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Laukhtina E, Moschini M, Teoh JYC, Shariat SF. Perioperative platform for muscle-invasive bladder cancer trials: designs and endpoints. Curr Opin Urol 2024:00042307-990000000-00190. [PMID: 39262345 DOI: 10.1097/mou.0000000000001228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/13/2024]
Abstract
PURPOSE OF REVIEW This review explores the design and endpoints of perioperative platforms in clinical trials for muscle-invasive bladder cancer (MIBC). RECENT FINDINGS The choice of clinical trial design in perioperative platforms for MIBC must align with specific research objectives to ensure robust and meaningful outcomes. Novel designs in perioperative platforms for MIBC integrate bladder-sparing approaches. Primary endpoints such as pathological complete response and disease-free survival are highlighted for their role in expediting trial results in perioperative setting. Incorporating patient-reported outcomes is important to inform healthcare decision makers about the outcomes most meaningful to patients. Given the growing body of evidence, potential biomarkers, predictive and prognostic tools should be considered and implemented when designing trials in perioperative platforms for MIBC. SUMMARY Effective perioperative platforms for MIBC trials are critical in enhancing patient outcomes. The careful selection and standardization of study designs and endpoints in the perioperative platform are essential for the successful implementation of new therapies and the advancement of personalized treatment approaches in MIBC.
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Affiliation(s)
- Ekaterina Laukhtina
- Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria
| | - Marco Moschini
- Department of Urology, IRCCS San Raffaele Hospital and Vita-Salute San Raffaele University, Milan, Italy
| | - Jeremy Yuen-Chun Teoh
- S.H. Ho Urology Centre, Department of Surgery, The Chinese University of Hong Kong, Hong Kong, China
| | - Shahrokh F Shariat
- Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria
- Karl Landsteiner Institute of Urology and Andrology, Vienna, Austria
- Department of Urology, Weill Cornell Medical College, New York, New York
- Department of Urology, University of Texas Southwestern, Dallas, Texas, USA
- Department of Urology, Second Faculty of Medicine, Charles University, Prague, Czech Republic
- Hourani Center for Applied Scientific Research, Al-Ahliyya Amman University, Amman, Jordan
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2
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Griffin J, Hartmann A, Comperat E. Variation in cystectomy pathology reporting practice-results from an international survey of 212 pathologists. Virchows Arch 2024:10.1007/s00428-024-03924-3. [PMID: 39243298 DOI: 10.1007/s00428-024-03924-3] [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: 07/03/2024] [Revised: 08/26/2024] [Accepted: 08/31/2024] [Indexed: 09/09/2024]
Abstract
The pathological assessment of cystectomy specimens is important for accurate prognostic information and to inform adjuvant therapy decisions. However, there is limited evidence regarding the best approach to fixation, dissection, block selection and microscopic assessment of cystectomies. We report the results of an international survey of 212 pathologists and their approach to cystectomy pathology. There is variation at all stages of the specimen journey including in fixation and dissection techniques, and in the approach to evaluating residual tumour. This is particularly evident in the post-neoadjuvant chemotherapy setting where there is variable use of response scoring systems and differing approaches to sampling. We also find variation in the use of digital and molecular pathology in cystectomy specimens. Finally, we have suggested areas for future research in cystectomy pathological assessment.
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Affiliation(s)
- Jon Griffin
- School of Medicine and Population Health, University of Sheffield, Sheffield, UK.
