NEW Urine test leads to better Treatment of Bladder Cancer

Researchers at the University of Birmingham believe that a simple urine test could help to guide clinicians in the treatment of bladder cancer patients. Being able to reliably identify those patients with the most aggressive cancers early via urine tests, and expediting aggressive therapeutic strategies, may significantly improve outcomes. The scientists believe that the validation of two urinary biomarkers could spell a new way of tailoring treatment.
Patient management has changed little over the last three decades, so it is hoped that this research, published in British Journal of Cancer, will prove to be a step forward for the field with a view to providing improved care for each patient.
Dr Douglas Ward, from the University of Birmingham, explained, "There is an urgent need for prognostic bio-markers that could guide patient management. If such a test could be delivered, in a non-invasive way, it could make treatment much more efficient and that can only be a good thing."
Although a number of prognostic markers have been reported for bladder cancer, they are not currently used in the clinic. These markers are either based on nucleic acids (such as gene expression and mutation profiles) or protein expression levels; and as such require expensive and invasive analysis of tumor tissue via complex laboratory tests.
This paper identified two prognostic urinary biomarkers, epidermal growth factor receptor (EGFR) and a protein, epithelial cell adhesion molecule (EpCAM), and validated them in over 400 clinical samples. Both urinary EGFR and EpCAM were found to be independent predictors of bladder cancer-specific survival and have prognostic value over and above that provided by standard clinical and pathological observations. Higher levels of the biomarkers correlated with more aggressive cases of cancer and those with poor survival. Measuring the biomarkers could therefore represent a simple and useful approach for fast-tracking the investigation and treatment of patients with the most aggressive bladder cancers.
Such tests would be useful in both newly-diagnosed patients and existing patients who receive a cystoscopic diagnosis of recurrence during surveillance.