title: Treatment of non-muscle invasive bladder cancer with Bacillus Calmette-Guerin (BCG): Biological markers and simulation studies.
abstract: Intravesical Bacillus Calmette-Guerin (BCG) vaccine is the preferred first line treatment for non-muscle invasive bladder carcinoma (NMIBC) in order to prevent recurrence and progression of cancer. There is ongoing need for the rational selection of i) BCG dose, ii) frequency of BCG administration along with iii) synergistic adjuvant therapy and iv) a reliable set of biochemical markers relevant to tumor response. In this review we evaluate cellular and molecular markers pertinent to the immunological response triggered by the BCG instillation and respective mathematical models of the treatment. Specific examples of markers include diverse immune cells, genetic polymorphisms, miRNAs, epigenetics, immunohistochemistry and molecular biology 'beacons' as exemplified by cell surface proteins, cytokines, signaling proteins and enzymes. We identified tumor associated macrophages (TAMs), human leukocyte antigen (HLA) class I, a combination of Ki-67/CK20, IL-2, IL-8 and IL-6/IL-10 ratio as the most promising markers for both pre-BCG and post-BCG treatment suitable for the simulation studies. The intricate and patient-specific nature of these data warrants the use of powerful multi-parametral mathematical methods in combination with molecular/cellular biology insight and clinical input.
authors.affiliation: NBIC, Moscow Institute of Physics and Technology, 9 Institutsky Per., Dolgoprudny, Moscow region 141700, Russia.
authors.forename: Alex
authors.initials: A
authors.lastname: Kiselyov
authors.affiliation: Department of Computer Science and Mathematics, Ariel University, Ariel 40700, Israel.
authors.forename: Svetlana
authors.initials: S
authors.lastname: Bunimovich-Mendrazitsky
authors.affiliation: Department of Urology, State Pediatric Medical University, St. Petersburg 194100, Russia.
authors.forename: Vladimir
authors.initials: V
authors.lastname: Startsev
keywords: Bacillus Calmette–Guerin; Biological marker; Bladder cancer; Mathematical models