- Histopathology Department, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK.
| | - Arndt Hartmann
- Institute of Pathology, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
- Comprehensive Cancer Center EMN, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
- Bavarian Center for Cancer Research (Bayerisches Zentrum Für Krebsforschung, BZKF), Erlangen, Germany
| | - Eva Comperat
- Department of Pathology, Medical University Vienna, Währingergürtel 18-20, 1090, Vienna, Austria
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3
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Lotan Y, Agarwal P, Black P, Dickstein R, Kamat AM, Lee B, Narayan VM, Porten S, Psutka SP, Smith AK, Svatek RS, Williams SB, Woldu S. Standardization of the evaluation and surveillance of patients with BCG unresponsive high grade non-muscle invasive bladder cancer clinical trials. Urol Oncol 2024; 42:223-228. [PMID: 38307803 DOI: 10.1016/j.urolonc.2024.01.019] [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: 11/12/2023] [Revised: 01/07/2024] [Accepted: 01/17/2024] [Indexed: 02/04/2024]
Abstract
There are multiple ongoing and planned clinical trials that are evaluating novel therapies to treat patients with BCG-unresponsive high grade nonmuscle invasive bladder cancer (NMIBC). Importantly, there is considerable variation in surveillance strategies between these clinical trials, specifically with regards to the use of advanced imaging, enhanced cystoscopy, and mandatory biopsies, which could impact landmark efficacy assessments of investigational agents. To present guideline recommendations for the standardization of cystoscopic evaluation, surveillance, and efficacy assessments for patients with BCG-unresponsive NMIBC participating in clinical trials. On September 29, 2023 at the annual meeting of the International Bladder Cancer Network, a breakout session was convened, during which representatives from various disciplines discussed potential guidance statements with opportunity for discussion and comment. A set of statements regarding use of white light and enhanced cystoscopy were developed to help guide a pragmatic approach to surveillance and efficacy assessments of patients in clinical trials. The use of "for cause" and "mandatory" biopsies was also addressed. A standard approach to evaluation of patients within the context of clinical trials is necessary to accurately assess the efficacy of novel agents, especially within single arm trials that lack an appropriate comparator. Additionally, the utilization and timing of mandatory biopsies is critical, as these biopsies may impact both disease evaluations and the determination of duration of response.
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Affiliation(s)
- Yair Lotan
- University of Texas Southwestern Medical Center, Dallas, TX.
| | | | - Peter Black
- Department of Urologic Sciences, University of British Columbia
| | - Rian Dickstein
- Department of Surgery-Urology, University of Maryland BWMC
| | - Ashish M Kamat
- University of Texas MD Anderson Cancer Center, Houston, TX
| | - Byron Lee
- Department of Urology, Glickman Urological and Kidney Institute
| | | | - Sima Porten
- Department of Urology, University of California, San Francisco
| | - Sarah P Psutka
- Department of Urology, University of Washington, Fred Hutchinson Cancer Center
| | | | - Robert S Svatek
- Department of Urology, University of Texas Health Science Center at San Antonio
| | - Stephen B Williams
- Division of Urology, Department of Surgery, University of Texas, Medical Branch Health System
| | - Solomon Woldu
- University of Texas Southwestern Medical Center, Dallas, TX
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4
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Rodden DJ, Chung EH, Pittie R, Miyamoto DT. Imposter among us: field cancerization in the bladder. Transl Androl Urol 2024; 13:1319-1323. [PMID: 39100848 PMCID: PMC11291423 DOI: 10.21037/tau-24-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2024] [Accepted: 04/24/2024] [Indexed: 08/06/2024] Open
