A chemosensitivity test to individualize intravesical treatment for non-muscle-invasive bladder cancer.
OBJECTIVE
To describe the design of a new chemosensitivity assay based on the expression of genes involved in the resistance to standard intravesical regimens, to allow individualization of therapy for high-risk non-muscle-invasive bladder cancer.


METHODS
To date, 35 patients with high-risk non-muscle-invasive bladder cancer have been enrolled, all candidates for transurethral resection of the bladder (TURB) followed by intravesical treatment. The intravesical regimen was chosen according to the risk profile of each patient. All patients were evaluated by cystoscopy 3 and 6 months after TURB. According to the molecular characterization of each tumour, our team of molecular oncologists determined for each patient a molecular profile of chemosensitivity to BCG, mitomycin c, anthracyclines and gemcitabine. This profile was then correlated to the response to intravesical therapy 6 months after TURB.


RESULTS
This chemosensitivity test was able to predict response to treatment in 96% of patients. The assay is easy to perform, inexpensive and quick.


CONCLUSIONS
Our results, although preliminary, are encouraging for the future of an individualized therapeutic approach, with the aim to provide a higher treatment success rate while sparing patients unnecessary toxicity from drugs that are not suited for their tumours.
Gazzaniga
Paola
P
Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy. paola.gazzaniga@uniroma1.it
Gradilone
Angela
A
de Berardinis
Ettore
E
Sciarra
Alessandro
A
Cristini
Cristiano
C
Naso
Giuseppe
G
di Silverio
Franco
F
Frati
Luigi
L
Aglianò
Anna Maria
AM
D000276:Adjuvants, Immunologic / Q000008:administration & dosage; D000283:Administration, Intravesical; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001500:BCG Vaccine / Q000008:administration & dosage; D015331:Cohort Studies; D018450:Disease Progression; D019008:Drug Resistance, Neoplasm / Q000235:genetics*; D004354:Drug Screening Assays, Antitumor / Q000379:methods; D006801:Humans; D009361:Neoplasm Invasiveness; D009364:Neoplasm Recurrence, Local / Q000209:etiology / Q000473:pathology; D011237:Predictive Value of Tests; D001749:Urinary Bladder Neoplasms / Q000188:drug therapy* / Q000235:genetics / Q000473:pathology
D000276:Adjuvants, Immunologic; D001500:BCG Vaccine