could reduce the number of patients requiring cystoscopy by at least 45%.

New non-invasive bladder cancer test could spare patients cystoscopy

more information:
Douglas J. Ward et al., Accurate and specific detection of bladder cancer by targeted ultra-deep sequencing of DNA in the urinary tract, European Urological Tumors (2022). DOI: 10.1016 / j.euo.2022.03.005

Presented by the University of Birmingham

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