Affiliation(s)
- Daniel J. Rodden
- Krantz Family Center for Cancer Research, Massachusetts General Hospital, Charlestown, MA, USA
- Department of Radiation Oncology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Ella H. Chung
- Krantz Family Center for Cancer Research, Massachusetts General Hospital, Charlestown, MA, USA
- Department of Radiation Oncology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Rea Pittie
- Krantz Family Center for Cancer Research, Massachusetts General Hospital, Charlestown, MA, USA
- Department of Radiation Oncology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - David T. Miyamoto
- Krantz Family Center for Cancer Research, Massachusetts General Hospital, Charlestown, MA, USA
- Department of Radiation Oncology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
- Broad Institute of MIT and Harvard, Cambridge, MA, USA
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5
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Soria F, Rosazza M, Livoti S, Moschini M, De Angelis M, Giudice FD, Pichler R, Hurle R, Mancon S, Carrion DM, Krajewski W, Mertens LS, D'Andrea D, Mari A, Di Maida F, Dutto D, Colucci F, Casale G, Fertitta G, Laukhtina E, Albisinni S, Pradere B, Teoh JYC, Shariat SF, Briganti A, Kamat AM, Gontero P. Clinical Validation of the Intermediate-risk Non-muscle-invasive Bladder Cancer Scoring System and Substratification Model Proposed by the International Bladder Cancer Group: A Multicenter Young Academic Urologists Urothelial Working Group Collaboration. Eur Urol Oncol 2024:S2588-9311(24)00151-2. [PMID: 38906794 DOI: 10.1016/j.euo.2024.06.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2024] [Revised: 05/20/2024] [Accepted: 06/05/2024] [Indexed: 06/23/2024]
Abstract
BACKGROUND AND OBJECTIVE Intermediate-risk (IR) non-muscle-invasive bladder cancer (NMIBC) encompasses a broad spectrum of disease, with heterogeneous outcomes in terms of disease recurrence and progression. The International Bladder Cancer Group (IBCG) recently proposed an updated scoring model for IR substratification that is based on five key risk factors. Our aim was to provide a clinical validation of the IBCG scoring system and substratification model for IR NMIBC. METHODS This was an international multicenter retrospective study. Patients diagnosed with IR NMIBC between 2012 and 2022 and treated with transurethral resection of the bladder and adjuvant intravesical chemotherapy were included. According to the presence or absence of risk factors, patients with IR NMIBC were further categorized in IR-low (no risk factors), IR-intermediate (1-2 risk factors), and IR-high (≥3 risk factors) groups. The 1-yr and 3-yr rates for recurrence-free survival (RFS) and progression-free survival (PFS) were evaluated for each subgroup. Cox regression analyses were used to compare oncological outcomes between the groups. KEY FINDINGS AND LIMITATIONS Of the 677 patients with IR NMIBC included in the study, 231 (34%), 364 (54%), and 82 (12%) were categorized in the IR-low, IR-intermediate, and IR-high groups, respectively. There were significant differences in RFS and PFS rates between these groups. CONCLUSIONS AND CLINICAL IMPLICATIONS We provide the first clinical validation of the IBCG scoring system and model for substratification of IR NMIBC. PATIENT SUMMARY Our study demonstrates that patients with intermediate-risk non-muscle-invasive bladder cancer can be correctly classified into three distinct subgroups according to their risk of both disease recurrence and progression. Our results support use of this scoring system in clinical practice.
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Affiliation(s)
- Francesco Soria
- Division of Urology, Department of Surgical Sciences, Torino School of Medicine, Torino, Italy.
| | - Matteo Rosazza
- Division of Urology, Department of Surgical Sciences, Torino School of Medicine, Torino, Italy
| | - Simone Livoti
- Division of Urology, Department of Surgical Sciences, Torino School of Medicine, Torino, Italy
| | - Marco Moschini
- Division of Experimental Oncology/Unit of Urology, Urological Research Institute, IRCCS Ospedale San Raffaele, Milan, Italy
| | - Mario De Angelis
- Division of Experimental Oncology/Unit of Urology, Urological Research Institute, IRCCS Ospedale San Raffaele, Milan, Italy
| | - Francesco Del Giudice
- Department of Maternal Infant and Urologic Sciences, Sapienza University of Rome, Policlinico Umberto I Hospital, Rome, Italy
| | - Renate Pichler
- Department of Urology, Comprehensive Cancer Center Innsbruck, Medical University of Innsbruck, Innsbruck, Austria
| | - Rodolfo Hurle
- Department of Urology, Humanitas Clinical and Research Hospital, Rozzano, Italy
| | - Stefano Mancon
- Department of Urology, Humanitas Clinical and Research Hospital, Rozzano, Italy
| | - Diego M Carrion
- Department of Urology, Torrejon University Hospital, Madrid, Spain
| | - Wojciech Krajewski
- Department of Urology and Oncologic Urology, Wroclaw Medical University, Wroclaw, Poland
| | - Laura S Mertens
- Department of Urology, Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - David D'Andrea
- Department of Urology, Comprehensive Cancer Center, Vienna General Hospital, Medical University of Vienna, Vienna, Austria
| | - Andrea Mari
- Unit of Oncologic Minimally-Invasive Urology and Andrology, Department of Urology, Careggi Hospital, University of Florence, Florence, Italy
| | - Fabrizio Di Maida
- Unit of Oncologic Minimally-Invasive Urology and Andrology, Department of Urology, Careggi Hospital, University of Florence, Florence, Italy
| | - Daniele Dutto
- Division of Urology, Department of Surgical Sciences, Torino School of Medicine, Torino, Italy
| | - Fulvia Colucci
- Division of Urology, Department of Surgical Sciences, Torino School of Medicine, Torino, Italy
| | - Giulia Casale
- Division of Urology, Department of Surgical Sciences, Torino School of Medicine, Torino, Italy
| | - Giorgia Fertitta
- Division of Urology, Department of Surgical Sciences, Torino School of Medicine, Torino, Italy
| | - Ekaterina Laukhtina
- Department of Urology, Comprehensive Cancer Center, Vienna General Hospital, Medical University of Vienna, Vienna, Austria
| | - Simone Albisinni
- Unit of Urology, Department of Surgical Sciences, Tor Vergata University Hospital, Tor Vergata University of Rome, Rome, Italy
| | - Benjamin Pradere
- Department of Urology, UROSUD, La Croix du Sud Hospital, Quint Fonsegrives, France
| | - Jeremy Y C Teoh
- S.H. Ho Urology Centre, Department of Surgery, The Chinese University of Hong Kong, Hong Kong, China
| | - Shahrokh F Shariat
- Department of Urology, Comprehensive Cancer Center, Vienna General Hospital, Medical University of Vienna, Vienna, Austria; Department of Urology, Weill Cornell Medical College, New York Presbyterian Hospital, New York, NY, USA; Department of Urology, University of Texas Southwestern Medical Center, Dallas, TX, USA; Hourani Center for Applied Scientific Research, Al-Ahliyya Amman University, Amman, Jordan
| | - Alberto Briganti
- Division of Experimental Oncology/Unit of Urology, Urological Research Institute, IRCCS Ospedale San Raffaele, Milan, Italy
| | - Ashish M Kamat
- Department of Urology, Division of Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Paolo Gontero
- Division of Urology, Department of Surgical Sciences, Torino School of Medicine, Torino, Italy
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Guerrero-Ramos F, Boormans JL, Daneshmand S, Gontero P, Kamat AM, Rouprêt M, Vilaseca A, Shariat SF. Novel Delivery Systems and Pharmacotherapeutic Approaches for the Treatment of Non-muscle-invasive Bladder Cancer. Eur Urol Oncol 2024:S2588-9311(24)00143-3. [PMID: 38849286 DOI: 10.1016/j.euo.2024.05.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2024] [Revised: 04/20/2024] [Accepted: 05/21/2024] [Indexed: 06/09/2024]
Abstract
BACKGROUND AND OBJECTIVE Therapeutic options for patients with non-muscle-invasive bladder cancer (NMIBC) have traditionally been limited to intravesical immunotherapy or chemotherapy. A considerable number of new options have been investigated in recent years. Our aim was to review the efficacy and toxicity of novel therapeutic options (results already reported or currently under investigation) for patients with NMIBC. METHODS We assessed the efficacy of various novel therapeutic options by examining key endpoints in diverse settings, including recurrence, progression, overall survival, disease-specific survival, and complete response. We identified the principal advantages and limitations for each option. Safety was predominantly evaluated as the incidence of grade ≥3 adverse events. Our investigation focused on evidence from scientific articles and congress abstracts published in English within the past 5 yr. KEY FINDINGS AND LIMITATIONS To date, pembrolizumab, nadofaragene firadenovec, and the combination of BCG with N-803 have received US Food and Drug administration approval for the treatment of BCG-unresponsive carcinoma in situ of the bladder (with or without papillary tumours). Five phase 3 trials are recruiting BCG-naïve patients with high-risk NMIBC. There is increasing interest in an ablative rather than an adjuvant approach for patients with intermediate-risk NMIBC. CONCLUSIONS AND CLINICAL IMPLICATIONS Novel drugs and device-assisted drug delivery systems are on the verge of changing the treatment of NMIBC. Novel intravesical options seem to have the same efficacy with fewer adverse events in comparison to systemic therapies. PATIENT SUMMARY We reviewed new therapy options for non-muscle-invasive bladder cancer. Two agents (pembrolizumab and nadofaragene firadenovec) have been approved to date. Ongoing trials are assessing direct delivery of drugs in solution into the bladder. This route seems to have similar efficacy and fewer side effects than intravenous immunotherapy.
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Affiliation(s)
| | - Joost L Boormans
- Department of Urology, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Siamak Daneshmand
- Department of Urology, University of Southern California/Norris Comprehensive Cancer Center, Los Angeles, CA, USA
| | - Paolo Gontero
- Division of Urology, Molinette Hospital, University of Torino School of Medicine, Torino, Italy
| | - Ashish M Kamat
- Department of Urology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Morgan Rouprêt
- Department of Urology, Hôpital Pitié-Salpétrière, Paris, France
| | - Antoni Vilaseca
- Department of Urology, Hospital Clínic, Barcelona, Spain; Department of Surgery and Surgical Specialties, University of Barcelona, Barcelona, Spain
| | - Shahrokh F Shariat
- Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria; Department of Urology, University of Texas Southwestern Medical Center, Dallas, TX, USA; Institute for Urology and Reproductive Health, I.M. Sechenov First Moscow State Medical University, Moscow, Russia; Department of Urology, Second Faculty of Medicine, Charles University, Prague, Czech Republic; Department of Urology, Weill Cornell Medical College, New York, NY, USA; Division of Urology, Department of Special Surgery, Jordan University Hospital, The University of Jordan, Amman, Jordan
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7
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Moschini M, Necchi A, Montorsi F. Re: Gemcitabine and cisplatin plus nivolumab as organ-sparing treatment for muscle-invasive bladder cancer: a phase 2 trial. Eur Urol 2024; 85:500-501. [PMID: 38369421 DOI: 10.1016/j.eururo.2023.12.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Revised: 11/05/2023] [Accepted: 12/05/2023] [Indexed: 02/20/2024]
Affiliation(s)
- Marco Moschini
- Division of Oncology/Unit of Urology, Urological Research Institute, IRCCS Ospedale San Raffaele, Milan, Italy.
| | - Andrea Necchi
- Department of Medical Oncology, IRCCS Ospedale San Raffaele, Milan, Italy
| | - Francesco Montorsi
- Division of Oncology/Unit of Urology, Urological Research Institute, IRCCS Ospedale San Raffaele, Milan, Italy
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8
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Fernández MI. Implementation of new treatments for BCG-unresponsive non-muscle-invasive bladder cancer. Considerations in Latin America. Actas Urol Esp 2024; 48:257-259. [PMID: 38615906 DOI: 10.1016/j.acuroe.2024.03.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2024] [Accepted: 03/05/2024] [Indexed: 04/16/2024]
Affiliation(s)
- Mario I Fernández
- Departamento de Urología, Facultad de Medicina, Clínica Alemana Universidad del Desarrollo, Santiago, CAU de Grupo de Trabajo de Cáncer de Vejiga, Chile.
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Kwong JCC, Wu J, Malik S, Khondker A, Gupta N, Bodnariuc N, Narayana K, Malik M, van der Kwast TH, Johnson AEW, Zlotta AR, Kulkarni GS. Predicting non-muscle invasive bladder cancer outcomes using artificial intelligence: a systematic review using APPRAISE-AI. NPJ Digit Med 2024; 7:98. [PMID: 38637674 PMCID: PMC11026453 DOI: 10.1038/s41746-024-01088-7] [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: 11/02/2023] [Accepted: 03/29/2024] [Indexed: 04/20/2024] Open
Abstract
Accurate prediction of recurrence and progression in non-muscle invasive bladder cancer (NMIBC) is essential to inform management and eligibility for clinical trials. Despite substantial interest in developing artificial intelligence (AI) applications in NMIBC, their clinical readiness remains unclear. This systematic review aimed to critically appraise AI studies predicting NMIBC outcomes, and to identify common methodological and reporting pitfalls. MEDLINE, EMBASE, Web of Science, and Scopus were searched from inception to February 5th, 2024 for AI studies predicting NMIBC recurrence or progression. APPRAISE-AI was used to assess methodological and reporting quality of these studies. Performance between AI and non-AI approaches included within these studies were compared. A total of 15 studies (five on recurrence, four on progression, and six on both) were included. All studies were retrospective, with a median follow-up of 71 months (IQR 32-93) and median cohort size of 125 (IQR 93-309). Most studies were low quality, with only one classified as high quality. While AI models generally outperformed non-AI approaches with respect to accuracy, c-index, sensitivity, and specificity, this margin of benefit varied with study quality (median absolute performance difference was 10 for low, 22 for moderate, and 4 for high quality studies). Common pitfalls included dataset limitations, heterogeneous outcome definitions, methodological flaws, suboptimal model evaluation, and reproducibility issues. Recommendations to address these challenges are proposed. These findings emphasise the need for collaborative efforts between urological and AI communities paired with rigorous methodologies to develop higher quality models, enabling AI to reach its potential in enhancing NMIBC care.
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Affiliation(s)
- Jethro C C Kwong
- Division of Urology, Department of Surgery, University of Toronto, Toronto, ON, Canada
- Temerty Centre for AI Research and Education in Medicine, University of Toronto, Toronto, ON, Canada
| | - Jeremy Wu
- Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Shamir Malik
- Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Adree Khondker
- Division of Urology, Department of Surgery, University of Toronto, Toronto, ON, Canada
| | - Naveen Gupta
- Georgetown University School of Medicine, Georgetown University, Washington, DC, USA
- Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA, USA
| | - Nicole Bodnariuc
- Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | | | - Mikail Malik
- Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Theodorus H van der Kwast
- Laboratory Medicine Program, University Health Network, Princess Margaret Cancer Centre, University of Toronto, Toronto, ON, Canada
| | - Alistair E W Johnson
- Temerty Centre for AI Research and Education in Medicine, University of Toronto, Toronto, ON, Canada
- Division of Biostatistics, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Alexandre R Zlotta
- Division of Urology, Department of Surgery, University of Toronto, Toronto, ON, Canada
- Division of Urology, Department of Surgery, Mount Sinai Hospital, Sinai Health System, Toronto, ON, Canada
- Division of Urology, Department of Surgery, Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada
| | - Girish S Kulkarni
- Division of Urology, Department of Surgery, University of Toronto, Toronto, ON, Canada.
- Temerty Centre for AI Research and Education in Medicine, University of Toronto, Toronto, ON, Canada.
- Division of Urology, Department of Surgery, Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada.
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10
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Pijpers OM, Boormans JL. Disease progression in Bacillus Calmètte Guerin unresponsive non-muscle invasive bladder cancer patients with carcinoma in situ, participating in clinical trials on bladder-sparing treatment. Transl Androl Urol 2024; 13:479-482. [PMID: 38590961 PMCID: PMC10999019 DOI: 10.21037/tau-23-672] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Accepted: 02/19/2024] [Indexed: 04/10/2024] Open
Affiliation(s)
- Olga M Pijpers
- Department of Urology, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Joost L Boormans
- Department of Urology, Erasmus University Medical Center, Rotterdam, The Netherlands
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11
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Li F, Wang P, Ye J, Xie G, Yang J, Liu W. Serum EZH2 is a novel biomarker for bladder cancer diagnosis and prognosis. Front Oncol 2024; 14:1303918. [PMID: 38476362 PMCID: PMC10927824 DOI: 10.3389/fonc.2024.1303918] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Accepted: 01/19/2024] [Indexed: 03/14/2024] Open
Abstract
Objective The primary objective of this study was to examine the levels of serum EZH2 in patients diagnosed with bladder cancer, and subsequently evaluate its potential as a biomarker for both the diagnosis and prognosis of bladder cancer. Methods Blood samples were obtained from 115 bladder cancer patients and 115 healthy persons. We measured the EZH2 concentrations in the serum of these subjects via enzyme-linked immunosorbent assay (ELISA). To assess the diagnostic performance of serum EZH2 in detecting bladder cancer, we plotted receiver operating characteristic (ROC) curves and calculated their corresponding area under the curve (AUC). We also used the Cox regression model and log-rank test to investigate the correlation between EZH2 levels and clinicopathological characteristics, and survival rates of bladder cancer patients. Results Serum EZH2 levels were significantly higher in bladder cancer patients when compared to those in healthy persons. Serum EZH2 levels exhibited a significant correlation with TNM stage, lymph node metastasis, muscle invasion, and tumor size. At a cutoff value of 8.23 ng/mL, EZH2 was able to differentiate bladder cancer patients from healthy persons, with an AUC of 0.87, a sensitivity of 81.31%, and a specificity of 78.42%. High EZH2 levels correlated with poor overall survival rates and progression-free survival rates of bladder cancer patients. Conclusions Serum EZH2 levels were elevated in bladder cancer patients, and patients with higher serum EZH2 levels exhibited a poorer prognosis. This indicates that serum EZH2 could be a novel biomarker for bladder cancer diagnosis and prognosis. Such findings could improve the prognosis of bladder cancer patients by facilitating early detection and continuous monitoring.
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Affiliation(s)
- Feng Li
- Department of Urology, The First Affiliated Hospital of Chengdu Medical College, Chengdu, China
| | - Pengqiao Wang
- Department of Medical Administration, The First Affiliated Hospital of Chengdu Medical College, Chengdu, China
| | - Jun Ye
- Department of Clinical Laboratory, The Second Affiliated Hospital of Guizhou Medical University, Kaili, China
| | - Guoping Xie
- Department of Urology, The First Affiliated Hospital of Chengdu Medical College, Chengdu, China
| | - Jinfeng Yang
- Department of Gastrointestinal Surgery, The First Affiliated Hospital of Chengdu Medical College, Chengdu, China
| | - Wei Liu
- Department of Oncology, The First Affiliated Hospital of Chengdu Medical College, Chengdu, China
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12
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Myers AA, Kamat AM, Kilbert A, Galsky MD. Toward standardization in bladder cancer clinical trials: Guidance from the SITC-IBCG expert panel. J Immunother Cancer 2024; 12:e008508. [PMID: 38309724 PMCID: PMC10840062 DOI: 10.1136/jitc-2023-008508] [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: 01/24/2024] [Indexed: 02/05/2024] Open
Abstract
Abstract
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Affiliation(s)
- Amanda A Myers
- Urology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Ashish M Kamat
- Department of Urology under Division of Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Angela Kilbert
- Society for Immunotherapy of Cancer, Milwaukee, Wisconsin, USA
| | - Matthew D Galsky
- Icahn School of Medicine at Mount Sinai Tisch Cancer Institute, New York, New York, USA
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